PDF document
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                                                          Rev. 09/19/22
   Department of
   Taxation
hio

Scan Specifications for the 

2022 Ohio IT 1041

   Important Note

The following document (2022 Ohio IT 1041) 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 2022 Ohio IT 1041 test samples must be initially submitted 
by December 1, 2022 and approved no later than April 1, 2023. 

                        Ohio Department of Taxation

                        4485 Northland Ridge Blvd.

                        Columbus, OH 43229

                        tax.ohio.gov



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   Department of
   Taxation
hio

General information 

regarding this form



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                              General Information

1) Dimensions: 
  
  Target or registration marks - 0.25” diameter circles. 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 1041.

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 (221801XX - 221808XX). 

  22 = tax year
  18 = Ohio IT 1041 
  01-08 = 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) Use Arial or Courier font for the static text on the form. The static text for all target marks and header informa-
tion (target marks, logo, title and 1D barcode) must match grid. Note: Courier must be used for the static tax 
year in the form title.

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

8) The possible negative fields for this return are lines 1, 2, 3, 4, 5, 6, 42, 51, 52, 56, 57, 59, 61, 62, 64, 65, 66, 
67, 68, and 72. Do not hard-code negative signs.

9) 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.

10) Any other documentation generate the following message for customers: “Do not enclose other documenta-
tion 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. Duplicates of page 8 or any 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

11) The 1041 Schedule XIV pages 6-8 can include up to 13 beneficiaries. Generate duplicate copies of page 8 to 
accommodate any additional investors, however omit the standard 1D and 2D barcodes from the duplicate pages 
and include the 10211411 barcode indicated above.



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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) For all balance due returns, generate the proper payment voucher.

14)*Important Note* Non-applicable lines must populate blank in the 2D barcode and show blank on the forms 
unless otherwise described in the schema. Schema guidelines must be followed.

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



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               Department of
               Taxation
 hio

 Additional instructions 

 for the 2D barcode

 regarding submissions, 

 testing and notifications 

 for the 2022 Ohio IT 1041

               Important Note

 It is required that vendors program the Ohio IT 1041 to include 2D barcodes.



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                                      2022 Ohio IT 1041

                       Fiduciary Income Tax Return

                                2D Barcode Instructions
General Information
 •  The Ohio IT 1041 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
 Optimal dpi level is 300 dpi. The mimimum dpi level is 200 dpi

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
   <CR> equals single carriage return character
   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 the 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 ver-
            sion. 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 2218<CR>
            Spec Version 0<CR> 
            Form Version 1<CR>
            Date Generated 011523<CR> 
            Line Item Specific Data IN<CR>
            Line Item Specific Data IT40<CR> 
            Line Item Specific Data 0<CR>
            Trailer *EOD* <CR>



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Submission Process
   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_ 22_1041
   Submissions must include
       One (1) full field sample in a PDF format
       Nine (9) test scenarios for the Ohio IT 1041 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 numbere.g.12_ABCTax_22_1041_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 1041 bundle packets commences on October 31, 2022 
   The deadline for an initial submission of Ohio IT 1041 bundle test packets is December 1, 2022 
   The deadline for approval of Ohio IT 1041 bundle test packets is April 18, 2023
   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):

         10211411

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 may 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 a visual indicator signifying the return can-
   not be filed is present on every page of the return.
 An emailed confirmation is sent to the vendor indicating the packet was approved, at which point the product is authorized to re-
   move the indicator.
 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, 2023 vendors will be notified and required to submit revised test packets.



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   Department of
   Taxation
hio

Grid layout



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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
2
3                                                               Do not staple or paper clip.
4
5                                                                                                               2022  Ohio IT 1041 
6                                                                                   Rev. 7/25/22   Fiduciary Income Tax Return
7                                                                                                                                                                                                                                                 22180110
8                                                                                                Use only black ink and UPPERCASE letters. Use whole dollars only.
                                                          88 88 88
9
                                                                                                                                                                                                                                                    Reporting Period Start Date
10                                                                 X         Check here if amended return                        X Check here if final return
11                                                                 X         Check here if federal extension filed               X Check here if income                                                                                               XX XX XX
12                                                                                                                                 distributed to a beneficiary
13                                                         FEIN                                   SSN of decedent (estates only)                                                                                                                    Reporting Period End Date
14
                                                           88 8888888                             888 88 8888                                                                                                                                         XX XX XX
15                                                         Name of trust or estate
16
                                                           JOHNXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
17
18                                                         Name of trust or estate (second line)
19
                                                           JANEXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
20
21                                                         Fiduciary name and title
22
                                                           THE NAME AND TITLEXXXXXXXXXXXXXXXXX
23
24                                                         Address         X Check here if address changed 
25
                                                           8888 BERRY AVEXXXXXXXXXXXXXXXXXXXXX
26                                                         City                                                                    State                 ZIP code
27
                                                           CITYXXXXXXXXXXXXXXXX                                                    OH                    88888
28
29                                                         Foreign State Code      Country Code    Foreign country (if the mailing address is outside the U.S.)                                                                                     Foreign postal code
30
                                                           ABC                          AB         ANYCOUNTRYXXXXXXXXXX                                                                                                                             AB88888
31
32                                                                           Trust Must Select One                               Trusts Select All That Apply
33                                                              Simple trust       OR             Complex trust       Irrevocable trust                    Testamentary trust                                                                       Check here if “qualify-
                                                           X                            X                           X                                    X                                                                                        X ing pre-income tax 
34                                                                           Trust Must Select One                               Estate Must Select One                                                                                             trust” (Attach letter of 
35                                                         X    Resident trust     OR   X         Nonresident trust X Bankruptcy estate OR               X Decedent’s estate                                                                        exemption)
36
37                                                              Schedule I – Taxable Income, Tax, Payments and Net Amount Due (If the amount on a line is negative, place a “–“ in the box provided.)
38                                                         
39                                                         1.   Federal taxable income (federal 1041, line 23)  Include page 1 of the federal 1041.................1.                                                                           - 888888888888
40
41                                                          2.   Net Schedule II adjustments from line 42 ....................................................................................2.                                                - 888888888888
42
43                                                          3.   Ohio taxable income (line 1 plus or minus line 2). Estates should skip to line 8 .........................3.                                                                   - 888888888888
44
                             Do not staple or paper clip. 
45                                                          4.   Trusts - Qualifying Trust Amount (from line 61) ...........................................................................4.                                                  - 888888888888
46
47                                                          5.   Trusts - Apportioned income (from line 64)..................................................................................5.                                                 - 888888888888
48
49                                                          6.   Trusts - Modified nonbusiness income (from line 67) ..................................................................6.                                                       - 888888888888
50                                                          7.  Trusts - Modified Ohio Taxable Income (sum of lines 4 through 6, if negative, enter zero) .................. 7.                                                                   888888888888
51
52                                                          8.   Tax liability on line 3 (estates) or line 7 (trusts). See instructions for tax tables. ..................................... 8.                                   
                                                                                                                                                                                                                                                  888888888888
53                                                          9.   Estates - Credits from line 50 ................................................................................................................... 9.                            888888888888
54
55                                                        10.   Credits from Schedules IV, V, IX and E ..................................................................................................10.                                      888888888888
56
57
58
59
60                                                                           Software vendors: Place 2D barcode in this location                                                                                                                MM DD      YY      CODE
61                                                                           Do not place a box around the 2D barcode. The box 
62                                                                                 is only here for placement purposes.
63
64                                                                                                                                                       2022 IT 1041 pg.   of12                                                                         8
65
66



