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Do not use staples.
Taxable year beginning in
IT 1040 Rev. 11/14
Individual
Use only black ink.  2014 Income Tax Return
Taxpayer Social Security no. (required) If deceased Spouse’s Social Security no. (only if joint return)If deceased Enter school district # for
this return (see pages 45-50).

Use UPPERCASE letters. check box check box SD#
Your ﬁrst name M.I. Last name

Spouse’s ﬁ rst name (only if married ﬁling jointly) M.I. Last name

Mailing address (for faster processing, use a street address)

City State ZIP code Ohio county (ﬁ rst four letters)

Home address (if different from mailing address) – do NOT show city or state ZIP code County (ﬁ rst four letters)

Foreign country (provide this information if the mailing address is outside the U.S.) Foreign postal code

Ohio Residency Status – Check applicable box Check applicable box for spouse (only if married ﬁling jointly)
Full-year Part-year Nonresident Full-year Part-year Nonresident
resident resident Indicate state resident resident Indicate state
Filing Status – Check one (as reported on federal income tax return, Required to ﬁ le Schedule IT S (see instructions on page 9)
with limited exceptions – see instructions on page 13)
Single, head of household or qualifying widow(er)
Do not staple or otherwise attach. Place your
Married ﬁling jointly W-2(s), check (payable to Ohio Treasurer of State),
Married ﬁling separately  Ohio form IT 40P and any other supporting documents
(enter spouse’s SS#) or statements after the last page of your return.
Include forms W-2G and 1099-R if tax was withheld.
Is someone else claiming you or your spouse (if joint return) Yes No
as a dependent?.....................................................................
Go paperless. It’s FREE!
Enter the number of dependents. If one or more, include Schedule J
with your Ohio income tax return (see instructions on page 19) ......... Visit tax.ohio.gov to try Ohio I-File.
Ohio Political Party Fund Yes No Most taxpayers who ﬁ le their returns electronically
Do you want $1 to go to this fund?.......................................... and request direct deposit will receive their refunds
in 10-15 business days. Paper returns will take
If joint return, does your spouse want $1 to go to this fund?...
Note: Checking “Yes” will not increase your tax or decrease your refund. approximately 30 days to process.

INCOME AND TAX INFORMATION – If amount is negative, shade the negative sign (“–”) in the box provided.
1. Federal adjusted gross income (from IRS forms 1040, line 37; 1040A, line 21;
1040EZ, line 4; 1040NR, line 36; 1040NR-EZ, line 10; or Ohio form IT S, line 31)... .... 1. , , , . 00

2. Adjustments from line 50 on page 3 of Ohio form IT 1040(enclose page 3) ..... .... 2. , , , . 00

3. Ohio adjusted gross income (line 2 added to or subtracted from line 1).............. .... 3. , , , . 00
4. Personal exemption and dependent exemption deduction (see page 19
of the instructions for information on Schedule J and exemption amount) ...................... 4. , . 00
5. Ohio taxable income (line 3 minus line 4; enter -0- if line 3 is less than line 4) ............... 5. , , , . 00
6. Tax on line 5 (see tax tables on pages 37-43 of the instructions) .................................................. 6. , , . 00

7. Schedule B credits from line 59 on page 4 of Ohio form IT 1040 (enclose page 4) ..................... 7. , , . 00
8. Ohio tax less Schedule B credits (line 6 minus line 7; enter -0- if line 6 is less than line 7) ...................8. , , . 00
9. Income-based exemption credit (see instructions on page 20) ..................................................... 9. . 00

10. Ohio tax less exemption credit (line 8 minus line 9; enter -0- if line 8 is less than line 9) ...................10. , , . 00
pg. 1 of 4
2014 IT 1040 2014 IT 1040

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                                                                                                           Taxable year beginning in 
                                                                                                                                                        IT 1040 Rev. 11/14 
                                                                                                                                                        Individual 
  SSN                                                                                                   2014                                    Income Tax Return 

 10a.  Amount from line 10 on page 1 ................................................................................................... 10a.           ,          ,                 . 00 
 11.  Joint ﬁling credit. See the instructions on page 20 for eligibility and documentation requirements                                                                               00 
    (this credit is for married ﬁling jointly status only).         % times line 10a (limit $650) ........... 11.                                                                    . 
 
