Department of                                                                                                 ADJ WS
 hio           Taxation                                                                                                      Rev. 11/09
               School District Income Tax
               P.O. Box 182388
               Columbus, OH  43218-2388

               School District Withholding Adjustments Worksheet
•  You may adjust your payments within the same school district by enter-   period, you should continue to adjust your next SD 101(s) until you are 
 ing your underpayment or overpayment from a prior period during the        in balance for that district.
 same taxable year and showing the net amount beside that school district 
 number below. Do not show a net amount below zero on Ohio form            •  Any adjustments between school districts (negatives) can only be made 
 SD 101 long. If you cannot use up your overpayment for that district this  on your annual reconciliation, Ohio form SD 141. 

                                         School District 
 School District Name                    Number          This Period        Underpayment                 (Overpayment)       Period Net

               Please make additional copies of this worksheet as necessary.