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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
2
3
4
5                                              2022 Ohio IT 1041

6  FEIN                          Rev. 7/25/22
7                                                                                                                                                    22180210
   88 8888888
8    11. Tax liability after nonrefundable credits (Line 8 minus lines 9 and 10) ......................................11.                           888888888888
9
10   12. Interest penalty on underpayment of estimated tax (include Ohio IT/SD 2210) ....................... 12.
                                                                                                                                                     888888888888
11   13. Total Ohio tax liability (add lines 11 and 12) ............................................................................. 13.
                                                                                                                                                     888888888888
12
13   14. Net payments from line 80 ....................................................................................................... 14.       888888888888
14   15. Refundable business credits from line 87 (include documentation / certificates) ..................... 15.                                   888888888888
15   16. Total payments and refundable business credits (add lines 14 and 15) ................................... 16.                                888888888888
16   17. Overpayment (if line 16 is more than 13, subtract 13 from 16, if negative, 
17       enter zero and skip to line 20.  ................................................................................................. 17.      888888888888
18   18. Amount of line 17 to be credited toward next year’s liability (if this is an amended return, 
19       enter zero) .............................................................................. CREDIT CARRYFORWARD18.                          888888888888
20   19. Amount of line 17 to be refunded (subtract line 18 from line 17) ..........................     REFUND19.                                  888888888888
21
     20. Tax due, if any (if line 13 is more than line 16, subtract line 16 from line 13, 
22       if negative, enter zero ............................................................................................................... 20. 888888888888
23
     21. Interest due on late payment of tax (see instructions) .............................................................. 21.
24                                                                                                                                                   888888888888
     22. Total amount due (add lines 20 and 21). Make check payable to Ohio Treasurer of State, 
25       include Ohio IT 1041 UPC and write FEIN on check .................................. AMOUNT DUE22.                                          888888888888
26
                      If your refund is $1.00 or less, no refund will be issued. If you owe $1.00 or less, no payment is necessary.
27
28 Sign Here (required): I have read this return. Under penalties of perjury, I declare that, to                                                     Do not staple or paper clip. 
29 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-1s, after the last page of this return.
30
31 Signature of fiduciary or trust officer     Preparer’s name (print)
                                                                                                                                                     Mail to: 
32
33 Title                      Date (MM/DD/YY)  Preparer’s address (include ZIP code)                                                                 Ohio Department of Taxation 
34                                                                                                                                                   P.O. Box 2619 
   Fiduciary’s or trust officer’s phone number Preparer’s phone number
35                                                                                                                                                   Columbus, OH 43216-2619
36 Preparer’s e-mail address                                        PTIN                            P 88888888
37                                                                                                                                                   Instructions for this form are 
38 Check here if you authorize your preparer to contact us regarding this return.                     X                                              available at tax.ohio.gov.
39
40 Schedule II - Adjustments to Federal Taxable Income
41 Additions (Add the following if not included on Ohio IT 1041, line 1)
42   23.  Federal and/or non-Ohio state or local government interest and dividends not distributed ......................23.                         888888888888
43   24.  Pass-through entity taxes paid/electing pass-through entity taxes paid .....................................................24.            888888888888
44
45   25. Income from an electing small business trust (ESBT) not shown in federal taxable income
46        (include documentation)   ............................................................................................................25.  888888888888
47
48   26. Losses from sale or disposition of Ohio public obligations ........................................................26.                      888888888888
49   27. Reimbursement of expenses previously deducted on an Ohio IT 1041 tax return ....................27.                                         888888888888
50
51   28. IRC §168(k) bonus depreciation and §179 expense add-back .................................................28.                               888888888888
52        X 2/3,  X   5/6 or     X 6/6 (check applicable box and complete Schedule XIII)
53   29.  Federal personal exemption (estates only) and federal conformity additions ........................................29.                     888888888888
54   30. Expenses claimed on Ohio estate return (estates only) ............................................................30.                       888888888888
55   31. Total additions (add lines 23 through 30) ..................................................................................31.             888888888888
56
57
58
59
60                    Software vendors: Place 2D barcode in this location
61                    Do not place a box around the 2D barcode. The box 
62                               is only here for placement purposes.
63
64                                                                                                                      2022 IT 1041 pg.   of22                 8
65
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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
2
3
4
5                                                     2022 Ohio IT 1041
6                              Rev. 7/25/22
7                                                                                                                                                           22180310
8     FEIN
9
10    88 8888888                           If the amount on a line is negative, place a “–” in the box provided.
   Schedule II – Adjustments to Federal Taxable Income...continued.
11              – Note: Deduct income items described below only to the extent that those amounts 
   Deductions
12 are not already deducted or excluded from federal taxable income after distributions.
13 32.  Federal interest and dividends exempt from state taxation ...................................................... 32.                                888888888888
14
15 33.  Certain municipal and state income tax overpayments ............................................................ 33.                                888888888888
16
17 34.  Losses from an ESBT not shown in federal taxable income (include documentation) ............. 34.                                                   888888888888
18
19 35.  Wages and expense not deducted based on the federal work opportunity tax credit. .............. 35.                                                 888888888888
20
   36.  Interest income from Ohio public obligations and purchase obligations; gains from 
21      the sale or other disposition of Ohio public obligations ............................................................. 36.                          888888888888
22
   37.  Refunds or reimbursements of prior year federal itemized deductions and any 
23      federal conformity deductions ................................................................................................... 37.               888888888888
24
25 38.  Farm income from a farm of at least 10 acres (trusts only) ...................................................... 38.                               888888888888
26
27 39.  Deduction for prior year IRC §168(k) bonus depreciation and §179 expense add-backs ........ 39.                                                     888888888888
28
29 40.  Repayment of income reported in a prior year ......................................................................... 40.                          888888888888
30
31 41.  Total deductions (add lines 32 through 40) ............................................................................... 41.                      888888888888
32
33 42.  Net adjustments (line 31 minus line 41). Enter here and on line 2 ........................................... 42.                                 - 888888888888
34
35 Schedule III – Estate Credits
36 43.  Retirement income credit (see instructions for credit table) (limit – $200) ................................ 43.
