Rev. 10/20/17

Scan Specifications for the 

    2017 Ohio IT 1140

       Important Note

   The following document (2017 Ohio IT 1140) contains grids for place-
   ment of information on this specific tax form. To accurately print, do not 
   reduce the size, rotate or center this document. Doing so jeopardizes 
   the integrity of the grid. When printing from Adobe Reader, select 
   “None” for “Page Scaling,” which is under “Page Handling.”

   The 2017 Ohio IT 1140 test samples must be completed and sub-
   mitted for approval no later than Dec. 1, 2017. 

       Ohio Department of Taxation

                            4485 Northland Ridge Blvd.

                            Columbus, OH 43229

                            tax.ohio.gov

Grid layout 

with notations

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4                                                                  Do not staple or paper clip. 
5
6                                                                                                                                                                            2017 Ohio IT 1140 
                                                                                                   Rev. 8/17
7                                                                                                                                      Pass-Through Entity and 
8                                                                                                                                  Trust Withholding Tax Return                                                                                                                           17170110
                                                             88 88 88
9                                                                                                                                                                            Use only black ink and UPPERCASE letters.
                                                                                                                                                                                          Placement of the tax year and 1D barcode is critical. 
10                                                                                                                     Check here if amended returnMake sure to followCheckCheckChecktheherehereheregridififpositionsiffinalfinalfinalreturnreturnreturnfor layout. Do                    For taxable year beginning in
                                                                                                             XX X                                                                                    X X X
11                                                                     This is the date the return was generated Check here if the federal extension was grantednot forget to get your barcode(s) assignments for 
                                                                                                                           X                                                                                                                                                                          88/2017
12                                                           FEINby the taxpayer (MM DD YY).                                                                                              every form, version and page.
13                                                           88 8888888                                                                Entity Type:                                                  S corporation                                          X          Partnership
                                                                                                                                       (check only one)                                         X
14                                                                                                                                                                                                   Limited liability company                                         Trust
                                                                                                                                                                                                X                                                           X
15                                                           Name of pass-through entity
16                                                           JOHNXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
17
18                                                           Address (if address change, check box)                                   X
19                                                           8888  CHERRY   LANEXXXXXXXXXXXXXXXXXXX
20                                                           City                                                                                                                                            State      ZIP code
                                                             CITYXXXXXXXXXXXXXXXX
21                                                                                                                                                                                                           OH         88888
22
23                                                           Foreign State Code                      Country Code                      Foreign country (if the mailing address is outside the U.S.)                                                                                       Foreign postal code
24
                                                                              888                                      88             88888888888888888888                                                                                                                                8888888
25
                                                                                                                   Number of investors                                                    Ownership percentage 
26                                                           Total number of investors                             included on return                                                     of investors on return   Apportionment ratio, page 3, line 8
27
                                                             888888                                                888888                                                                 8.8888                   8.888888
28                                                                                                                                                                                                                                            Do not place spaces between 
29                                                                                                                                                                                                                                            whole dollar numbers. There 
30                                                                                                                                                                                                                                            is only a space between dollar 
31                                                           Schedule A – Reconciliation Tax and Payments                                                                                                                                     amountsandcentsfields.
32                                                                                                                                                                                              Column (I) – Withholding Tax                                                              Column (II) – Entity Tax
33                                                             1. Tax for each column (from Schedule B, line 11, 
34                                                                   columns A and B or from Schedule D, line 5)  ..............1.
                                                                                                                                                                                                          888888888 00                                                        888888888 00
35                                                            2. Interest penalty on underpayment of estimated tax 
36                              Do not staple or paper clip.         (include Ohio IT/SD 2210) ...........................................2.
                                                                                                                                                                                                          888888888 00                                                        888888888 00
37                                                             2a. Add lines 1 and 2 ......................................................2a.
                                                                                                                                                                                                          888888888 00                                                        888888888 00
38                                                             3. Ohio IT 1140ES and UPC payments the entity or trust 
39                                                                   made and/or 2016 overpayment creditedNEW!toFor2017 (seestatic text use Arial font (black ink) and 
40                                                                   Note 1 on page 7) ........................................................3.trytomatchsize.Fordataentryfields(shown in 88888888                                                                          888888888 00
                                                                                                                                                                                                888888888 00888888888 008 00
41                                                            3a. Payments transferred from Ohio IT 4708ES and UPC redforidentificationpurposesonly), use Arial font 
                                                                                                                       (black ink).All the data entry fields must follow
42                                                                   (include schedule if required; see 1140 instructions) and grid layout. Never hard code a negative sign, and 
43                                                                   other payments previously madedofornotthisincludetaxabletheyearnegative .....3a.sign with the888888888amounts.00
44                                                            3b. Payments transferred to Ohio IT 4708 and refunds, Thisisnowaseparatefield.
45                                                                   if any, previously claimed for this taxable year ............3b.                                                                     888888888 00
46                                                            3c. Net payments (sum of lines 3 and 3a minus line 3b) 
47                                                                   not less than zero ......................................................3c.                                                         888888888 00                                                        8888888888888888 0088 00
48                                                              4. For eachNumbercolumn,of investorssubtract line 3c from line 2a                                             ..............4.  -                                                                           - 888888888 00
                                                                                                                                                                                                          888888888 00
49                                                             NEW!5. If the  sumThesefieldsmaypossiblybeanegativevalue.includedof lineon4, columnsreturn (I) and (II) is an overpayment, enter that sum here     ..........YOUR REFUND                                5.    888888888 00
                                                              Include a “-“ sign here if this line has a negative value.
50                                                            6. If the   sum888888of line 4, columns (I) and (II) is a balance due or zero, enter here                                                       ............................................6.                  888888888 00
51                                                            Interestandpenaltydueonlate-paidtaxand/orlate-filedreturn,ifany                                                                              .......................................................7.          888888888 00
52                                                             8. Total amount due (add lines 6 and 7). Make check payable2D barcodeto OhioisTreasurera requirement.of State.                                     
53                                                                 Include Ohio  UPC and place FEIN on check                            ..................................................................Delete this box and replace it with AMOUNT DUE               8.    888888888 00
54                                                                                                                                                                           the 2D barcode.
55                                                                                   If your refund is $1.00 or less, no refund will be issued. If you owe $1.00 or less, no payment is necessary.
56                                                                 Target marks or registration marks 
57                                                                 must measure 6 mm X 6 mm.  The 
                                                                   four target marks or registration 
58                                                                 marks on every page must follow                                                                                                                                                                     For Department Use Only
59                                                                 grid layout.  Software vendors: Place 2D barcode in this location
60                                                                               Do not place a box around the 2D barcode. The box                                                                                                                                            /           /
61                                                                                                   is only here for placement purposes.                                                                                                                                     Postmark date           Code
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6                                                                 2017 Ohio IT 1140 
                               Rev. 8/17
7                                                            Pass-Through Entity and 
                                                                                                                                              17170210
8  FEIN                                                 Trust Withholding Tax Return
9  88 8888888
10
11 Sign Here (required): I have read this return. Under penalties of perjury, I declare that, to 
12 the best of my knowledge and belief, the return and all enclosures are true, correct and complete.                           Do not staple or paper clip. 
13                                                                                                                         Place any supporting documents, including 
                                                                                                                           Ohio IT K-1’s, after the last page of this return.
14
15 Pass-throughentityofficeroragent(print)
16                                                                                                                                            Mail to: 
17 Titleofofficeroragent                                     Phonenumber
                                                                                                                                Ohio Dept. of Taxation
18                                                                                                                                 P.O. Box 181140
   Signatureofpass-throughofficeror          Date(MM/DD/YY)
19
                                                                                                                           Columbus, OH 43218-1140
20 Preparer’s name (print)                                   Phone number
21
22 Preparer’s e-mail address                                 PTIN                                                          Instructions for this form are on our 
                                                                                                                                website at tax.ohio.gov. 
23 Do you authorize your preparer to contact us regarding this return? Yes                          X No X  
24
25 Schedule B – Qualifying Pass-Through Entities – Tax Due
26 Use this schedule to calculate the adjusted qualifying amounts and tax due for all qualifying investors in qualifying pass-through entities. Include federal K-1(s) 
   and a listing of pass-through credits of participating investors. See “Special Notes” in the instructions, which are available on our website at tax.ohio.gov. 
27
28                                                               Number of investors                                                          (B)
                                                             NEW!Thesefieldsmaypossiblybeanegativevalue.included on return         Qualifying Investors Other 
29                                                           Include a “-“ sign here if this line has a negative value.         Than Nonresident Individuals
30                                                               888888
    1.  Sum of all qualifying investors’ distributive 
31   shares of income, gain, expenses and losses  .............1.                          - 888888888 00                       -  888888888 00
32  2a.  Add X  2/3,   X5/6 or  X 6/6 (check applicable 
33       box) of the qualifying investors’ distributive 
         shares of Internal Revenue Code (I.R.C.) 
34       sections 168(k) and 179 depreciation expense 
35       and miscellaneous federal income tax adjust-
         ments, if any. Include a separate schedule 
36       showing calculations .................................................2a.           888888888 00                          888888888 00
37  2b.  Subtract qualifying investors’ distributive shares 
         of other statutory adjustments and miscella-
38       neous federal income tax adjustments, if any .............2b.                       888888888 00                          888888888 00
39  3. Qualifying investors’ distributive shares of ad-
         justed qualifying amount: Sum of lines 1 and 
40       2a minus line 2b    ...........................................................3. - 888888888 00                       -  888888888 00
41   4.  Add all qualifying investors’ distributive shares 
42       of expenses and losses incurred in connection 
         with all direct and indirect transactions between 
43       the qualifying pass-through entity and its related 
44       members, including certain investors’ family 
         members (see Note 2 on page 7). However, do 
45       not add expenses or losses incurred in connec-
46       tion with sales of inventory to the extent that the 
47       cost of the inventory and the loss incurred were 
         calculated in accordance with I.R.C. sections 
48       263A and 482 (see Note 3 on page 7)  .........................4.                  - 888888888 00                       -  888888888 00
49   5. If the qualifying pass-through entity is either 
50       a partnership or a limited liability company 
51       treated as a partnership, add all qualifying 
         investors’ distributive shares of guaranteed 
52       payments that the qualifying pass-through           2D barcode is a requirement. 
53       entity made to any qualifying investor directly     Delete this box and replace it with 
         or indirectly owning at least 20% of the qualify-
54       ing pass-through entity  ................................................5.the 2D barcode. 888888888 00                   888888888 00
55
56
57
58
59                   Software vendors: Place 2D barcode in this location
60                   Do not place a box around the 2D barcode. The box
61                               is only here for placement purposes.
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6                                                                         2017 Ohio IT 1140 
                              Rev. 8/17
7                                                     Pass-Through Entity and 
                                                                                                                                                                                                     17170310
8  FEIN                                               Trust Withholding Tax Return
9  88 8888888
10
11
12 Schedule B – Qualifying Pass-Through Entities – Tax Due...cont.
13                                                                                                                                   (A)                                                                                     (B)
14   6. If the qualifying pass-through entity is an S corporation, add all                                       Qualifying Investors Who Are                                                        Qualifying Investors Other 
15        qualifying investors’ distributive shares of compensation that the                                     Nonresident Individuals                                                          Than Nonresident Individuals
          qualifying pass-through entity S corporation made to any qualifying 
16        investor directly or indirectly owning at least 20% of the qualifying 
          pass-through entity. Reciprocity agreements do not apply. (See 
17        Note 3 on page 7.)  ................................................................................6.               888888888 00                                                                        888888888 00
18
19  7. Qualifying investors’ adjusted distributive shares. Add lines 
          3, 4, 5 and 6, but not less than -0-  .....................................................7.                        888888888 00                                                                        888888888 00
20
     8.  Apportionment ratio from Schedule C, line 4, below ............................8.
21                                                                                                                                   8.888888                                                                                        8.888888
22  
23  9. Qualifying investors’ adjusted qualifying amount: Line 7 times 
          line 8. Complete the remainder of this schedule only if the sum 
24        of columns A and B on line 9 exceeds $1,000  .....................................9.                                 888888888 00                                                                        888888888 00
25
     10.  Tax rate (see Note 4 on page 7) ........................................................10.                                                                 X .05                                                                    X .085
26
27 11. Tax due: Line 9 times line 10. Round tax to the nearest dollar. Enter 
          the column A amount on page 1, line 1, column I; enter the column 
28        B amount on page 1, line 1, column II ..................................................11.                          888888888 00                                                                        888888888 00
29
30 Schedule C – Qualifying Pass-Through Entities – Apportionment Worksheet
31 Usethisscheduletocalculatetheapportionmentratioforaqualifyingpass-throughentitythatisnotafinancialinstitutionasdefinedinOhioRevisedCode
32 section(R.C.)5725.01.Ifthepass-throughentityisafinancialinstitution,refertotheinstructions. Note: All ratios are to be carried to six decimal places.
33  1.  Property                                                          Within Ohio                                                                                                             Total Everywhere
34     a) Owned (average cost)                              88888888888 00                                                                                                          88888888888 00
35                                                                        Within Ohio                                                                                                             Total Everywhere
                                                                                                                                                                                    Weightisavariabledatafieldand
36     b) Rented (annual rental X 8)                        88888888888 00       This field requires a leading zero,                                                                88888888888must00TotalincludeEverywherea leading zero. See 
37                                                                        Withine.g. .000026Ohioshould be displayed                                                   88888888888 00schemaTotalforEverywhereaccepted characters.
38     c) Total (lines 1a and 1b)                           88888888888 00       as 0.000026.                                        ÷                                              88888888888 00Total Everywhere
39
40                                                                                                                    Ratio                                           Weight                                       Weighted Ratio
41                                                                                            =                  8.888888                                          x =8.88                                         8.888888
42                                                                        Within Ohio                                                                                                             Total Everywhere
43  2.  Payroll                                             88888888888 00                                                           ÷                                              88888888888 00
44                                                                                                                    Ratio                                           Weight                                       Weighted Ratio
    