  12.  Ohio income tax less joint ﬁling credit (line 10a minus line 11) ..................................................... 12.                       ,          ,                 . 00 
 
  13.  Total credits from line 71 on page 4 of Ohio form IT 1040 (enclose page 4) ............................... 13.                                   ,          ,                 . 00 
 
  14.  Earned income credit (see the worksheet on page 20 of the instructions) ................................... 14.                                                               . 00 
  15.  Ohio adoption credit ...................................................................................................................... 15.             ,                 . 00
  16.  Manufacturing equipment grant. You must include the grant request form ..........................................16.                             ,          ,                 . 00 
  17.  Ohio income tax (line 12 minus lines 13, 14, 15 and 16; enter -0- if the total of lines 13, 14, 15                                                                              00 
    and 16 is more than line 12) ......................................................................................................... 17.          ,          ,                 . 
  18.  Interest penalty on underpayment of estimated tax. Enclose Ohio form IT/SD 2210 (see page                                                                                       00 
    21 of the instructions) ....................................................................................................................... 18. ,          ,                 . 
  19.  Sales and use tax due on Internet, mail order or other out-of-state purchases (see                                                                                              00 
    instructions on page 34). If you certify that no sales or use tax is due, check here ................                       19.                     ,          ,                 . 
                                                                                                                                                                                       00 
  20.  Total Ohio tax liability (add lines 17, 18 and 19) ................................................... TOTAL TAX20.                             ,          ,                 . 
  21.  Ohio income tax withheld (box 17 on W-2; box 15 on W-2G; and box 12 on 1099-R). Place                                                                                           00 
    W-2(s), W-2G(s) and 1099-R(s) after the last page of this return ......... AMOUNT WITHHELD21.                                                      ,          ,                 . 
 22.  Add the 2014 Ohio form IT 1040ES payment(s), 2014 Ohio form IT 40P extension payment(s)                                                                                          00 
    and 2013 overpayment credited to 2014 ........................................................................................... 22.               ,          ,                 . 
                                                                                                                                                                                       00 
  23. Refundable credits from line 73 on page 4 of Ohio form IT 1040 (enclose page 4) ..................... 23.                                         ,          ,                 . 
  24. Add lines 21, 22 and 23 .............................................................................TOTAL PAYMENTS24.                           ,          ,                 . 00 
  If line 24 is MORE THAN line 20, go to line 25. If line 24 is LESS THAN line 20, skip to line 29. 
  25.  If line 24 is MORE THAN line 20, subtract line 20 from line 24............. AMOUNT OVERPAID25.                                                  ,          ,                 . 00 
 
  26.  Amount of line 25 to be credited to 2015 income tax liability ....................... CREDIT TO 201526.                                         ,          ,                 . 00 
  27.  Amount of line 25 that you wish to donate to the following fund(s): 
     a. Military injury relief          b. Wildlife species                                          c. Ohio Historical Society 
            ,             . 00                 ,            . 00                                     ,          . 00 
      d. State nature preserves         e. Breast / cervical cancer 
            ,             . 00                 ,            . 00
  28.  Line 25 minus the sum of lines 26 and 27a, b, c, d and e. Enter here, then skip to line 30 .......... 28.                                        ,          ,                 . 00 
  29.  If line 24 is LESS THAN line 20, subtract line 24 from line 20 ......................... AMOUNT DUE29.                                          ,          ,                 . 00 
  30.  Interest and penalty due on late-paid tax and/or late-ﬁled return (see page 22 of the                                                                                           00 
    instructions) ...................................................................................INTEREST AND PENALTY30.                           ,          ,                 . 
  If you entered an amount on line 28, skip to line 32. If you entered an amount on line 29, go to line 31. 
  31.  Amount due plus interest and penalty (add lines 29 and 30). If payment is enclosed, make 
    check payable to Ohio Treasurer of State and include Ohio form IT 40P (see our Web site at  
  tax.ohio.gov) ............................................AMOUNT DUE PLUS INTEREST AND PENALTY31.                                                    ,          ,                 . 00 
  32.  Refund less interest and penalty (line 28 minus line 30). Enter the amount here. 
    (If line 30 is more than line 28, you have an amount due. Subtract line 28 from 
    line 30 and enter this amount on line 31.) .............................YOUR  REFUND32.                                    ,                       ,          . 00 
  SIGN HERE (required): I have read this return. Under penalties of perjury, I declare that, to                                 If your refund is $1.00 or less, no refund will be issued. 
  the best of my knowledge and belief, the return and all enclosures are true, correct and complete.                              If you owe $1.00 or less, no payment is necessary. 
                                                                                                                                                        For Department Use Only 
 Your signature                                                            Date (MM/DD/YYYY) 
 Spouse’s signature (see page 10 of the instructions)                      Phone number (optional)                                                     ,          ,                 . 