                                                                                                                                                                    888
37 44.  Lump sum retirement credit (see instructions for worksheet; include a copy) .......................... 44.
                                                                                                                                                            888888888888
38 45.  Senior citizen credit (limit - $50 per return) ............................................................................... 45.
39                                                                                                                                                                  88
40 46.  Lump sum distribution credit (see instructions for worksheet; include a copy) ......................... 46. 
                                                                                                                                                            888888888888
41 47.  Child and dependent care credit (see instructions and worksheet in Ohio IT 1041 booklet) .... 47.                                                   888888888888
42 48.  Campaign contribution credit for Ohio statewide office or General Assembly .......................... 48.                                                   888
43 48a. Scholarship donations credit ................................................................................................... 48a.                       888
44 49.  Vocational job credit and/or Ohio adoption credit (adoption credit limit $10,000) ..................... 49.                                         888888888888
45 50.  Total estate credits (add lines 43 through 49) Enter here and on line 9 ................................... 50.                                     888888888888
46
47 Schedule IV – Estate Resident Credit
   51.  Portion of Ohio taxable income (line 3) subjected to tax by another state or the 
48      District of Columbia while you were an Ohio resident (include Ohio IT RCTE) ........................ 51.                                          - 888888888888
49 52.  Ohio taxable income (line 3) ..................................................................................................... 52.            - 888888888888
50 53.  Divide line 51 by line 52 and enter percentage888.88here                      %. Multiply this percentage by 
51      the amount shown on line 8 reduced by any amount shown on line 9 ..................................... 53.                                          888888888888
52
53 54.  2022 income tax liability after credits paid to another state or the District of Columbia ............ 54.
                                                                                                                                                            888888888888
54 55.  Enter the lesser of line 53 or line 54. This is your Ohio resident tax credit. Enter here and
55      on line 10 .................................................................................................................................. 55.   888888888888
56
57
58
59
60                  Software vendors: Place 2D barcode in this location
61                  Do not place a box around the 2D barcode. The box 
62                             is only here for placement purposes.
63
64                                                                                                                   2022 IT 1041 pg.   of23              8
65
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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
2
3
4
5                                                      2022 Ohio IT 1041
6                              Rev. 7/25/22
7                                                                                                                                                         22180410
8  FEIN
9
   88 8888888
10
   Schedule V – Estate Nonresident Credit
11
12 56.  Nonresident portion of Ohio taxable income - Ohio IT NRCE, 
        Section B, line 15 (include a copy) ............................................................................................56.             - 888888888888
13 57.  Ohio taxable income (line 3) ......................................................................................................57.          - 888888888888
14 58.  Divide line 56 by line 57 and enter percentage888.88here                     %. Multiply this percentage by the
15      amount shown on line 8 less line 9 and total Ohio Schedule E nonrefundable credits. 
16      Enter here and on line 10 ..........................................................................................................58.           888888888888
17 Schedule VI – Qualifying Trust Amounts
18
19 59.  Certain capital gains/ losses included in the Ohio taxable income (line 3) of a trust 
20      (see instructions) .......................................................................................................................59.   - 888888888888
21 60.  Ratio of the qualifying investees’ physical assets in Ohio to its total physical assets ...............60.                                        8.8888
22 61.  Qualifying Trust Amount (line 59 times line 60). Enter here and on line 4. ................................61.                                  - 888888888888
23
24 Schedule VII – Trust Apportioned Income
25
26
   62.  Portion of Ohio taxable income (line 3) less amounts included on line 59, that is 
27      business income or qualifying investment income ....................................................................62.                         - 888888888888
28     
29 63.  Ohio apportionment ratio from line 78 .......................................................................................63.                  8.888888
30
31 64.  Trust’s Apportioned Income (line 62 times line 63). Enter here and on line 5. ..........................64.                                     - 888888888888
32
33
34 Schedule VIII – Modified Nonbusiness Income for Trusts
35 Income/ Loss from a pass-through entity should generally be reported on Schedule VII.
36
   65.  Resident trusts: Portion of Ohio taxable income (line 3) not reported on 
37      lines 59 or 62 .............................................................................................................................65. - 888888888888
38
39 66.  Nonresident trusts: Portion of Ohio taxable income (line 3) not reported on lines 
40      59 or 62 that was derived from Ohio real or tangible property or is apportioned 
        to Ohio under R.C. 5747.212 (see instructions) ........................................................................66.                      - 888888888888
41
42 67.  Modified Nonbusiness Income (line 65 plus line 66). Enter here and on line 6                   .........................67.                     - 888888888888
43
44
45 Schedule IX – Trust Resident Credit (include the Ohio IT RCTE)
46
47 68.  Portion of line 65 subject to tax in another state or the District of Columbia .............................68.                                 - 888888888888
48 69.  Tax liability on modified taxable income (from line 8) ................................................................69.                        888888888888
49 70.  Modified Ohio taxable income from line 7 .................................................................................70.                     888888888888
50
51 71.  Effective Tax Rate (line 69 divided by line 70) ...........................................................................71.                    8.8888
52 72.  Line 68 times line 71 .................................................................................................................72.      - 888888888888
53
   73.  Taxes paid on the trust’s modified nonbusiness income to another state or the 
54      District of Columbia ...................................................................................................................73.       888888888888
55
56 74.  Trust’s resident credit (lesser of line 72 or 73) ..........................................................................74.                   888888888888
57
58
59
60                    Software vendors: Place 2D barcode in this location
61                    Do not place a box around the 2D barcode. The box 
62                             is only here for placement purposes.
63
64                                                                                                                  2022 IT 1041 pg.   of24             8
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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
2
3
4
5                                                       2022 Ohio IT 1041
6                              Rev. 7/25/22
7                                                                                                                                                   22180510
8   FEIN
9
    88 8888888
10 Schedule X - Apportionment Worksheet
11
   Use this schedule to calculate the apportionment ratio for the trust’s modified business income and qualifying investment income.
12 Note: Carry all ratios to six decimal places.
13                                                          Within Ohio                                                                              Total Everywhere
     75. Property 
14     a) Owned (original cost)                             888888888888                                                                            888888888888
15
16                                                          Within Ohio                                                                              Total Everywhere
    