45                                                                                            =                  8.888888                                          x =Weight8.88This field requiresWeighteda8.888888leadingRatiozero,
                                                                                                                                                                                    e.g. .000026 should be displayed 
46                                                                        Within Ohio                                                                                 8.88as 0.000026.Total Everywhere8.888888
47  3.  Sales                                               88888888888 00                                                           ÷                                              88888888888 00
48                                                                                                                    Ratio                                           Weight                                       Weighted Ratio
    
49                                                                                            =                  8.888888                                             8.88                                         8.888888
50                                                                                                                                                                 x =
51                                                                                                                                                                                                                 Weighted Ratio
52  4.  Total weighted apportionment ratio (add lines 1c, 2 and2D3).barcodeEnter ratiois ahererequirement.and on line 8, above (both columns)....................4.                                                8.888888
53                                                                        Delete this box and replace it with 
   Note:If the denominator of any factor is zero, the weightthegiven2D barcode.to the other factors must be proportionately increased so that the total weight given to the 
54 combined number of factors used is 100%, i.e., if no property/payroll, use 25% and 75%; if no sales, use 50% property/payroll; if only one factor, use 100%.
55
56
57
58
59                     Software vendors: Place 2D barcode in this location
60                     Do not place a box around the 2D barcode. The box
61                                is only here for placement purposes.
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6                                                                                                       2017 Ohio IT 1140 
                                                           Rev. 8/17
7                                                                                        Pass-Through Entity and 
                                                                                                                                                                                                                    17170410
8  FEIN                                                                       Trust Withholding Tax Return
9  88 8888888
10
11                                                                            Number of investors 
   Schedule D – Trusts – Tax Due
12                                                                     NEW!Thesefieldsmaypossiblybeanegativevalue.included on return 
   Use this schedule to calculate the adjustedIncludequalifyinga “-“ sign hereamountsif thisandline haswithholdinga negativetaxvalue.due for nonresident individuals who are beneficiaries of trusts that
13 made distributions of either income or gain attributable888888to the trust’s ownership of or disposition of either tangible personal property located in Ohio or real 
14 property located in Ohio.
15
16  1. Sum of all distributions to nonresident individuals of income or gain attributable to the trust’s 
17                                     ownership of or disposition of either tangible personal property located in Ohio or real property 
                                       located in Ohio ........................................................................................................................................1.     - 888888888 00
18
    