  Preparer’s printed name (see page 10 of the instructions)                 Phone number 
                                                                                                                                                                                 Code 
  Do you authorize your preparer to contact us regarding this return?                                      Yes  No 
             NO Payment Enclosed   –Mail to:                   Enclose your federal income                                                              Payment Enclosed   –Mail to: 
                Ohio Department of Taxation                 tax return if line 1 on page 1 of this                                                      Ohio Department of Taxation 
                          P.O. Box 2679                             return is -0- or negative.                                                            P.O. Box 2057 
                  Columbus, OH  43270-2679                                                                                                              Columbus, OH  43270-2057 
                                                                            pg. 2 of 4
       2014 IT 1040                                                                                                                                     2014 IT 1040

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If line 2 (on page 1) is -0- or blank, do not mail page 3.

Taxable year beginning in
IT 1040 Rev. 11/14
Individual
SSN  2014 Income Tax Return

SCHEDULE A – Income Adjustments (Additions and Deductions)
Additions (add income items only to the extent not included on page 1, line 1).
33. Non-Ohio state or local government interest and dividends .........................................................33. , , . 00
34. Certain Ohio pass-through entity and ﬁnancial institutions taxes paid and Ohio Revised Code 00
section 5733.40(A) pass-through entity adjustment ......................................................................34. , , .
00
35a. Federal interest and dividends subject to state taxation .............................................................35a. , , .
b. Reimbursement of college tuition expenses and fees deducted in any previous year(s) and 00
noneducation expenditures from a college savings account ..........................................................b. , , .
c. Losses from sale or disposition of Ohio public obligations .............................................................c. , , . 00

d. Nonmedical withdrawals from a medical savings account ..............................................................d. , , . 00
e. Reimbursement of expenses previously deducted for Ohio income tax purposes, but only if 00
the reimbursement is not in federal adjusted gross income ............................................................e. , , .
, , .
f. Lump sum distribution add-back and miscellaneous federal income tax adjustments ....................f. 00
g. Adjustment for Internal Revenue Code sections 168(k) and 179 depreciation expense ................g. , , . 00

36. Total additions (add lines 33 through 35g ONLY and enter here) ................................36. , , , . 00

Deductions (deduct income items only to the extent included on page 1, line 1).

37a. Federal interest and dividends exempt from state taxation ........................................................37a. , , . 00
b. Adjustment for Internal Revenue Code sections 168(k) and 179 depreciation expense ................b. , , . 00
38. Employee compensation earned in Ohio by full-year residents of neighboring states and certain
income earned by military nonresidents and civilian nonresident spouses ....................................38. , , . 00
39a. Military pay for Ohio residents, but only if the military pay is included on line 1 of this return , , 00
and is received while the military member was stationed outside Ohio ......................................39a. .
b. Uniformed services retirement income and military injury relief fund amounts included in 00
federal adjusted gross income (line 1 on page 1) ...........................................................................b. , , .
40a. State or municipal income tax overpayments shown on IRS form 1040, line 10 ........................40a. , , . 00
b. Refund or reimbursements shown on IRS form 1040, line 21 for itemized deductions claimed
on a prior year federal income tax return ........................................................................................b. , , . 00
c. Repayment of income reported in a prior year and miscellaneous federal tax adjustments ...........c. , , . 00
41. Small business investor income deduction ...................................................................................41. , , . 00

42. Disability and survivorship beneﬁts (do not include pension continuation beneﬁ ts) .....................42. , , . 00
43. Qualifying Social Security beneﬁts and certain railroad retirement beneﬁ ts .................................43. , , . 00
44a. Education: Ohio 529 contributions; tuition credit purchases ...........................................................44a. , , . 00
b. Pell/Ohio College Opportunity taxable grant amounts used to pay room and board ..........................b. , , . 00

45. Certain Ohio National Guard reimbursements and beneﬁ ts .........................................................45. , , . 00
46a. Unreimbursed long-term care insurance premiums, unsubsidized health care insurance
premiums and excess health care expenses (see worksheet on page 28 of the instructions) ...46a. , , . 00
b. Funds deposited into, and earnings of, a medical savings account for eligible health care
expenses (see worksheet on page 24 of the instructions) ..............................................................b. , , . 00
c. Qualiﬁ ed organ donor expenses (maximum $10,000 per taxpayer) and amounts contributed 00
to an individual development account .............................................................................................c. , , .
47. Wage expense not deducted due to claiming the federal work opportunity tax credit ..................47. , , . 00
48. Interest income from Ohio public obligations and from Ohio purchase obligations; gains from
the sale or disposition of Ohio public obligations; public service payments received from the
state of Ohio or income from a transfer agreement ......................................................................48. , , . 00

, , , . 00
49. Total deductions (add lines 37a through 48 ONLY) ...................................................... 49.
50. Net adjustments – If line 36 is MORE THAN line 49, enter the difference here
and on line 2 as a positive amount. If line 36 is LESS THAN line 49, enter , , , . 00
the difference here and on line 2 as a negative amount ................................... ... 50.