17     b) Rented (annual rental X 8)                        888888888888                                                                            888888888888
18
19                                                          Within Ohio                                                                              Total Everywhere
20     c) Total (lines 75a and 75b)                         888888888888                                                                   ÷        888888888888
21                                                                                      Ratio                                                Weight   Weighted Ratio
22                                                                                    =                                                    x        =
                                                                                        8.888888                                             8.88     8.888888
23
24                                                          Within Ohio                                                                              Total Everywhere
25   76.  Payroll                                           888888888888                                                                   ÷        888888888888
26
27                                                                                      Ratio                                                Weight   Weighted Ratio
28
                                                                                      =                                                    x 8.88   = 8.888888
29                                                                                      8.888888
30                                                          Within Ohio                                                                              Total Everywhere
31   77.  Sales                                             888888888888                                                                   ÷        888888888888
32
33                                                                                      Ratio                                                Weight   Weighted Ratio
34                                                                                    = 8.888888                                           x 8.88   = 8.888888
35
36   78.  Ohio apportionment ratio (add weighted ratio from lines 75c, 76 and 77). Enter ratio here and 
       on line 63 (carry to six decimal places) ...................................................................................... 78.            8.888888
37
38 Note: If the “Total Everywhere” 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%.
39
   Schedule XI - Net Payment Worksheet – Include 1099(s) and W-2(s)
40
   79a. Estimated payments                                     79b. 1099 withholdings                   79c. W-2 withholdings
41
42
            88888888                                    88888888                                                                           88888888
43
   79d. Prior year credit carryover                   79e. Refunds previously claimed                             80. Net payments add lines 79a-d minus line 79e 
44                                                                                                                                         Enter here and on page 2, line 14.
45
            88888888                                   88888888                                                                            88888888
46
47 Schedule XII - Refundable Business Credits
48 Note: Certificates from the Ohio Department of Development and/or Ohio IT K-1s must be included to verify each refundable credit claimed.
49 81.  Motion picture / Broadway Credit                  82.   JCTC / JRTC                             83.   Pass-through entity credit
           
50
            88888888                                   88888888                                                                            88888888
51
52 84.  Venture capital credit                        85.  Ohio historic preservation credit            86.  Reserved                                
53
            88888888                                    88888888
54
55 87. Total refundable business credits (add lines 81-86). Enter here and on line 15.
56
            888888888
57
58
59
60                Software vendors: Place 2D barcode in this location
61                Do not place a box around the 2D barcode. The box 
62                             is only here for placement purposes.
63
64                                                                                               2022 IT 1041 pg.   of25                                  8
65
66



- 14 -
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
2
3
4
5                                                                       2022 Ohio IT 1041
6                                  Rev. 7/25/22
7                                                                                                                        22180610
8    FEIN
9
     88 8888888
10 Schedule XIII IRC  168K§Bonus Depreciation and  179 Expense§       Add-back Schedule
          
11 X Check the box if partial or full depreciation add-back has been waived
12 88. Current year IRC §168(k) bonus depreciation and §179 expense add-back ..............................88.           888888888888
13 89. Prior years add-back amount and applicable add-back ratio                 Column (A) – Amount                     Column (B) – Ratio
14   
15          89a. Year Prior........................................89a.          888888888888                          X 2/3                X 5/6                  X   6/6
16
17          89b. 2 Years Prior ...................................89b.           888888888888                          X 2/3                X 5/6                  X   6/6
18
19          89c. 3 Years Prior ...................................89c.           888888888888                          X 2/3                X 5/6                  X   6/6
20
21          89d. 4 Years Prior ...................................89d.           888888888888                          X 2/3                X 5/6                  X   6/6
22
23          89e. 5 Years Prior ...................................89e.           888888888888                          X 2/3                X 5/6                  X   6/6
24
25
   Schedule XIV - Beneficiary Schedule
26 Provide beneficiary information for all beneficiaries of the estate or trust. Use an additional sheet, if necessary.
27   SSN                                        FEIN                                     Amount distributed
28
     888 88 8888                                88 8888888                               888888888
29
30   First name/entity                                                  M.I. Last name
31
     JOHNXXXXXXXXXXX                                                    Q        PUBLICXXXXXXXXXXXXXX
32   Address
33
     8888 CHERRY LANEXXXXXXXXXXXXXXXXXXX
34   City                                                                                State ZIP code
35
     CITYXXXXXXXXXXXXXXXX                                                                OH    88888
36
37   SSN                                        FEIN                                     Amount distributed
38
     888 88 8888                                88 8888888                               888888888 
39
40   First name/entity                                                  M.I. Last name
41
     JOHNXXXXXXXXXXX                                                    Q        PUBLICXXXXXXXXXXXXXX
42   Address
43
     8888 CHERRY LANEXXXXXXXXXXXXXXXXXXX
44   City                                                                                State ZIP code
45
     CITYXXXXXXXXXXXXXXXX                                                                OH    88888
46
47   SSN                                        FEIN                                     Amount distributed
48
     888 88 8888                                88 8888888                               888888888
49
50   First name/entity                                                  M.I. Last name
51
     JOHNXXXXXXXXXXX                                                    Q        PUBLICXXXXXXXXXXXXXX
52   Address
53
     8888 CHERRY LANEXXXXXXXXXXXXXXXXXXX
54   City                                                                                State ZIP code
55
     CITYXXXXXXXXXXXXXXXX                                                                OH    88888
56
57
58
59
60                    Software vendors: Place 2D barcode in this location
61                      Do not place a box around the 2D barcode. The box 
62                             is only here for placement purposes.
63
64                                                                                             2022 IT 1041 pg.   of26   8
65
66