19 2a. Add                                  X2/3,    X 5/6 or     X6/6 (check applicable box) of I.R.C. section 168(k) depreciation 
20                                     expense and miscellaneous federal income tax adjustments attributed to nonresident individu-
                                       alswhoarebeneficiariesoftrusts.Includeaseparatescheduleshowing                                      ......................2a.                                    888888888 00
21  
22  2b. Other statutory adjustments and miscellaneous federal income tax adjustments attributed to 
                                       nonresidentindividualswhoarebeneficiariesof                       .........................................................................2b.                   888888888 00
23  
24  3. Adjusted qualifying amount: sum of lines 1 and 2a minus line 2b. Complete the remainder of 
                                       the worksheet only if line 3 exceeds $1,000  ...........................................................................................3.                     - 888888888 00
25
26                                                                                                                                                                                                                  X .05
     4. Tax rate  ...................................................................................................................................................4.
27  
28    5. Tax due: Line 3 times line 4. Round tax to the nearest dollar. Enter here and on page 1, line 1, 
                                       column I ...................................................................................................................................................5.   888888888 00
29
30 Schedule E – Investor Information
31 Provide investor information for                           all (resident and nonresident) investorsValue isinthethenumericpass-throughequivalententity or trust. List investors by highest to lowest ownership percent-
32 age. Use an additional sheet, if necessary. See Note 5 on page 7 for the amountof the percentof pass-throughof ownershipentityandtax credits.
33                                                                                                              must include the leading zero, e.g. 
        X                                Check the box if the investor is included on the return.               45.62% = 0.4562
34                                       
35 SSN                                                                        FEIN                                                  Percent of ownership                 Amount of PTE tax credit
36
   888 88 8888                                                         88 8888888                                                   8.8888                               888888888 00
37 First name / entity                                                                                  M.I.           Last name
38 JOHNXXXXXXXXXXX                                                                                      Q              PUBL I CXXXXXXXXXXXXXX
39 Address
40 8888 CHERRY  LANEXXXXXXXXXXXXXXXXXXX                     
41 City                                                                                                                             State          ZIP code
42 CITYXXXXXXXXXXXXXXXX                                                                                                             OH             88888
43
44      X                                Check the box if the investor is included on the return.
45
46 SSN                                                                        FEIN                                                  Percent of ownership                 Amount of PTE tax credit
47
   888 88 8888                                                         88 8888888                                                   8.8888                               888888888 00
48 First name / entity                                                                                  M.I.           Last name
49
   JOHNXXXXXXXXXXX                                                                                      Q              PUBL I CXXXXXXXXXXXXXX
50 Address
51                                                          
   8888 CHERRY  LANEXXXXXXXXXXXXXXXXXXX
52 City                                                                                       2D barcode is a requirement.          State          ZIP code
53                                                                                            Delete this box and replace it with 
   CITYXXXXXXXXXXXXXXXX                                                                                                             OH             88888
54                                                                                            the 2D barcode.
55
56
57
58
59                                             Software vendors: Place 2D barcode in this location
60                                             Do not place a box around the 2D barcode. The box
61                                                            is only here for placement purposes.
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6                                                      2017 Ohio IT 1140 
                                         Rev. 8/17
7                                                      Pass-Through Entity and 
                                                                                                                                    17170510
8  FEIN                                           Trust Withholding Tax Return
9  88 8888888
10
11
   Schedule E – Investor Information...cont.
12
13 Provide investor information for all (resident and nonresident) investors in the pass-through entity or trust. List investors by highest to lowest ownership percent-
   age. Use an additional sheet, if necessary. See Note 5 on page 7 for the amount of pass-through entity tax credits.
14
15
        X                                Check the box if the investor is included on the return.
16                                       
17 SSN                                            FEIN                                                         Percent of ownership Amount of PTE tax credit
18 888 88 8888                                    88 8888888                                                   8.8888               888888888 00
19 First name / entity                                                                           M.I. Last name
20 JOHNXXXXXXXXXXX                                                                               Q    PUBL I CXXXXXXXXXXXXXX
21 Address
22                                        
   8888 CHERRY  LANEXXXXXXXXXXXXXXXXXXX
23 City                                                                                                        State ZIP code
24 CITYXXXXXXXXXXXXXXXX                                                                                        OH    88888
25
26      X                                Check the box if the investor is included on the return.
27
28 SSN                                            FEIN                                                         Percent of ownership Amount of PTE tax credit
29
   888 88 8888                                    88 8888888                                                   8.8888               888888888 00
30 First name / entity                                                                           M.I. Last name
31
   JOHNXXXXXXXXXXX                                                                               Q    PUBL I CXXXXXXXXXXXXXX
32 Address
33                                        
   8888 CHERRY  LANEXXXXXXXXXXXXXXXXXXX
34 City                                                                                                        State ZIP code
35
   CITYXXXXXXXXXXXXXXXX                                                                                        OH    88888
36
37
38                                       Check the box if the investor is included on the return.
        X

39 SSN                                            FEIN                                                         Percent of ownership Amount of PTE tax credit
40
   888 88 8888                                    88 8888888                                                   8.8888               888888888 00
41 First name / entity                                                                           M.I. Last name
42
   JOHNXXXXXXXXXXX                                                                               Q 
43                                                                                                    PUBL I CXXXXXXXXXXXXXX
   Address
44
   8888 CHERRY  LANEXXXXXXXXXXXXXXXXXXX   
45
   City                                                                                                        State ZIP code
46
   CITYXXXXXXXXXXXXXXXX                                                                                        OH    88888
47
48
49
50
51
52                                                     2D barcode is a requirement. 
53                                                     Delete this box and replace it with 
54                                                     the 2D barcode.
55
56
57
58
59                                       Software vendors: Place 2D barcode in this location
60                                       Do not place a box around the 2D barcode. The box
61                                        is only here for placement purposes.
62
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6                                                      2017 Ohio IT 1140 
                                         Rev. 8/17
7                                                      Pass-Through Entity and 
                                                                                                                                    17170610
8  FEIN                                           Trust Withholding Tax Return
9  88 8888888
10
11
   Schedule E – Investor Information...cont.
12
13 Provide investor information for all (resident and nonresident) investors in the pass-through entity or trust. List investors by highest to lowest ownership percent-
   age. Use an additional sheet, if necessary. See Note 5 on page 7 for the amount of pass-through entity tax credits.
14
15
        X                                Check the box if the investor is included on the return.
16                                       
17 SSN                                            FEIN                                                         Percent of ownership Amount of PTE tax credit
18 888 88 8888                                    88 8888888                                                   8.8888               888888888 00
19 First name / entity                                                                           M.I. Last name
20 JOHNXXXXXXXXXXX                                                                               Q    PUBL I CXXXXXXXXXXXXXX
21 Address
22                                        
   8888 CHERRY  LANEXXXXXXXXXXXXXXXXXXX
23 City                                                                                                        State ZIP code
24 CITYXXXXXXXXXXXXXXXX                                                                                        OH    88888
25
26      X                                Check the box if the investor is included on the return.
27
28 SSN                                            FEIN                                                         Percent of ownership Amount of PTE tax credit
29
   888 88 8888                                    88 8888888                                                   8.8888               888888888 00
30 First name / entity                                                                           M.I. Last name
31
   JOHNXXXXXXXXXXX                                                                               Q    PUBL I CXXXXXXXXXXXXXX
32 Address
33                                        
   8888 CHERRY  LANEXXXXXXXXXXXXXXXXXXX
34 City                                                                                                        State ZIP code
35
   CITYXXXXXXXXXXXXXXXX                                                                                        OH    88888
36
37
38                                       Check the box if the investor is included on the return.
        X

39 SSN                                            FEIN                                                         Percent of ownership Amount of PTE tax credit
40
   888 88 8888                                    88 8888888                                                   8.8888               888888888 00
41 First name / entity                                                                           M.I. Last name
42
   JOHNXXXXXXXXXXX                                                                               Q 
43                                                                                                    PUBL I CXXXXXXXXXXXXXX
   Address
44
   8888 CHERRY  LANEXXXXXXXXXXXXXXXXXXX   
45
   City                                                                                                        State ZIP code
46
   CITYXXXXXXXXXXXXXXXX                                                                                        OH    88888
47
48
49
50
51
52                                                     2D barcode is a requirement. 
53                                                     Delete this box and replace it with 
54                                                     the 2D barcode.
55
56
57
58
59                                       Software vendors: Place 2D barcode in this location
60                                       Do not place a box around the 2D barcode. The box
61                                        is only here for placement purposes.
62
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Grid layout