2014 IT 1040 pg. 3 of 4 2014 IT 1040

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         If line 7 (page 1) and lines 13 and 23 (page 2) are all -0- or blank, do not mail page 4. 

                                                                                                Taxable year beginning in 
                                                                                                                                                           IT 1040    Rev. 11/14 
                                                                                                                                                           Individual 
  SSN                                                                                   2014                                                       Income Tax Return 

  SCHEDULE B – Nonbusiness Credits 

  51.  Retirement income credit (limit $200 per return). See the table on page 30 of the instructions .... 51.                                                                   . 00 

  52.  Senior citizen credit (you must be 65 or older to claim this credit; limit $50 per return) ............. 52.                                                              . 00
  53.  Lump sum distribution credit (you must be 65 or older to claim this credit) .................................. 53.                                  ,          ,          . 00
 
  54.  Child care and dependent care credit (see the worksheet on page 30 of the instructions) .......... 54.                                                         ,          . 00 
  55.  Lump sum retirement credit .......................................................................................................... 55.           ,          ,          . 00 
  56.  If line 5 on page 1 is $10,000 or less, enter $88; otherwise, enter -0- .......................................... 56.                                                    . 00 
  57.  Displaced worker training credit (see the worksheet and instructions on pages 31 and 32)                                                                                    00 
  (limit $500 per taxpayer) ............................................................................................................. 57.                         ,          . 
  58.  Ohio political contributions credit (limit $50 per taxpayer) .......................................................... 58.                                               . 00 
 
   59.  Total Schedule B credits (add lines 51 through 58). Enter here and on page 1, line 7 .............. 59.                                            ,          ,          . 00 
 
  SCHEDULE C – Full-Year Ohio Resident Credit 
 
  60.  Enter the portion of line 3 on page 1 subjected to tax by other states or the District of  
        Columbia while you were an Ohio resident (limits apply – see page   32 of the instructions) ...            60.                          ,          ,          ,          . 00 
  61.  Enter Ohio adjusted gross income (line 3 on page 1) .....................................................61.                             ,          ,          ,          . 00 

  62.  Divide line 60  by line 61 and enter the result here (four digits; do not round).. 
    Multiply this factor by the amount on line 12 and enter the result here........................................... 62.                                 ,          ,          . 00 
  63.	  Enter the 2014 income tax, less all credits other than withholding and estimated tax payments and 
    overpayment carryforwards from previous years, paid to other states or the District of Columbia 
    (limits apply – see page 32 of the instructions) ............................................................................. 63.                     ,          ,          . 00 
  64.  Enter the smaller of line 62 or line 63. This is your Ohio resident tax credit. Enter here and on 
    line 69 below. If you ﬁled    a return for 2014 with a state(s) other than Ohio, enter the two-letter 
    state abbreviation in the box(es) below .......................................................................................64.                     ,          ,          . 00 

  SCHEDULE D – Nonresident / Part-Year Resident Credit (date of part-year residency)                                                                                    to 
  65.  Enter the portion of Ohio adjusted gross income (line 3) that was not earned or received                                                                                    00 
    in Ohio. Include Ohio form IT 2023 if required (see page 32 of the instructions) ............65.                                            ,          ,          ,          .
  66.  Enter the Ohio adjusted gross income (line 3 on page 1) ...............................................66.                               ,          ,          ,          . 00 

  67.	  Divide line 65 by line 66 and enter the result here (four digits; do not round)..                                                                                          00
    Multiply this factor by the amount on line 12.              Enter here and on line 70 below .............................. 67.                         ,          ,          . 
  SUMMARY OF CREDITS FROM SCHEDULES C, D AND E 
  68.  Enter the amount from line 10 of Schedule E, Nonrefundable Business Credits (see page 32 of                                                                                 00 
        the instructions)............................................................................................................................. 68. ,          ,          . 
  69.  Enter the amount from line 64 above ............................................................................................ 69.                ,          ,          . 00
  70.  Enter the amount from line 67 above ............................................................................................ 70.                ,          ,          . 00
  71.  Add lines 68, 69 and 70. Enter here and on page 2, line 13 ...................................................... 71.                               ,          ,          . 00 
  REFUNDABLE CREDITS – INCLUDE CERTIFICATE(S) AND K-1(S) 
  72a. Business jobs credit                                   	 72b. Pass-through entity credit              72c. Historic preservation credit 
              ,           ,           . 00                            ,           ,             . 00                                            ,          ,          . 00 
  72d. Motion picture production credit                         72e. Financial Institutions Tax (FIT) credit  
              ,           ,           . 00      	                     ,           ,             . 00 
  73.   Total of lines 72a-e. Enter here and on page 2, line 23.
                    ,               ,           . 00
                                                                                  pg. 4 of 4 
              2014 IT 1040	                                                                                                                                2014 IT 1040