- 15 -
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
2
3
4
5                                                  2022 Ohio IT 1041
                                                        FEIN
6                    Rev. 7/25/22
                                                   88 8888888                  22180710
7  Schedule XIV - Beneficiary Schedule continued...
8  SSN                           FEIN                    Amount distributed
9
10 888 88 8888                   88 8888888              888888888
11 First name/entity                               M.I. Last name
12
   JOHNXXXXXXXXXXX                                 Q    PUBLICXXXXXXXXXXXXXX
13 Address
14
   8888 CHERRY LANEXXXXXXXXXXXXXXXXXXX
15 City                                                          State ZIP code
16
17 CITYXXXXXXXXXXXXXXXX                                          OH    88888
18 SSN                           FEIN                    Amount distributed
19
   888 88 8888                   88 8888888              888888888
20
21 First name/entity                               M.I. Last name
   JOHNXXXXXXXXXXX
22                                                 Q    PUBLICXXXXXXXXXXXXXX
23 Address
24
   8888 CHERRY LANEXXXXXXXXXXXXXXXXXXX
25 City                                                          State ZIP code
26
   CITYXXXXXXXXXXXXXXXX                                          OH    88888
27
28 SSN                           FEIN                    Amount distributed
29
   888 88 8888                   88 8888888              888888888
30
31 First name/entity                               M.I. Last name
   JOHNXXXXXXXXXXX
32                                                 Q    PUBLICXXXXXXXXXXXXXX
33 Address
34
   8888 CHERRY LANEXXXXXXXXXXXXXXXXXXX
35 City                                                          State ZIP code
36
   CITYXXXXXXXXXXXXXXXX                                          OH    88888
37
38 SSN                           FEIN                    Amount distributed
39
40 888 88 8888                   88 8888888              888888888
41 First name/entity                               M.I. Last name
42
   JOHNXXXXXXXXXXX                                 Q    PUBLICXXXXXXXXXXXXXX
43 Address
44
   8888 CHERRY LANEXXXXXXXXXXXXXXXXXXX
45 City                                                          State ZIP code
46
47 CITYXXXXXXXXXXXXXXXX                                          OH    88888
48 SSN                           FEIN                    Amount distributed
49
50 888 88 8888                   88 8888888              888888888
51 First name/entity                               M.I. Last name
52
   JOHNXXXXXXXXXXX                                 Q    PUBLICXXXXXXXXXXXXXX
53 Address
54
   8888 CHERRY LANEXXXXXXXXXXXXXXXXXXX
55 City                                                          State ZIP code
56
57 CITYXXXXXXXXXXXXXXXX                                          OH    88888
58
59
60        Software vendors: Place 2D barcode in this location
61        Do not place a box around the 2D barcode. The box 
62                   is only here for placement purposes.
63
64                                                                     2022 IT 1041 pg.   of278
65
66



- 16 -
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
2
3
4
5                                                  2022OhioFEINIT 1041
6                    Rev. 7/25/22
                                                   88 8888888                  22180810
7  Schedule XIV - Beneficiary Schedule continued...
8  SSN                           FEIN                    Amount distributed
9
10 888 88 8888                   88 8888888              888888888
11 First name/entity                               M.I. Last name
12
   JOHNXXXXXXXXXXX                                 Q   PUBLICXXXXXXXXXXXXXX
13 Address
14
   8888 CHERRY LANEXXXXXXXXXXXXXXXXXXX
15 City                                                          State ZIP code
16
17 CITYXXXXXXXXXXXXXXXX                                          OH    88888
18 SSN                           FEIN                    Amount distributed
19
   888 88 8888                   88 8888888              888888888
20
21 First name/entity                               M.I. Last name
   JOHNXXXXXXXXXXX
22                                                 Q   PUBLICXXXXXXXXXXXXXX
23 Address
24
   8888 CHERRY LANEXXXXXXXXXXXXXXXXXXX
25 City                                                          State ZIP code
26
   CITYXXXXXXXXXXXXXXXX                                          OH    88888
27
28 SSN                           FEIN                    Amount distributed
29
   888 88 8888                   88 8888888              888888888
30
31 First name/entity                               M.I. Last name
   JOHNXXXXXXXXXXX
32                                                 Q   PUBLICXXXXXXXXXXXXXX
33 Address
34
   8888 CHERRY LANEXXXXXXXXXXXXXXXXXXX
35 City                                                          State ZIP code
36
   CITYXXXXXXXXXXXXXXXX                                          OH    88888
37
38 SSN                           FEIN                    Amount distributed
39
40 888 88 8888                   88 8888888              888888888
41 First name/entity                               M.I. Last name
42
   JOHNXXXXXXXXXXX                                 Q   PUBLICXXXXXXXXXXXXXX
43 Address
44
   8888 CHERRY LANEXXXXXXXXXXXXXXXXXXX
45 City                                                          State ZIP code
46
47 CITYXXXXXXXXXXXXXXXX                                          OH    88888
48 SSN                           FEIN                    Amount distributed
49
50 888 88 8888                   88 8888888              888888888
51 First name/entity                               M.I. Last name
52
   JOHNXXXXXXXXXXX                                 Q   PUBLICXXXXXXXXXXXXXX
53 Address
54
   8888 CHERRY LANEXXXXXXXXXXXXXXXXXXX
55 City                                                          State ZIP code
56
57 CITYXXXXXXXXXXXXXXXX                                          OH    88888
58
59
60        Software vendors: Place 2D barcode in this location
61        Do not place a box around the 2D barcode. The box 
62                   is only here for placement purposes.
63
64                                                                     2022 IT 1041 pg.   of288
65
66



- 17 -
   Department of
   Taxation
hio

   Layout 

without grid



- 18 -
Do not staple or paper clip.
2022  Ohio IT 1041 
Rev. 7/25/22 Fiduciary Income Tax Return
22180110
Use only black ink and UPPERCASE letters. Use whole dollars only.
88 88 88
Reporting Period Start Date
X Check here if amended return X Check here if final return
X Check here if federal extension filed X Check here if income XX XX XX
distributed to a beneficiary
FEIN SSN of decedent (estates only) Reporting Period End Date
88 8888888 888 88 8888 XX XX XX
Name of trust or estate
JOHNXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX

Name of trust or estate (second line)
JANEXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
Fiduciary name and title
THE NAME AND TITLEXXXXXXXXXXXXXXXXX

Address         X Check here if address changed 
8888 BERRY AVEXXXXXXXXXXXXXXXXXXXXX
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
ABC AB ANYCOUNTRYXXXXXXXXXX AB88888
Trust Must Select One Trusts Select All That Apply
Simple trust OR Complex trust Irrevocable trust Testamentary trust Check here if “qualify-
X X X X X ing pre-income tax 
Trust Must Select OneEstate Must Select One trust” (Attach letter of 
X Resident trust OR X Nonresident trust X Bankruptcy estate OR X Decedent’s estate exemption)

Schedule I – Taxable Income, Tax, Payments and Net Amount Due (If the amount on a line is negative, place a “–“ in the box provided.)
 