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85
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4                                                                  Do not staple or paper clip. 
5
6                                                                                                                                                                                2017 Ohio IT 1140 
7                                                                                        Rev. 8/17                                                                               Pass-Through Entity and 
8                                                                                                                                                                               Trust Withholding Tax Return                                                                17170110
                                                             88 88 88
9                                                                                                                                                                                Use only black ink and UPPERCASE letters.
10                                                                                                    Check here if amended return                                                                   Check here if final return                                             For taxable year beginning in
                                                                                                   X                                                                                               X
11                                                                                                                                                                              Check here if the federal extension was granted
                                                                                                                                                                              X                                                                                                     88/2017
12                                                           FEIN
13                                                           88 8888888                                                                                                          Entity Type:        S corporation             X         Partnership
                                                                                                                                                                                 (check only one)  X
14                                                                                                                                                                                                   Limited liability company           Trust
                                                                                                                                                                                                   X                           X
15                                                           Name of pass-through entity
16                                                           JOHNXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
17
18                                                           Address (if address change, check box)                                                                             X
19                                                           8888  CHERRY   LANEXXXXXXXXXXXXXXXXXXX
20                                                           City                                                                                                                                    State         ZIP code
                                                             CITYXXXXXXXXXXXXXXXX
21                                                                                                                                                                                                   OH            88888
22
23                                                           Foreign State Code                    Country Code                                                                  Foreign country (if the mailing address is outside the U.S.)                               Foreign postal code
24
                                                                          888                         88                                                                        88888888888888888888                                                                        8888888
25
                                                                                                      Number of investors                                                        Ownership percentage 
26                                                           Total number of investors                included on return                                                         of investors on return            Apportionment ratio, page 3, line 8
27
                                                             888888                                   888888                                                                     8.8888                            8.888888
28
29
30
31                                                           Schedule A – Reconciliation Tax and Payments
32                                                                                                                                                                                            Column (I) – Withholding Tax                                                  Column (II) – Entity Tax
33                                                             1. Tax for each column (from Schedule B, line 11, 
34                                                                   columns A and B or from Schedule D, line 5)  ..............1.
                                                                                                                                                                                                     888888888 00                                               888888888 00
35                                                            2. Interest penalty on underpayment of estimated tax 
36                              Do not staple or paper clip.         (include Ohio IT/SD 2210) ...........................................2.
                                                                                                                                                                                                     888888888 00                                               888888888 00
37                                                             2a. Add lines 1 and 2 ......................................................2a.
                                                                                                                                                                                                     888888888 00                                               888888888 00
38                                                             3. Ohio IT 1140ES and UPC payments the entity or trust 
39                                                                   made and/or 2016 overpayment credited to 2017 (see 
40                                                                   Note 1 on page 7) ........................................................3.                                                    888888888 00                                               888888888 00
41                                                            3a. Payments transferred from Ohio IT 4708ES and UPC 
42                                                                   (include schedule if required; see IT 1140 instructions) 
43                                                                   and other payments previously made for this taxable year .....3a.                                                               888888888 00
44                                                            3b. Payments transferred to Ohio IT 4708 and refunds, 
45                                                                   if any, previously claimed for this taxable year ............3b.                                                                888888888 00
46                                                            3c. Net payments (sum of lines 3 and 3a minus line 3b) 
47                                                                   not less than zero ......................................................3c.                                                    888888888 00                                               8888888888888888 0088 00
48                                                              4. For each column, subtract line 3c from line 2a                                                                 ..............4. -                                          -                 888888888 00
                                                                                                                                                                                                     888888888 00
49                                                             5. If the  sum of line 4, columns (I) and (II) is an overpayment, enter that sum here ..........                                                    YOUR REFUND           5.                    888888888 00
50                                                            6. If the   sum of line 4, columns (I) and (II) is a balance due or zero, enter here ............................................6.                                                               888888888 00
51                                                            Interestandpenaltydueonlate-paidtaxand/orlate-filedreturn,ifany                                                                         .......................................................7. 888888888 00
52                                                             8. Total amount due (add lines 6 and 7). Make check payable to Ohio Treasurer of State. 
53                                                                Include Ohio  UPC and place FEIN on check ..................................................................                                                 AMOUNT DUE     8.               888888888 00
54
55                                                                                If your refund is $1.00 or less, no refund will be issued. If you owe $1.00 or less, no payment is necessary.
56
57
58                                                                                                                                                                                                                                       For Department Use Only
59                                                                            Software vendors: Place 2D barcode in this location
60                                                                            Do not place a box around the 2D barcode. The box                                                                                                                                 /           /
61                                                                                       is only here for placement purposes.                                                                                                                   Postmark date                       Code
62
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6                                                                 2017 Ohio IT 1140 
7                              Rev. 8/17                     Pass-Through Entity and 
                                                                                                                                17170210
8  FEIN                                                 Trust Withholding Tax Return
9  88 8888888
10
11 Sign Here (required): I have read this return. Under penalties of perjury, I declare that, to 
12 the best of my knowledge and belief, the return and all enclosures are true, correct and complete.                        Do not staple or paper clip. 
13                                                                                                                      Place any supporting documents, including 
                                                                                                                        Ohio IT K-1’s, after the last page of this return.
14
15 Pass-throughentityofficeroragent(print)
16                                                                                                                              Mail to: 
17 Titleofofficeroragent                                     Phonenumber
                                                                                                                             Ohio Dept. of Taxation
18                                                                                                                              P.O. Box 181140
   Signatureofpass-throughofficeror          Date(MM/DD/YY)
19
                                                                                                                        Columbus, OH 43218-1140
20 Preparer’s name (print)                                   Phone number
21
22 Preparer’s e-mail address                                 PTIN                                                       Instructions for this form are on our 
                                                                                                                             website at tax.ohio.gov. 
23 Do you authorize your preparer to contact us regarding this return? Yes                   X No  X  
24
25 Schedule B – Qualifying Pass-Through Entities – Tax Due
26 Use this schedule to calculate the adjusted qualifying amounts and tax due for all qualifying investors in qualifying pass-through entities. Include federal K-1(s) 
   and a listing of pass-through credits of participating investors. See “Special Notes” in the instructions, which are available on our website at tax.ohio.gov. 
27
28                                                                                             (A)                                      (B)
29                                                                                         Qualifying Investors Who Are         Qualifying Investors Other 
                                                                                           Nonresident Individuals           Than Nonresident Individuals
30
    1.  Sum of all qualifying investors’ distributive 
31   shares of income, gain, expenses and losses  .............1.                          - 888888888 00                    -  888888888 00
32  2a.  Add X  2/3,   X5/6 or  X 6/6 (check applicable 
33       box) of the qualifying investors’ distributive 
         shares of Internal Revenue Code (I.R.C.) 
34       sections 168(k) and 179 depreciation expense 
35       and miscellaneous federal income tax adjust-
         ments, if any. Include a separate schedule 
36       showing calculations .................................................2a.           888888888 00                       888888888 00
37  2b.  Subtract qualifying investors’ distributive shares 
         of other statutory adjustments and miscella-
38       neous federal income tax adjustments, if any .............2b.                       888888888 00                       888888888 00
39  3. Qualifying investors’ distributive shares of ad-
         justed qualifying amount: Sum of lines 1 and 
40       2a minus line 2b    ...........................................................3. - 888888888 00                    -  888888888 00
41   4.  Add all qualifying investors’ distributive shares 
42       of expenses and losses incurred in connection 
         with all direct and indirect transactions between 
43       the qualifying pass-through entity and its related 
44       members, including certain investors’ family 
         members (see Note 2 on page 7). However, do 
45       not add expenses or losses incurred in connec-
46       tion with sales of inventory to the extent that the 
47       cost of the inventory and the loss incurred were 
         calculated in accordance with I.R.C. sections 
48       263A and 482 (see Note 3 on page 7)  .........................4.                  - 888888888 00                    -  888888888 00
49   5. If the qualifying pass-through entity is either 
50       a partnership or a limited liability company 
51       treated as a partnership, add all qualifying 
         investors’ distributive shares of guaranteed 
52       payments that the qualifying pass-through 
53       entity made to any qualifying investor directly 
         or indirectly owning at least 20% of the qualify-
54       ing pass-through entity  ................................................5.         888888888 00                       888888888 00
55
56
57
58
59                   Software vendors: Place 2D barcode in this location
60                   Do not place a box around the 2D barcode. The box
61                               is only here for placement purposes.
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6                                                          2017 Ohio IT 1140 
7                      Rev. 8/17                      Pass-Through Entity and 
                                                                                                                                        17170310
8  FEIN                                               Trust Withholding Tax Return
9  88 8888888
10
11
12 Schedule B – Qualifying Pass-Through Entities – Tax Due...cont.
13                                                                                                               (A)                            (B)
14   6. If the qualifying pass-through entity is an S corporation, add all                                 Qualifying Investors Who Are Qualifying Investors Other 
15  qualifying investors’ distributive shares of compensation that the                                     Nonresident Individuals      Than Nonresident Individuals
    qualifying pass-through entity S corporation made to any qualifying 
16  investor directly or indirectly owning at least 20% of the qualifying 
    pass-through entity. Reciprocity agreements do not apply. (See 
17  Note 3 on page 7.)  ................................................................................6. 888888888 00                        888888888 00
18
19  7. Qualifying investors’ adjusted distributive shares. Add lines 
    3, 4, 5 and 6, but not less than -0-  .....................................................7.          888888888 00                        888888888 00
20
     8.  Apportionment ratio from Schedule C, line 4, below ............................8.
21                                                                                                                  8.888888                            8.888888
22  
23  9. Qualifying investors’ adjusted qualifying amount: Line 7 times 
    line 8. Complete the remainder of this schedule only if the sum 
24  of columns A and B on line 9 exceeds $1,000  .....................................9.                   888888888 00                        888888888 00
25
     10.  Tax rate (see Note 4 on page 7) ........................................................10.                    X .05                          X .085
26
27 11. Tax due: Line 9 times line 10. Round tax to the nearest dollar. Enter 
    the column A amount on page 1, line 1, column I; enter the column 
28  B amount on page 1, line 1, column II ..................................................11.            888888888 00                        888888888 00
29
30 Schedule C – Qualifying Pass-Through Entities – Apportionment Worksheet
31 Usethisscheduletocalculatetheapportionmentratioforaqualifyingpass-throughentitythatisnotafinancialinstitutionasdefinedinOhioRevisedCode
32 section(R.C.)5725.01.Ifthepass-throughentityisafinancialinstitution,refertotheinstructions. Note: All ratios are to be carried to six decimal places.
33  1.  Property                                           Within Ohio                                                                  Total Everywhere
       a) Owned (average cost)          
34                                                    88888888888 00                                                               88888888888 00
35                                                         Within Ohio                                                                  Total Everywhere
36     b) Rented (annual rental X 8)                  88888888888 00                                                               88888888888 00
37                                                         Within Ohio                                                                  Total Everywhere
38     c) Total (lines 1a and 1b)                     88888888888 00                                                ÷              88888888888 00
39
40                                                                                                         Ratio         Weight                Weighted Ratio
41                                                         =                                               8.888888   x =8.88                  8.888888
42                                                         Within Ohio                                                                  Total Everywhere
43  2.  Payroll                                       88888888888 00                                                ÷              88888888888 00
44                                                                                                         Ratio         Weight                Weighted Ratio
    
45                                                         =                                               8.888888   x =8.88                  8.888888
46                                                         Within Ohio                                                                  Total Everywhere
47                                                    88888888888 00                                                ÷              88888888888 00
    3.  Sales
48                                                                                                         Ratio         Weight                Weighted Ratio
    