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Taxable year beginning in
Schedule J
Rev. 11/14
2014
Primary SS# 
Schedule J
Dependents Claimed on the Ohio IT 1040EZ or IT 1040 Return
Use UPPERCASE letters.
Use this dependent schedule to claim dependents on your Ohio form IT 1040EZ or IT 1040. If you have more than 14 dependents, copy page 2 of this sched-
ule and include all completed pages with your income tax return. Do not list on this schedule the primary and/or spouse reported on the income tax return.
1. Dependent’s Social Security no. (required) Dependent's date of birth (MM/DD/YYYY)

Dependent’s ﬁ rst name M.I. Last name

2. Dependent’s Social Security no. (required) Dependent's date of birth (MM/DD/YYYY)

Dependent’s ﬁ rst name M.I. Last name

3. Dependent’s Social Security no. (required) Dependent's date of birth (MM/DD/YYYY)

Dependent’s ﬁ rst name M.I. Last name

4. Dependent’s Social Security no. (required) Dependent's date of birth (MM/DD/YYYY)

Dependent’s ﬁ rst name M.I. Last name

5. Dependent’s Social Security no. (required) Dependent's date of birth (MM/DD/YYYY)

Dependent’s ﬁ rst name M.I. Last name

6. Dependent’s Social Security no. (required) Dependent's date of birth (MM/DD/YYYY)

Dependent’s ﬁ rst name M.I. Last name

Do not staple or otherwise attach. Place your W-2(s), check
(payable to Ohio Treasurer of State), Ohio form IT 40P and any
other supporting documents or statements after the last page of
your return. Include forms W-2G and 1099-R if tax was withheld.

Go paperless. It’s FREE!
Visit tax.ohio.gov to try Ohio I-File.
MostMost taxpayerstaxpayers whowho ﬁ le their returns electronically and request ﬁle their returns electronically and request
direct deposit will receive their refunds in 10-15 business days. direct deposit will receive their refunds in 10-15 business days.
Paper returns will take approximately 30 days to process.Paper returns will take approximately 30 days to process.

2014 Schedule J 2014 Schedule J
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Taxable year beginning in
Schedule J
Rev. 11/14
2014
Primary SS# 

Schedule J
Dependents Claimed on the Ohio IT 1040EZ or IT 1040 Return
Use UPPERCASE letters.
Use this dependent schedule to claim dependents on your Ohio form IT 1040EZ or IT 1040. If you have more than 14 dependents, copy page 2 of this sched-
ule and include all completed pages with your income tax return. Do not list on this schedule the primary and/or spouse reported on the income tax return.
7. Dependent’s Social Security no. (required) Dependent's date of birth (MM/DD/YYYY)

Dependent’s ﬁ rst name M.I. Last name

8. Dependent’s Social Security no. (required) Dependent's date of birth (MM/DD/YYYY)

Dependent’s ﬁ rst name M.I. Last name

9. Dependent’s Social Security no. (required) Dependent's date of birth (MM/DD/YYYY)

Dependent’s ﬁ rst name M.I. Last name

10. Dependent’s Social Security no. (required) Dependent's date of birth (MM/DD/YYYY)

Dependent’s ﬁ rst name M.I. Last name

11. Dependent’s Social Security no. (required) Dependent's date of birth (MM/DD/YYYY)

Dependent’s ﬁ rst name M.I. Last name

12. Dependent’s Social Security no. (required) Dependent's date of birth (MM/DD/YYYY)

Dependent’s ﬁ rst name M.I. Last name

13. Dependent’s Social Security no. (required) Dependent's date of birth (MM/DD/YYYY)

Dependent’s ﬁ rst name M.I. Last name

14. Dependent’s Social Security no. (required) Dependent's date of birth (MM/DD/YYYY)

Dependent’s ﬁ rst name M.I. Last name

2014 Schedule J 2014 Schedule J
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