 1.   Federal taxable income (federal 1041, line 23)  Include page 1 of the federal 1041.................1. - 888888888888

  2.   Net Schedule II adjustments from line 42 ....................................................................................2. - 888888888888

  3.   Ohio taxable income (line 1 plus or minus line 2). Estates should skip to line 8 .........................3. - 888888888888
Do not staple or paper clip. 
  4.   Trusts - Qualifying Trust Amount (from line 61) ...........................................................................4. - 888888888888

  5.   Trusts - Apportioned income (from line 64)..................................................................................5. - 888888888888

  6.   Trusts - Modified nonbusiness income (from line 67) ..................................................................6. - 888888888888
  7.  Trusts - Modified Ohio Taxable Income (sum of lines 4 through 6, if negative, enter zero) .................. 7.        888888888888
  8.   Tax liability on line 3 (estates) or line 7 (trusts). See instructions for tax tables. ..................................... 8.                                   
888888888888
  9.   Estates - Credits from line 50 ................................................................................................................... 9.                          888888888888

10.   Credits from Schedules IV, V, IX and E ..................................................................................................10. 888888888888

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

2022 IT 1041 pg.   of128



- 19 -
                                            2022 Ohio IT 1041

FEIN                          Rev. 7/25/22
                                                                                                                                                  22180210
88 8888888
  11. Tax liability after nonrefundable credits (Line 8 minus lines 9 and 10) ......................................11.                           888888888888
  12. Interest penalty on underpayment of estimated tax (include Ohio IT/SD 2210) ....................... 12.
                                                                                                                                                  888888888888
  13. Total Ohio tax liability (add lines 11 and 12) ............................................................................. 13.
                                                                                                                                                  888888888888

  14. Net payments from line 80 ....................................................................................................... 14.       888888888888
  15. Refundable business credits from line 87 (include documentation / certificates) ..................... 15.                                   888888888888
  16. Total payments and refundable business credits (add lines 14 and 15) ................................... 16.                                888888888888
  17. Overpayment (if line 16 is more than 13, subtract 13 from 16, if negative, 
      enter zero and skip to line 20.  ................................................................................................. 17.      888888888888
  18. Amount of line 17 to be credited toward next year’s liability (if this is an amended return, 
      enter zero) .............................................................................. CREDIT CARRYFORWARD18.                          888888888888
  19. Amount of line 17 to be refunded (subtract line 18 from line 17) ..........................     REFUND19.                                  888888888888
  20. Tax due, if any (if line 13 is more than line 16, subtract line 16 from line 13, 
      if negative, enter zero ............................................................................................................... 20. 888888888888
  21. Interest due on late payment of tax (see instructions) .............................................................. 21.                   888888888888
  22. Total amount due (add lines 20 and 21). Make check payable to Ohio Treasurer of State, 
      include Ohio IT 1041 UPC and write FEIN on check .................................. AMOUNT DUE22.                                          888888888888
                   If your refund is $1.00 or less, no refund will be issued. If you owe $1.00 or less, no payment is necessary.
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-1s, after the last page of this return.

Signature of fiduciary or trust officer     Preparer’s name (print)
                                                                                                                                                  Mail to: 
Title                      Date (MM/DD/YY)  Preparer’s address (include ZIP code)                                                                 Ohio Department of Taxation 
                                                                                                                                                  P.O. Box 2619 
Fiduciary’s or trust officer’s phone number Preparer’s phone number
                                                                                                                                                  Columbus, OH 43216-2619
Preparer’s e-mail address                                        PTIN                            P 88888888
                                                                                                                                                  Instructions for this form are 
Check here if you authorize your preparer to contact us regarding this return.                     X                                              available at tax.ohio.gov.
Schedule II - Adjustments to Federal Taxable Income
Additions (Add the following if not included on Ohio IT 1041, line 1)
  23.  Federal and/or non-Ohio state or local government interest and dividends not distributed ......................23.                         888888888888
  24.  Pass-through entity taxes paid/electing pass-through entity taxes paid .....................................................24.            888888888888
  25. Income from an electing small business trust (ESBT) not shown in federal taxable income
       (include documentation)   ............................................................................................................25.  888888888888

  26. Losses from sale or disposition of Ohio public obligations ........................................................26.                      888888888888
  27. Reimbursement of expenses previously deducted on an Ohio IT 1041 tax return ....................27.                                         888888888888

 28. IRC §168(k) bonus depreciation and §179 expense add-back .................................................28.                                888888888888
       X 2/3,  X   5/6 or     X 6/6 (check applicable box and complete Schedule XIII)
  29.  Federal personal exemption (estates only) and federal conformity additions ........................................29.                     888888888888
  30. Expenses claimed on Ohio estate return (estates only) ............................................................30.                       888888888888
  31. Total additions (add lines 23 through 30) ..................................................................................31.             888888888888

                   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.

                                                                                                                     2022 IT 1041 pg.   of22                 8



- 20 -
                                                   2022 Ohio IT 1041
                            Rev. 7/25/22
                                                                                                                                                         22180310
   FEIN

   88 8888888                           If the amount on a line is negative, place a “–” in the box provided.
Schedule II – Adjustments to Federal Taxable Income...continued.
Deductions – Note: Deduct income items described below only to the extent that those amounts 
are not already deducted or excluded from federal taxable income after distributions.
32.  Federal interest and dividends exempt from state taxation ...................................................... 32.                                888888888888

33.  Certain municipal and state income tax overpayments ............................................................ 33.                                888888888888

34.  Losses from an ESBT not shown in federal taxable income (include documentation) ............. 34.                                                   888888888888

35.  Wages and expense not deducted based on the federal work opportunity tax credit. .............. 35.                                                 888888888888
36.  Interest income from Ohio public obligations and purchase obligations; gains from 
     the sale or other disposition of Ohio public obligations ............................................................. 36.                          888888888888
37.  Refunds or reimbursements of prior year federal itemized deductions and any 
     federal conformity deductions ................................................................................................... 37.               888888888888

38.  Farm income from a farm of at least 10 acres (trusts only) ...................................................... 38.                               888888888888

39.  Deduction for prior year IRC §168(k) bonus depreciation and §179 expense add-backs ........ 39.                                                     888888888888

40.  Repayment of income reported in a prior year ......................................................................... 40.                          888888888888

41.  Total deductions (add lines 32 through 40) ............................................................................... 41.                      888888888888

42.  Net adjustments (line 31 minus line 41). Enter here and on line 2 ........................................... 42.                                 - 888888888888

Schedule III – Estate Credits
43.  Retirement income credit (see instructions for credit table) (limit – $200) ................................ 43.
                                                                                                                                                                 888
44.  Lump sum retirement credit (see instructions for worksheet; include a copy) .......................... 44.
                                                                                                                                                         888888888888
45.  Senior citizen credit (limit - $50 per return) ............................................................................... 45.
                                                                                                                                                                 88
46.  Lump sum distribution credit (see instructions for worksheet; include a copy) ......................... 46. 
                                                                                                                                                         888888888888
47.  Child and dependent care credit (see instructions and worksheet in Ohio IT 1041 booklet) .... 47.                                                   888888888888
48.  Campaign contribution credit for Ohio statewide office or General Assembly .......................... 48.                                                   888
48a. Scholarship donations credit ................................................................................................... 48a.                       888
49.  Vocational job credit and/or Ohio adoption credit (adoption credit limit $10,000) ..................... 49.                                         888888888888
50.  Total estate credits (add lines 43 through 49) Enter here and on line 9 ................................... 50.                                     888888888888
Schedule IV – Estate Resident Credit
51.  Portion of Ohio taxable income (line 3) subjected to tax by another state or the 
     District of Columbia while you were an Ohio resident (include Ohio IT RCTE) ........................ 51.                                          - 888888888888
52.  Ohio taxable income (line 3) ..................................................................................................... 52.            - 888888888888
53.  Divide line 51 by line 52 and enter percentage888.88here                      %. Multiply this percentage by 
     the amount shown on line 8 reduced by any amount shown on line 9 ..................................... 53.                                          888888888888
54.  2022 income tax liability after credits paid to another state or the District of Columbia ............ 54.
                                                                                                                                                         888888888888
55.  Enter the lesser of line 53 or line 54. This is your Ohio resident tax credit. Enter here and
     on line 10 .................................................................................................................................. 55.   888888888888

                 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.