49                                                         =                                               8.888888      8.88                  8.888888
50                                                                                                                    x =
51                                                                                                                                             Weighted Ratio
52  4.  Total weighted apportionment ratio (add lines 1c, 2 and 3). Enter ratio here and on line 8, above (both columns)....................4. 8.888888
53
   Note: If the denominator of any factor is zero, the weight given to the other factors must be proportionately increased so that the total weight given to the 
54 combined number of factors used is 100%, i.e., if no property/payroll, use 25% and 75%; if no sales, use 50% property/payroll; if only one factor, use 100%.
55
56
57
58
59               Software vendors: Place 2D barcode in this location
60               Do not place a box around the 2D barcode. The box
61                     is only here for placement purposes.
62
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6                                                                                                       2017 Ohio IT 1140 
7                                                          Rev. 8/17                     Pass-Through Entity and 
                                                                                                                                                                                                                    17170410
8  FEIN                                                                       Trust Withholding Tax Return
9  88 8888888
10
11
   Schedule D – Trusts – Tax Due
12
   Use this schedule to calculate the adjusted qualifying amounts and withholding tax due for nonresident individuals who are beneficiaries of trusts that
13 made distributions of either income or gain attributable to the trust’s ownership of or disposition of either tangible personal property located in Ohio or real 
14 property located in Ohio.
15
16  1. Sum of all distributions to nonresident individuals of income or gain attributable to the trust’s 
17                                     ownership of or disposition of either tangible personal property located in Ohio or real property 
                                       located in Ohio ........................................................................................................................................1.     - 888888888 00
18
    
19 2a. Add                                  X2/3,    X 5/6 or     X6/6 (check applicable box) of I.R.C. section 168(k) depreciation 
20                                     expense and miscellaneous federal income tax adjustments attributed to nonresident individu-
                                       alswhoarebeneficiariesoftrusts.Includeaseparatescheduleshowing                                      ......................2a.                                    888888888 00
21  
22  2b. Other statutory adjustments and miscellaneous federal income tax adjustments attributed to 
                                       nonresidentindividualswhoarebeneficiariesof                       .........................................................................2b.                   888888888 00
23  
24  3. Adjusted qualifying amount: sum of lines 1 and 2a minus line 2b. Complete the remainder of 
                                       the worksheet only if line 3 exceeds $1,000  ...........................................................................................3.                     - 888888888 00
25
26                                                                                                                                                                                                                  X .05
     4. Tax rate  ...................................................................................................................................................4.
27  
28    5. Tax due: Line 3 times line 4. Round tax to the nearest dollar. Enter here and on page 1, line 1, 
                                       column I ...................................................................................................................................................5.   888888888 00
29
30 Schedule E – Investor Information
31 Provide investor information for all (resident and nonresident) investors in the pass-through entity or trust. List investors by highest to lowest ownership percent-
32 age. Use an additional sheet, if necessary. See Note 5 on page 7 for the amount of pass-through entity tax credits.
33
        X                                Check the box if the investor is included on the return.
34                                       
35 SSN                                                                        FEIN                                                  Percent of ownership Amount of PTE tax credit
36
   888 88 8888                                                         88 8888888                                                   8.8888               888888888 00
37 First name / entity                                                                                  M.I.           Last name
38 JOHNXXXXXXXXXXX                                                                                      Q              PUBL I CXXXXXXXXXXXXXX
39 Address
40 8888 CHERRY  LANEXXXXXXXXXXXXXXXXXXX                     
41 City                                                                                                                             State ZIP code
42 CITYXXXXXXXXXXXXXXXX                                                                                                             OH    88888
43
44      X                                Check the box if the investor is included on the return.
45
46 SSN                                                                        FEIN                                                  Percent of ownership Amount of PTE tax credit
47
   888 88 8888                                                         88 8888888                                                   8.8888               888888888 00
48 First name / entity                                                                                  M.I.           Last name
49
   JOHNXXXXXXXXXXX                                                                                      Q              PUBL I CXXXXXXXXXXXXXX
50 Address
51                                                          
   8888 CHERRY  LANEXXXXXXXXXXXXXXXXXXX
52 City                                                                                                                             State ZIP code
53
   CITYXXXXXXXXXXXXXXXX                                                                                                             OH    88888
54
55
56
57
58
59                                             Software vendors: Place 2D barcode in this location
60                                             Do not place a box around the 2D barcode. The box
61                                                            is only here for placement purposes.
62
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6                                                       2017 Ohio IT 1140 
7                                        Rev. 8/17      Pass-Through Entity and 
                                                                                                                                    17170510
8  FEIN                                            Trust Withholding Tax Return
9  88 8888888
10
11
   Schedule E – Investor Information...cont.
12
13 Provide investor information for all (resident and nonresident) investors in the pass-through entity or trust. List investors by highest to lowest ownership percent-
   age. Use an additional sheet, if necessary. See Note 5 on page 7 for the amount of pass-through entity tax credits.
14
15
        X                                Check the box if the investor is included on the return.
16                                       
17 SSN                                             FEIN                                                        Percent of ownership Amount of PTE tax credit
18 888 88 8888                                     88 8888888                                                  8.8888               888888888 00
19 First name / entity                                                                           M.I. Last name
20 JOHNXXXXXXXXXXX                                                                               Q    PUBL I CXXXXXXXXXXXXXX
21 Address
22                                        
   8888 CHERRY  LANEXXXXXXXXXXXXXXXXXXX
23 City                                                                                                        State ZIP code
24 CITYXXXXXXXXXXXXXXXX                                                                                        OH    88888
25
26      X                                Check the box if the investor is included on the return.
27
28 SSN                                             FEIN                                                        Percent of ownership Amount of PTE tax credit
29
   888 88 8888                                     88 8888888                                                  8.8888               888888888 00
30 First name / entity                                                                           M.I. Last name
31
   JOHNXXXXXXXXXXX                                                                               Q    PUBL I CXXXXXXXXXXXXXX
32 Address
33                                        
   8888 CHERRY  LANEXXXXXXXXXXXXXXXXXXX
34 City                                                                                                        State ZIP code
35
   CITYXXXXXXXXXXXXXXXX                                                                                        OH    88888
36
37
38                                       Check the box if the investor is included on the return.
        X

39 SSN                                             FEIN                                                        Percent of ownership Amount of PTE tax credit
40
   888 88 8888                                     88 8888888                                                  8.8888               888888888 00
41 First name / entity                                                                           M.I. Last name
42
   JOHNXXXXXXXXXXX                                                                               Q 
43                                                                                                    PUBL I CXXXXXXXXXXXXXX
   Address
44
   8888 CHERRY  LANEXXXXXXXXXXXXXXXXXXX   
45
   City                                                                                                        State ZIP code
46
   CITYXXXXXXXXXXXXXXXX                                                                                        OH    88888
47
48
49
50
51
52
53
54
55
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57
58
59                                       Software vendors: Place 2D barcode in this location
60                                       Do not place a box around the 2D barcode. The box
61                                        is only here for placement purposes.
62
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6                                                       2017 Ohio IT 1140 
7                                        Rev. 8/17      Pass-Through Entity and 
                                                                                                                                    17170610
8  FEIN                                            Trust Withholding Tax Return
9  88 8888888
10
11
   Schedule E – Investor Information...cont.
12
13 Provide investor information for all (resident and nonresident) investors in the pass-through entity or trust. List investors by highest to lowest ownership percent-
   age. Use an additional sheet, if necessary. See Note 5 on page 7 for the amount of pass-through entity tax credits.
14
15
        X                                Check the box if the investor is included on the return.
16                                       
17 SSN                                             FEIN                                                        Percent of ownership Amount of PTE tax credit
18 888 88 8888                                     88 8888888                                                  8.8888               888888888 00
19 First name / entity                                                                           M.I. Last name
20 JOHNXXXXXXXXXXX                                                                               Q    PUBL I CXXXXXXXXXXXXXX
21 Address
22                                        
   8888 CHERRY  LANEXXXXXXXXXXXXXXXXXXX
23 City                                                                                                        State ZIP code
24 CITYXXXXXXXXXXXXXXXX                                                                                        OH    88888
25
26      X                                Check the box if the investor is included on the return.
27
28 SSN                                             FEIN                                                        Percent of ownership Amount of PTE tax credit
29
   888 88 8888                                     88 8888888                                                  8.8888               888888888 00
30 First name / entity                                                                           M.I. Last name
31
   JOHNXXXXXXXXXXX                                                                               Q    PUBL I CXXXXXXXXXXXXXX
32 Address
33                                        
   8888 CHERRY  LANEXXXXXXXXXXXXXXXXXXX
34 City                                                                                                        State ZIP code
35
   CITYXXXXXXXXXXXXXXXX                                                                                        OH    88888
36
37
38                                       Check the box if the investor is included on the return.
        X

39 SSN                                             FEIN                                                        Percent of ownership Amount of PTE tax credit
40
   888 88 8888                                     88 8888888                                                  8.8888               888888888 00
41 First name / entity                                                                           M.I. Last name
42
   JOHNXXXXXXXXXXX                                                                               Q 
43                                                                                                    PUBL I CXXXXXXXXXXXXXX
   Address
44
   8888 CHERRY  LANEXXXXXXXXXXXXXXXXXXX   
45
   City                                                                                                        State ZIP code
46
   CITYXXXXXXXXXXXXXXXX                                                                                        OH    88888
47
48
49
50
51
52
53
54
55
56
57
58
59                                       Software vendors: Place 2D barcode in this location
60                                       Do not place a box around the 2D barcode. The box
61                                        is only here for placement purposes.
62
63                                                                                                                    2017 IT 1140 – page   of66
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Layout 

without grid

Do not staple or paper clip. 

2017 Ohio IT 1140 
Rev. 8/17 Pass-Through Entity and 
Trust Withholding Tax Return 17170110
88 88 88 Use only black ink and UPPERCASE letters.
For taxable year beginning in
X Check here if amended return X Check here if final return
X Check here if the federal extension was granted 88/2017
FEIN
88 8888888 Entity Type: X S corporation X Partnership
(check only one)
Limited liability company Trust
Name of pass-through entity X X
JOHNXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
Address (if address change, check box) X
8888  CHERRY   LANEXXXXXXXXXXXXXXXXXXX
City State ZIP code
CITYXXXXXXXXXXXXXXXX OH  88888
Foreign State Code Country Code Foreign country (if the mailing address is outside the U.S.) Foreign postal code
888 88 88888888888888888888 8888888
Number of investors Ownership percentage 
Total number of investors included on return of investors on return Apportionment ratio, page 3, line 8
888888 888888 8.8888 8.888888

Schedule A – Reconciliation Tax and Payments
Column (I) – Withholding Tax Column (II) – Entity Tax
  1. Tax for each column (from Schedule B, line 11, 
 columns A and B or from Schedule D, line 5)  ..............1. 888888888 00 888888888 00
 2. Interest penalty on underpayment of estimated tax 
Do not staple or paper clip.  (include Ohio IT/SD 2210) ...........................................2. 888888888 00 888888888 00
  2a. Add lines 1 and 2 ......................................................2a. 888888888 00 888888888 00
  3. Ohio IT 1140ES and UPC payments the entity or trust 
made and/or 2016 overpayment credited to 2017 (see 
 Note 1 on page 7) ........................................................3. 888888888 00 888888888 00
 3a. Payments transferred from Ohio IT 4708ES and UPC 
(include schedule if required; see IT 1140 instructions) 
 and other payments previously made for this taxable year .....3a. 888888888 00
 3b. Payments transferred to Ohio IT 4708 and refunds, 
 if any, previously claimed for this taxable year ............3b. 888888888 00
 3c. Net payments (sum of lines 3 and 3a minus line 3b) 
 not less than zero ......................................................3c. 888888888 00 8888888888888888 0088 00
   4. For each column, subtract line 3c from line 2a ..............4. - 888888888 00 - 888888888 00
  5. If the  sum of line 4, columns (I) and (II) is an overpayment, enter that sum here ..........YOUR REFUND5. 888888888 00
 6. If the   sum of line 4, columns (I) and (II) is a balance due or zero, enter here ............................................6.888888888 00
 Interestandpenaltydueonlate-paidtaxand/orlate-filedreturn,ifany   .......................................................7. 888888888 00
  8. Total amount due (add lines 6 and 7). Make check payable to Ohio Treasurer of State. 
     Include Ohio  UPC and place FEIN on check ..................................................................AMOUNT DUE8. 888888888 00
 If your refund is $1.00 or less, no refund will be issued. If you owe $1.00 or less, no payment is necessary.

For Department Use Only
Software vendors: Place 2D barcode in this location
Do not place a box around the 2D barcode. The box / /
is only here for placement purposes. Postmark date Code

2017 IT 1140 – page   of16

                                                               2017 Ohio IT 1140 
                            Rev. 8/17                     Pass-Through Entity and 
                                                                                                                             17170210
FEIN                                                 Trust Withholding Tax Return
88 8888888

Sign Here (required): I have read this return. Under penalties of perjury, I declare that, to                             Do not staple or paper clip. 
the best of my knowledge and belief, the return and all enclosures are true, correct and complete.
                                                                                                                     Place any supporting documents, including 
                                                                                                                     Ohio IT K-1’s, after the last page of this return.
Pass-throughentityofficeroragent(print)
Titleofofficeroragent                                     Phonenumber                                                        Mail to: 
                                                                                                                          Ohio Dept. of Taxation
Signatureofpass-throughofficeror          Date(MM/DD/YY)                                                                     P.O. Box 181140
                                                                                                                     Columbus, OH 43218-1140
Preparer’s name (print)                                   Phone number

Preparer’s e-mail address                                 PTIN                                                       Instructions for this form are on our 
                                                                                                                          website at tax.ohio.gov. 
Do you authorize your preparer to contact us regarding this return? Yes                   X No  X  
Schedule B – Qualifying Pass-Through Entities – Tax Due
Use this schedule to calculate the adjusted qualifying amounts and tax due for all qualifying investors in qualifying pass-through entities. Include federal K-1(s) 
and a listing of pass-through credits of participating investors. See “Special Notes” in the instructions, which are available on our website at tax.ohio.gov. 
                                                                                            (A)                                      (B)
                                                                                        Qualifying Investors Who Are         Qualifying Investors Other 
                                                                                        Nonresident Individuals           Than Nonresident Individuals
 1.  Sum of all qualifying investors’ distributive 
  shares of income, gain, expenses and losses  .............1.                          - 888888888 00                    -  888888888 00
 2a.  Add X  2/3,   X5/6 or  X 6/6 (check applicable 
      box) of the qualifying investors’ distributive 
      shares of Internal Revenue Code (I.R.C.) 
      sections 168(k) and 179 depreciation expense 
      and miscellaneous federal income tax adjust-
      ments, if any. Include a separate schedule 
      showing calculations .................................................2a.           888888888 00                       888888888 00
 2b.  Subtract qualifying investors’ distributive shares 
      of other statutory adjustments and miscella-
      neous federal income tax adjustments, if any .............2b.                       888888888 00                       888888888 00
 3. Qualifying investors’ distributive shares of ad-
      justed qualifying amount: Sum of lines 1 and 
      2a minus line 2b    ...........................................................3. - 888888888 00                    -  888888888 00
  4.  Add all qualifying investors’ distributive shares 
      of expenses and losses incurred in connection 
      with all direct and indirect transactions between 
      the qualifying pass-through entity and its related 
      members, including certain investors’ family 
      members (see Note 2 on page 7). However, do 
      not add expenses or losses incurred in connec-
      tion with sales of inventory to the extent that the 
      cost of the inventory and the loss incurred were 
      calculated in accordance with I.R.C. sections 
      263A and 482 (see Note 3 on page 7)  .........................4.                  - 888888888 00                    -  888888888 00
  5. If the qualifying pass-through entity is either 
      a partnership or a limited liability company 
      treated as a partnership, add all qualifying 
      investors’ distributive shares of guaranteed 
      payments that the qualifying pass-through 
      entity made to any qualifying investor directly 
      or indirectly owning at least 20% of the qualify-
      ing pass-through entity  ................................................5.         888888888 00                       888888888 00

                  Software vendors: Place 2D barcode in this location
                  Do not place a box around the 2D barcode. The box
                              is only here for placement purposes.

                                                                                                                     2017 IT 1140 – page   of26

                                                        2017 Ohio IT 1140 
                    Rev. 8/17                      Pass-Through Entity and 
                                                                                                                                     17170310
FEIN                                               Trust Withholding Tax Return
88 8888888

Schedule B – Qualifying Pass-Through Entities – Tax Due...cont.
                                                                                                              (A)                            (B)
  6. If the qualifying pass-through entity is an S corporation, add all                                 Qualifying Investors Who Are Qualifying Investors Other 
 qualifying investors’ distributive shares of compensation that the                                     Nonresident Individuals      Than Nonresident Individuals
 qualifying pass-through entity S corporation made to any qualifying 
 investor directly or indirectly owning at least 20% of the qualifying 
 pass-through entity. Reciprocity agreements do not apply. (See 
 Note 3 on page 7.)  ................................................................................6. 888888888 00                        888888888 00
 7. Qualifying investors’ adjusted distributive shares. Add lines 
 3, 4, 5 and 6, but not less than -0-  .....................................................7.          888888888 00                        888888888 00

  8.  Apportionment ratio from Schedule C, line 4, below ............................8.                          8.888888                            8.888888
 
 9. Qualifying investors’ adjusted qualifying amount: Line 7 times 
 line 8. Complete the remainder of this schedule only if the sum 
 of columns A and B on line 9 exceeds $1,000  .....................................9.                   888888888 00                        888888888 00
  10.  Tax rate (see Note 4 on page 7) ........................................................10.                    X .05                          X .085
11. Tax due: Line 9 times line 10. Round tax to the nearest dollar. Enter 
 the column A amount on page 1, line 1, column I; enter the column 
 B amount on page 1, line 1, column II ..................................................11.            888888888 00                        888888888 00
Schedule C – Qualifying Pass-Through Entities – Apportionment Worksheet
Usethisscheduletocalculatetheapportionmentratioforaqualifyingpass-throughentitythatisnotafinancialinstitutionasdefinedinOhioRevisedCode
section(R.C.)5725.01.Ifthepass-throughentityisafinancialinstitution,refertotheinstructions. Note: All ratios are to be carried to six decimal places.
 1.  Property                                           Within Ohio                                                                  Total Everywhere
    a) Owned (average cost)                        88888888888 00                                                               88888888888 00
                                                        Within Ohio                                                                  Total Everywhere
    b) Rented (annual rental X 8)                  88888888888 00                                                               88888888888 00
                                                        Within Ohio                                                                  Total Everywhere
    c) Total (lines 1a and 1b)                     88888888888 00                                                ÷              88888888888 00

                                                                                                        Ratio         Weight                Weighted Ratio
                                                        =                                               8.888888   x =8.88                  8.888888
                                                        Within Ohio                                                                  Total Everywhere
 2.  Payroll                                       88888888888 00                                                ÷              88888888888 00
                                                                                                        Ratio         Weight                Weighted Ratio
 
                                                        =                                               8.888888   x =8.88                  8.888888
                                                        Within Ohio                                                                  Total Everywhere
 3.  Sales                                         88888888888 00                                                ÷              88888888888 00
                                                                                                        Ratio         Weight                Weighted Ratio
 
                                                        =                                               8.888888      8.88                  8.888888
                                                                                                                   x =
                                                                                                                                            Weighted Ratio
 4.  Total weighted apportionment ratio (add lines 1c, 2 and 3). Enter ratio here and on line 8, above (both columns)....................4. 8.888888
Note: If the denominator of any factor is zero, the weight given to the other factors must be proportionately increased so that the total weight given to the 
combined number of factors used is 100%, i.e., if no property/payroll, use 25% and 75%; if no sales, use 50% property/payroll; if only one factor, use 100%.