                                                                                                                  2022 IT 1041 pg.   of23              8



- 21 -
                                                      2022 Ohio IT 1041
                            Rev. 7/25/22
                                                                                                                                                       22180410
FEIN
88 8888888
Schedule V – Estate Nonresident Credit
56.  Nonresident portion of Ohio taxable income - Ohio IT NRCE, 
     Section B, line 15 (include a copy) ............................................................................................56.             - 888888888888
57.  Ohio taxable income (line 3) ......................................................................................................      57.    - 888888888888
58.  Divide line 56 by line 57 and enter percentage888.88here                     %. Multiply this percentage by the
     amount shown on line 8 less line 9 and total Ohio Schedule E nonrefundable credits. 
     Enter here and on line 10 ..........................................................................................................58.           888888888888
Schedule VI – Qualifying Trust Amounts

59.  Certain capital gains/ losses included in the Ohio taxable income (line 3) of a trust 
     (see instructions) .......................................................................................................................59.   - 888888888888
60.  Ratio of the qualifying investees’ physical assets in Ohio to its total physical assets ...............60.                                        8.8888
61.  Qualifying Trust Amount (line 59 times line 60). Enter here and on line 4. ................................61.                                  - 888888888888

Schedule VII – Trust Apportioned Income

62.  Portion of Ohio taxable income (line 3) less amounts included on line 59, that is 
     business income or qualifying investment income ....................................................................62.                         - 888888888888
    
63.  Ohio apportionment ratio from line 78 .......................................................................................63.                  8.888888

64.  Trust’s Apportioned Income (line 62 times line 63). Enter here and on line 5. ..........................64.                                     - 888888888888

Schedule VIII – Modified Nonbusiness Income for Trusts
Income/ Loss from a pass-through entity should generally be reported on Schedule VII.

65.  Resident trusts: Portion of Ohio taxable income (line 3) not reported on 
     lines 59 or 62 .............................................................................................................................65. - 888888888888
66.  Nonresident trusts: Portion of Ohio taxable income (line 3) not reported on lines 
     59 or 62 that was derived from Ohio real or tangible property or is apportioned 
     to Ohio under R.C. 5747.212 (see instructions) ........................................................................66.                      - 888888888888

67.  Modified Nonbusiness Income (line 65 plus line 66). Enter here and on line 6                   .........................                 67.    - 888888888888

Schedule IX – Trust Resident Credit (include the Ohio IT RCTE)

68.  Portion of line 65 subject to tax in another state or the District of Columbia .............................68.                                 - 888888888888
69.  Tax liability on modified taxable income (from line 8) ................................................................69.                        888888888888
70.  Modified Ohio taxable income from line 7 .................................................................................               70.      888888888888

71.  Effective Tax Rate (line 69 divided by line 70) ...........................................................................              71.      8.8888
72.  Line 68 times line 71   .................................................................................................................72.    - 888888888888
73.  Taxes paid on the trust’s modified nonbusiness income to another state or the 
     District of Columbia ................................................................................................................... 73.      888888888888

74.  Trust’s resident credit (lesser of line 72 or 73) ..........................................................................             74.      888888888888

                   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.

                                                                                                                             2022 IT 1041 pg.   of24 8



- 22 -
                                                     2022 Ohio IT 1041
                            Rev. 7/25/22
                                                                                                                                                         22180510
 FEIN
 88 8888888
Schedule X - Apportionment Worksheet
Use this schedule to calculate the apportionment ratio for the trust’s modified business income and qualifying investment income.
Note: Carry all ratios to six decimal places.
  75. Property                                           Within Ohio                                                                                      Total Everywhere
    a) Owned (original cost)                             888888888888                                                                             888888888888

                                                         Within Ohio                                                                                      Total Everywhere
    b) Rented (annual rental X 8)                        888888888888                                                                             888888888888
                                                         Within Ohio                                                                                      Total Everywhere
    c) Total (lines 75a and 75b)                         888888888888                                                                   ÷         888888888888
                                                                                     Ratio                                                Weight                    Weighted Ratio
                                                                                   =                                                    x                =
                                                                                     8.888888                                             8.88                      8.888888
                                                         Within Ohio                                                                                      Total Everywhere
  76.  Payroll                                           888888888888                                                                   ÷         888888888888
                                                                                     Ratio                                                Weight                    Weighted Ratio
                                                                                   = 8.888888                                           x 8.88           =          8.888888
                                                         Within Ohio                                                                                      Total Everywhere
  77.  Sales                                             888888888888                                                                   ÷         888888888888

                                                                                     Ratio                                                Weight                    Weighted Ratio
                                                                                   = 8.888888                                           x 8.88           =          8.888888
 78.  Ohio apportionment ratio (add weighted ratio from lines 75c, 76 and 77). Enter ratio here and 
    on line 63 (carry to six decimal places) ...................................................................................... 78.                    8.888888
Note: If the “Total Everywhere” 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%.
Schedule XI - Net Payment Worksheet – Include 1099(s) and W-2(s)
79a. Estimated payments                                     79b. 1099 withholdings                                                  79c. W-2 withholdings

         88888888                                    88888888                                                                           88888888
79d. Prior year credit carryover                   79e. Refunds previously claimed                             80. Net payments add lines 79a-d minus line 79e 
                                                                                                                                        Enter here and on page 2, line 14.
         88888888                                   88888888                                                                            88888888

Schedule XII - Refundable Business Credits
Note: Certificates from the Ohio Department of Development and/or Ohio IT K-1s must be included to verify each refundable credit claimed.
81.  Motion picture / Broadway Credit                  82.   JCTC / JRTC                                                            83.   Pass-through entity credit
        
         88888888                                   88888888                                                                            88888888
84.  Venture capital credit                        85.  Ohio historic preservation credit                                           86.  Reserved         
         88888888                                    88888888
87. Total refundable business credits (add lines 81-86). Enter here and on line 15.
         888888888

               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.