              Software vendors: Place 2D barcode in this location
              Do not place a box around the 2D barcode. The box
                    is only here for placement purposes.

                                                                                                                   2017 IT 1140 – page   of36

                                                                                                     2017 Ohio IT 1140 
                                                        Rev. 8/17                     Pass-Through Entity and 
                                                                                                                                                                                                                 17170410
FEIN                                                                       Trust Withholding Tax Return
88 8888888

Schedule D – Trusts – Tax Due
Use this schedule to calculate the adjusted qualifying amounts and withholding tax due for nonresident individuals who are beneficiaries of trusts that
made distributions of either income or gain attributable to the trust’s ownership of or disposition of either tangible personal property located in Ohio or real 
property located in Ohio.
 1. Sum of all distributions to nonresident individuals of income or gain attributable to the trust’s 
                                    ownership of or disposition of either tangible personal property located in Ohio or real property 
                                    located in Ohio ........................................................................................................................................1.     - 888888888 00
 
2a. Add                                X2/3,    X   5/6 or     X6/6 (check applicable box) of I.R.C. section 168(k) depreciation 
                                    expense and miscellaneous federal income tax adjustments attributed to nonresident individu-
                                    alswhoarebeneficiariesoftrusts.Includeaseparatescheduleshowing                                      ......................2a.                                    888888888 00
 
 2b. Other statutory adjustments and miscellaneous federal income tax adjustments attributed to 
                                    nonresidentindividualswhoarebeneficiariesof                       .........................................................................2b.                   888888888 00
 
 3. Adjusted qualifying amount: sum of lines 1 and 2a minus line 2b. Complete the remainder of 
                                    the worksheet only if line 3 exceeds $1,000  ...........................................................................................3.                     - 888888888 00

                                                                                                                                                                                                                 X .05
   4. Tax rate  ...................................................................................................................................................4.
   5. Tax due: Line 3 times line 4. Round tax to the nearest dollar. Enter here and on page 1, line 1, 
                                    column I ...................................................................................................................................................5.   888888888 00

Schedule E – Investor Information
Provide investor information for all (resident and nonresident) investors in the pass-through entity or trust. List investors by highest to lowest ownership percent-
age. Use an additional sheet, if necessary. See Note 5 on page 7 for the amount of pass-through entity tax credits.
                                    Check the box if the investor is included on the return.
     X  
SSN                                                                        FEIN                                                  Percent of ownership Amount of PTE tax credit
888 88 8888                                                         88 8888888                                                   8.8888               888888888 00
First name / entity                                                                                  M.I.           Last name
JOHNXXXXXXXXXXX                                                                                      Q              PUBL I CXXXXXXXXXXXXXX
Address
8888 CHERRY  LANEXXXXXXXXXXXXXXXXXXX                     
City                                                                                                                             State ZIP code
CITYXXXXXXXXXXXXXXXX                                                                                                             OH    88888

     X                              Check the box if the investor is included on the return.

SSN                                                                        FEIN                                                  Percent of ownership Amount of PTE tax credit
888 88 8888                                                         88 8888888                                                   8.8888               888888888 00
First name / entity                                                                                  M.I.           Last name
JOHNXXXXXXXXXXX                                                                                      Q              PUBL I CXXXXXXXXXXXXXX
Address
8888 CHERRY  LANEXXXXXXXXXXXXXXXXXXX                     
City                                                                                                                             State ZIP code
CITYXXXXXXXXXXXXXXXX                                                                                                             OH    88888

                                            Software vendors: Place 2D barcode in this location
                                            Do not place a box around the 2D barcode. The box
                                                           is only here for placement purposes.

                                                                                                                                        2017 IT 1140 – page   of46

                                                   2017 Ohio IT 1140 
                                    Rev. 8/17      Pass-Through Entity and 
                                                                                                                               17170510
FEIN                                          Trust Withholding Tax Return
88 8888888

Schedule E – Investor Information...cont.
Provide investor information for all (resident and nonresident) investors in the pass-through entity or trust. List investors by highest to lowest ownership percent-
age. Use an additional sheet, if necessary. See Note 5 on page 7 for the amount of pass-through entity tax credits.

                                    Check the box if the investor is included on the return.
     X  
SSN                                           FEIN                                                        Percent of ownership Amount of PTE tax credit
888 88 8888                                   88 8888888                                                  8.8888               888888888 00
First name / entity                                                                         M.I. Last name
JOHNXXXXXXXXXXX                                                                             Q    PUBL I CXXXXXXXXXXXXXX
Address
8888 CHERRY  LANEXXXXXXXXXXXXXXXXXXX 
City                                                                                                      State ZIP code
CITYXXXXXXXXXXXXXXXX                                                                                      OH    88888

     X                              Check the box if the investor is included on the return.

SSN                                           FEIN                                                        Percent of ownership Amount of PTE tax credit
888 88 8888                                   88 8888888                                                  8.8888               888888888 00
First name / entity                                                                         M.I. Last name
JOHNXXXXXXXXXXX                                                                             Q    PUBL I CXXXXXXXXXXXXXX
Address
8888 CHERRY  LANEXXXXXXXXXXXXXXXXXXX 
City                                                                                                      State ZIP code
CITYXXXXXXXXXXXXXXXX                                                                                      OH    88888

     X                              Check the box if the investor is included on the return.

SSN                                           FEIN                                                        Percent of ownership Amount of PTE tax credit
888 88 8888                                   88 8888888                                                  8.8888               888888888 00
First name / entity                                                                         M.I. Last name
JOHNXXXXXXXXXXX                                                                             Q    PUBL I CXXXXXXXXXXXXXX
Address
8888 CHERRY  LANEXXXXXXXXXXXXXXXXXXX 
City                                                                                                      State ZIP code
CITYXXXXXXXXXXXXXXXX                                                                                      OH    88888

                                    Software vendors: Place 2D barcode in this location
                                    Do not place a box around the 2D barcode. The box
                                     is only here for placement purposes.

                                                                                                                 2017 IT 1140 – page   of56

                                                   2017 Ohio IT 1140 
                                    Rev. 8/17      Pass-Through Entity and 
                                                                                                                               17170610
FEIN                                          Trust Withholding Tax Return
88 8888888

Schedule E – Investor Information...cont.
Provide investor information for all (resident and nonresident) investors in the pass-through entity or trust. List investors by highest to lowest ownership percent-
age. Use an additional sheet, if necessary. See Note 5 on page 7 for the amount of pass-through entity tax credits.

                                    Check the box if the investor is included on the return.
     X  
SSN                                           FEIN                                                        Percent of ownership Amount of PTE tax credit
888 88 8888                                   88 8888888                                                  8.8888               888888888 00
First name / entity                                                                         M.I. Last name
JOHNXXXXXXXXXXX                                                                             Q    PUBL I CXXXXXXXXXXXXXX
Address
8888 CHERRY  LANEXXXXXXXXXXXXXXXXXXX 
City                                                                                                      State ZIP code
CITYXXXXXXXXXXXXXXXX                                                                                      OH    88888

     X                              Check the box if the investor is included on the return.

SSN                                           FEIN                                                        Percent of ownership Amount of PTE tax credit
888 88 8888                                   88 8888888                                                  8.8888               888888888 00
First name / entity                                                                         M.I. Last name
JOHNXXXXXXXXXXX                                                                             Q    PUBL I CXXXXXXXXXXXXXX
Address
8888 CHERRY  LANEXXXXXXXXXXXXXXXXXXX 
City                                                                                                      State ZIP code
CITYXXXXXXXXXXXXXXXX                                                                                      OH    88888

     X                              Check the box if the investor is included on the return.

SSN                                           FEIN                                                        Percent of ownership Amount of PTE tax credit
888 88 8888                                   88 8888888                                                  8.8888               888888888 00
First name / entity                                                                         M.I. Last name
JOHNXXXXXXXXXXX                                                                             Q    PUBL I CXXXXXXXXXXXXXX
Address
8888 CHERRY  LANEXXXXXXXXXXXXXXXXXXX 
City                                                                                                      State ZIP code
CITYXXXXXXXXXXXXXXXX                                                                                      OH    88888

                                    Software vendors: Place 2D barcode in this location
                                    Do not place a box around the 2D barcode. The box
                                     is only here for placement purposes.