                                                                                              2022 IT 1041 pg.   of25                                             8



- 23 -
                                                                     2022 Ohio IT 1041
                                Rev. 7/25/22
                                                                                                                      22180610
  FEIN
  88 8888888
Schedule XIII IRC  168K§Bonus Depreciation and  179 Expense§       Add-back Schedule
       X Check the box if partial or full depreciation add-back has been waived
88. Current year IRC §168(k) bonus depreciation and §179 expense add-back ..............................88.           888888888888
89. Prior years add-back amount and applicable add-back ratio                 Column (A) – Amount                     Column (B) – Ratio
  
         89a. Year Prior........................................89a.          888888888888                          X 2/3                X 5/6                  X   6/6

         89b. 2 Years Prior ...................................89b.           888888888888                          X 2/3                X 5/6                  X   6/6

         89c. 3 Years Prior ...................................89c.           888888888888                          X 2/3                X 5/6                  X   6/6

         89d. 4 Years Prior ...................................89d.           888888888888                          X 2/3                X 5/6                  X   6/6

         89e. 5 Years Prior ...................................89e.           888888888888                          X 2/3                X 5/6                  X   6/6

Schedule XIV - Beneficiary Schedule
Provide beneficiary information for all beneficiaries of the estate or trust. Use an additional sheet, if necessary.
  SSN                                        FEIN                                     Amount distributed
  888 88 8888                                88 8888888                               888888888

  First name/entity                                                  M.I. Last name
  JOHNXXXXXXXXXXX                                                    Q        PUBLICXXXXXXXXXXXXXX
  Address
  8888 CHERRY LANEXXXXXXXXXXXXXXXXXXX
  City                                                                                State ZIP code
  CITYXXXXXXXXXXXXXXXX                                                                OH    88888

  SSN                                        FEIN                                     Amount distributed
  888 88 8888                                88 8888888                               888888888 

  First name/entity                                                  M.I. Last name
  JOHNXXXXXXXXXXX                                                    Q        PUBLICXXXXXXXXXXXXXX
  Address
  8888 CHERRY LANEXXXXXXXXXXXXXXXXXXX
  City                                                                                State ZIP code
  CITYXXXXXXXXXXXXXXXX                                                                OH    88888

  SSN                                        FEIN                                     Amount distributed
  888 88 8888                                88 8888888                               888888888

  First name/entity                                                  M.I. Last name
  JOHNXXXXXXXXXXX                                                    Q        PUBLICXXXXXXXXXXXXXX
  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.

                                                                                            2022 IT 1041 pg.   of26   8



- 24 -
                                                2022 Ohio IT 1041
                                                     FEIN
                  Rev. 7/25/22
                                                88 8888888                  22180710
Schedule XIV - Beneficiary Schedule continued...
SSN                           FEIN                    Amount distributed
888 88 8888                   88 8888888              888888888
First name/entity                               M.I. Last name
JOHNXXXXXXXXXXX                                 Q    PUBLICXXXXXXXXXXXXXX
Address
8888 CHERRY LANEXXXXXXXXXXXXXXXXXXX
City                                                          State ZIP code
CITYXXXXXXXXXXXXXXXX                                          OH    88888
SSN                           FEIN                    Amount distributed
888 88 8888                   88 8888888              888888888
First name/entity                               M.I. Last name
JOHNXXXXXXXXXXX                                 Q    PUBLICXXXXXXXXXXXXXX
Address
8888 CHERRY LANEXXXXXXXXXXXXXXXXXXX
City                                                          State ZIP code
CITYXXXXXXXXXXXXXXXX                                          OH    88888
SSN                           FEIN                    Amount distributed
888 88 8888                   88 8888888              888888888
First name/entity                               M.I. Last name
JOHNXXXXXXXXXXX                                 Q    PUBLICXXXXXXXXXXXXXX
Address
8888 CHERRY LANEXXXXXXXXXXXXXXXXXXX
City                                                          State ZIP code
CITYXXXXXXXXXXXXXXXX                                          OH    88888

SSN                           FEIN                    Amount distributed
888 88 8888                   88 8888888              888888888
First name/entity                               M.I. Last name
JOHNXXXXXXXXXXX                                 Q    PUBLICXXXXXXXXXXXXXX
Address
8888 CHERRY LANEXXXXXXXXXXXXXXXXXXX
City                                                          State ZIP code
CITYXXXXXXXXXXXXXXXX                                          OH    88888
SSN                           FEIN                    Amount distributed
888 88 8888                   88 8888888              888888888
First name/entity                               M.I. Last name
JOHNXXXXXXXXXXX                                 Q    PUBLICXXXXXXXXXXXXXX
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.

                                                                    2022 IT 1041 pg.   of278



- 25 -
                                                2022OhioFEINIT 1041
                  Rev. 7/25/22
                                                88 8888888                  22180810
Schedule XIV - Beneficiary Schedule continued...
SSN                           FEIN                    Amount distributed
888 88 8888                   88 8888888              888888888
First name/entity                               M.I. Last name
JOHNXXXXXXXXXXX                                 Q   PUBLICXXXXXXXXXXXXXX
Address
8888 CHERRY LANEXXXXXXXXXXXXXXXXXXX
City                                                          State ZIP code
CITYXXXXXXXXXXXXXXXX                                          OH    88888
SSN                           FEIN                    Amount distributed
888 88 8888                   88 8888888              888888888
First name/entity                               M.I. Last name
JOHNXXXXXXXXXXX                                 Q   PUBLICXXXXXXXXXXXXXX
Address
8888 CHERRY LANEXXXXXXXXXXXXXXXXXXX
City                                                          State ZIP code
CITYXXXXXXXXXXXXXXXX                                          OH    88888
SSN                           FEIN                    Amount distributed
888 88 8888                   88 8888888              888888888
First name/entity                               M.I. Last name
JOHNXXXXXXXXXXX                                 Q   PUBLICXXXXXXXXXXXXXX
Address
8888 CHERRY LANEXXXXXXXXXXXXXXXXXXX
City                                                          State ZIP code
CITYXXXXXXXXXXXXXXXX                                          OH    88888

SSN                           FEIN                    Amount distributed
888 88 8888                   88 8888888              888888888
First name/entity                               M.I. Last name
JOHNXXXXXXXXXXX                                 Q   PUBLICXXXXXXXXXXXXXX
Address
8888 CHERRY LANEXXXXXXXXXXXXXXXXXXX
City                                                          State ZIP code
CITYXXXXXXXXXXXXXXXX                                          OH    88888
SSN                           FEIN                    Amount distributed
888 88 8888                   88 8888888              888888888
First name/entity                               M.I. Last name
JOHNXXXXXXXXXXX                                 Q   PUBLICXXXXXXXXXXXXXX
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.

                                                                    2022 IT 1041 pg.   of288






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