                                                                                                                 2017 IT 1140 – page   of66

General information 

regarding this form

        General Information (2017 Ohio IT 1140):
1) Dimensions: 
  
  Target or registration marks - 6 mm X  6 mm. Follow grid layout for positioning.

  1D barcode (2 of 5 interleaved) - .375”H x 1.5”W. Follow grid layout for positioning. Center the barcode number 
   directly under the barcode.

  2D barcode (PDF 417) - See 2D instructions and schema. Follow grid layout for positioning. There is one 2D 
   barcode on each page of the Ohio IT 1140.

2) 1D barcode - The last two numbers of the 1D barcode represent the vendor number. Use the same vendor 
number as you did for last year’s return. If you have a question about your barcode assignment, e-mail the Forms 
Unit at Forms@tax.state.oh.us. The first six numbers are constant for this form (171701XX - 171706XX). 

  17 = tax year
  17 = Ohio IT 1140 
  01-06 = page number 
  XX = vendor number (assigned to you by the Ohio Dept. of Taxation, Forms Unit).

   NOTE: The vendor number also serves as the first two digits of the SSN and FEIN fields in the test 
   scenarios.

3) New! Use Arial font for the static text on the form. The static text for all target marks and header information 
(target marks, logo, title and 1D barcode) must match grid.

4) Use monospaced Arial or similar monospaced san serif font for the variable data fields on the form.

5) Follow the grid layout for the variable data fields shown in red. Ensure that the tax year, target or reg-
istration marks, “For Department Use Only” area and the 1D and 2D barcodes follow grid layout.

6) Do not use commas, hyphens or decimals in the variable data fields except where shown in specs.

7)  All monetary fields must always show “00” in the cents field even though there may not be a value for that line.

8) You must include a leading zero on ratio fields. For example, if the ratio is .000026, it should display as 0.000026.

9) The possible negative fields for this return are Schedule A: both columns of line 4; Schedule B: both columns 
of  lines 1, 3 and 4 and Schedule D, lines 1 and 3. Do not hard-code negative signs.

10) Provide guidance to customers regarding duplex printing that instructs them to print pages 1 and 2 together 
and pages 3 and 4 together. Taxpayers have filed returns with pages 2 and 3 duplexed or a worksheet or software 
receipt on the back of a page of the return. This slows the processing of the tax return.

11) New! Generate the following message for customers: “Do not enclose other documentation unless it is 
specified on the tax return or instructions.” Taxpayers often submit worksheets and receipts from the vendor 
product, which slows the processing of tax returns. Any other documentation generated from the software must 
include a 1D barcode identifying it as an additional information. The preferred placement is centered on the top 
edge of the page within the print area, however placement at any location on the page will be accepted. Always 
use the following 1D barcode (2 of 5 interleaved):

        10211411

12) IMPORTANT NOTE: Add this statement to your software programs. It should print out with the taxpayer’s 
return. “Do not hand write in any corrections on the printed paper return. Hand writing in corrections will 
result in capturing incorrect data and delaying the processing of this income tax return. Make any cor-
rections to this income tax return within [the software program name], then print and mail.”

13) See the 2D barcode instructions for submission details.

Additional Instructions 

for the 2D barcode and 

regarding submissions, 

testing and notifications 

for the 2017 Ohio IT 1140

              Important Note

It is required that vendors program the Ohio IT 1140 to include 2D barcodes.

                     2017 Ohio IT 1140 

 Pass-Through Entity and Trust Withholding Tax Return 

                     2D Barcode Instructions 
 
 General Information 
 • The Ohio IT 1140 must be enabled for 2D barcode decoding 
 • A form enabled for 2D barcode should not allow users or practitioners the option to turn 
   off/on the 2D barcode function 
 • The minimum error correction code level is 4 
 • Products must not print a 2D barcode prior to being approved in Ohio 
 
 2D Barcode Size and Placement on the Form 
 • 2D barcode must be placed on each page of form in the designated area indicated in the 
   grid layout 
 • The maximum size of the 2D barcode is 3.5 inches wide by 1 inch in height and must fit 
   within the designated space in the grid layout 
 • 2D barcode must not be bigger than the allocated area 
 
 2D Barcode Layout 
 • Each field in the barcode is delimited by a single carriage return 
   o    <CR> equals single carriage return character 
   o    This separates each piece of data so it may be identified and processed. 
 • Data included in the 2D barcode can be broken down into three general sections 
 
 Header 
   Header Version Number 
        • Static for all barcodes, value is T1 
   Developer Code 
        • A four-digit vendor code identifying the software developer whose application 
          produced the barcode 
   Jurisdiction 
        • Static for all barcodes, value is OH 
   Description 
        • A four-digit form identifier, specific to each form 
   Spec Version 
        • A one-digit specification version control number starting with the number zero 
        • This number identifies the version of the specifications used to produce the form 
          barcode 
   Form Version 
        • A one-digit form version control number starting with the number one (1) 
        • This number will only be incremented when there are changes made that would 
          affect the content of the barcode 
   Date Generated 
        • Included on page 1 only 
        • Indicates date return was generated from the product 
 
 Form Specific Data – Please see encoding schemas for form specific data 
   •    All fields on form are required and must be included in the 2D barcode 
   •    Fields with values are represented by the data followed by a carriage return 

   •     Fields with no values are represented by a carriage return only; this results in two 
         adjacent carriage returns 
   •     Note that the data format within the 2D barcode for the Weight, Ratio and Weighted 
         Ratio differs from the print version. Do not include the decimal point in the 2D data. 
 
 Trailer 
   •     The last field in the barcode data stream is the trailer 
   •     The trailer is used to indicate the end of data has been reached 
   •     A static string of *EOD* is used as the trailer value 
 
 Examples of 2D Barcode data streams 
   Header Version Number           T1<CR> 
   Developer Code                  1111<CR> 
   Jurisdiction                    OH<CR> 
   Description                     1717<CR> 
   Spec Version                    0<CR> 
   Form Version                    1<CR> 
   Date Generated                  011517<CR> 
   Line Item Specific Data         IN<CR> 
   Line Item Specific Data         IT40<CR> 
   Line Item Specific Data         0<CR> 
   Trailer                         *EOD* <CR> 
 
 Submission Process 
 • The deadline for submitting Ohio IT 1140 test packets is December 1, 2017 
 • Test packets may be submitted by email to  Forms@tax.state.oh.us 
 • The email subject line must include the vendor number, product name, tax year and form 
   number in that order e.g. 12_ABCTax_ 17_1140 
 • Submissions must include 
   •     Ohio form STF- Approval Request for Scannable Tax Forms 
   •     One (1) full field sample in a PDF format 
   •     Six (6) test scenarios for the Ohio IT 1140 provided by the Ohio Department of Taxation 
         • Each test scenario must be in a separate PDF using the following naming 
           convention: vendor number, product name, tax year, form number, test number 
           e.g.12_ABCTax_17_1140_Test 1 
 • An emailed confirmation is sent to the vendor indicating the packet was received 
 • Submissions found to be missing any of the items above are rejected 
 
 Testing Process 
 • Testing of Ohio IT 1140 packets commences on November 17, 2017 
 • Test packets are reviewed in two (2) content areas- printed forms and 2D barcode data 
 • A submission is approved in its entirety once all sample documents pass in both areas 
 
 Printed forms 
         • Vendor full field matches template provided in the specifications 
         • All fields are present, are formatted properly and align with grid layout 
         • Test scenarios contain values specified by Ohio Department of Taxation 
 
 2D Barcode Data 
         • Barcodes read as valid 
         • All test scenarios can be decoded 
         • 2D barcode data matches data on printed forms 

 Additional instructions 
   • The static text for all target marks and header information (target marks, logo, title and 
     1D barcode) must match grid. 
   • Any other documentation generated from the software must include a 1D barcode 
     identifying it as an additional information. The preferred placement is centered on the top 
     edge of the page within the print area, however placement at any location on the page 
     will be accepted. Always use the following 1D barcode (2 of 5 interleaved): 

 Notifications 
 • Communications from the Ohio Department of Taxation regarding submissions are sent 
    from  Forms@tax.state.oh.us  to the vendor email address(es) on file for the product 
 •  Vendor contact information is compiled from STF- Approval Request for Scannable Tax 
    Forms but may also be submitted by email to the address above. 
 • If unapproved forms are released in software packages, vendors must include a visual 
    indicator signifying the return cannot be filed. 
 • If unapproved forms are released in software packages, vendors must ensure that 
    taxpayers cannot print returns containing 2D barcodes. 
 • An emailed confirmation is sent to the vendor indicating the packet was approved, at 
    which point the product is authorized to print with a 2D barcode. 
 • An emailed confirmation is sent to the vendor for packets that are rejected 
     •   Feedback is provided regarding the errors found 
     •   Resubmit packets must include all test scenarios and the full field return 
     •   After the third submission of test materials, the department cannot guarantee 
         timeliness of the review 
 • If a tax form changes before January 1, 2018 vendors will be notified and required to 
    submit revised test packets.