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                                             9/30/16

2D Schema, Test 

Scenarios and Instructions 

2016 Ohio IT 
                           1041

Important Note

New for Tax Year 2016- It is now required that vendors program the 
Ohio IT 1041 to include 2D barcodes. This document contains the 
schema,  test  scenarios  and  instructions  needed  to  assist  vendors 
with this new requirement. 

                           Ohio Department of Taxation

                           4485 Northland Ridge Blvd.

                           Columbus, OH 43229

                           tax.ohio.gov

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                    2016 Ohio IT 1041 

             Fiduciary Income Tax Return 

                   2D Barcode Instructions 

General Information 
• The Ohio 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
• Products must not print a 2D barcode prior to being approved in Ohio

2D Barcode Size and Placement on the Form 
• 2D Barcode must be placed on each page of form in the designated area indicated in the
  grid layout
• The maximum size of the 2D Barcode is 3.5 inches wide by 1 inch in height and must fit
  within the designated space in the grid layout
• 2D Barcode must not be bigger than the allocated area

2D Barcode Layout 
• Each field in the barcode is delimited by a single carriage return
  o    <CR> equals single carriage return character
  o    This separates each piece of data so it may be identified and processed.
• Data included in the 2D Barcode can be broken down into three general sections

Header 
  Header Version Number 
       • Static for all Barcodes, value is T1
  Developer Code 
       • A four-digit vendor code identifying the software developer whose application
         produced the Barcode
  Jurisdiction 
       • Static for all Barcodes, value is OH
  Description 
       • A four-digit form identifier, specific to each form
  Spec Version 
       • A one-digit specification version control number starting with the number zero
       • This number identifies the version of the specifications used to produce the form
         Barcode
  Form Version 
       • A one-digit form version control number starting with the number one (1)
       • This number will only be incremented when there are changes made that would
         affect the content of the Barcode
  Date Generated 
       • Included on page 1 only
       • Indicates date return was generated from the product

Form Specific Data – Please see encoding schemas for form specific data 
  •    All fields on form are required and must be included in the 2D Barcode
  •    Fields with values are represented by the data followed by a carriage return

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  •     Fields with no values are represented by a carriage return only; this results in two
        adjacent carriage returns
  •     Note that the data format within the 2D barcode for the Weight, Ratio and Weighted
        Ratio differs from the print version. Do not include the decimal point in the 2D data.

Trailer 
  •     The last field in the Barcode data stream is the trailer
  •     The trailer is used to indicate the end of data has been reached
  •     A static string of *EOD* is used as the trailer value

Examples of 2D Barcode data streams 
  Header Version Number          T1<CR> 
  Developer Code                 1111<CR> 
  Jurisdiction                   OH<CR> 
  Description                    1618<CR> 
  Spec Version                   0<CR> 
  Form Version                   1<CR> 
  Date Generated                 011516<CR> 
  Line Item Specific Data        IN<CR>   
  Line Item Specific Data        IT40<CR> 
  Line Item Specific Data        0<CR> 
  Trailer                        *EOD* <CR>

Submission Process 
• The deadline for submitting Ohio 1041 test packets is November 25, 2016
• 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_ 16_1041
• Submissions must include
  •     Ohio form STF- Approval Request for Scannable Tax Forms
  •     One (1) full field sample in a PDF format
  •     Seven (7) test scenarios for the 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 number
          e.g.12_ABCTax_16_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 1041 packets commences on November 14, 2016
• 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

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 Notifications 
 •  Communications from the Ohio Department of Taxation regarding submissions are sent 
   from Forms@tax.state.oh.us  to the vendor email address(es) on file for the product 
 •  Vendor contact information is compiled from STF- Approval Request for Scannable Tax 
   Forms but may also be submitted by email to the address above.  
 •  If unapproved forms are released in software packages, vendors must include a visual 
   indicator signifying the return cannot be filed. 
 • If unapproved forms are released in software packages, vendors must ensure that 
   taxpayers cannot print returns containing 2D barcodes. 
 •  An emailed confirmation is sent to the vendor indicating the packet was approved, at 
   which point the product is authorized to print with a 2D barcode.  
 •  An emailed confirmation is sent to the vendor for packets that are rejected 
    •  Feedback is provided regarding the errors found 
    •  Resubmit packets must include all test scenarios and the full field return   
    •  After the third submission of test materials, the department cannot guarantee 
        timeliness of the review 
 •  If a tax form changes before January 1, 2017 vendors will be notified and required to 
   submit revised test packets. 
                
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                                             Ohio Department of Taxation
                                             2016 1041 2D Barcode Schema

     RATIO LINES & % OWNERSHIP LINES : Send as whole 
     number. First digit is the whole number, the decimal 
     point is interpreted internally and starting from 2nd digit                    General Fields
     to end of data is the decimal portion of the ratio.                            Demographic Fields
     Ex.:  0.092461 should be -----> 0092461                                        Line Item Fields

Item Page           Field Name\Line Item                          Max                               Field Format
No.                                                               Char
1    N/A    header_version_number                                 2   Always T1 
2    N/A    developer_code                                        4   Vendor’s NACTP code 
3    N/A    jurisdiction                                          2   Always: OH 
4    N/A    description                                           4   Form code: 1618
5    N/A    spec version                                          1   At this time: 0 
6    N/A    form version                                          1   At this time: 1 
7    N/A    Date_Generated                                        6   Numeric ; MMDDYY format
8    Page 1 amended return                                        1   Numeric; 1 = Amended, 0 = Original
9    Page 1 Final return                                          1   Numeric; 1 = Final, 0 = Regular
10   Page 1 Month                                                 2   Numeric
11   Page 1 Year                                                  4   Numeric: 2016
12   Page 1 FEIN                                                  9   Numeric
13   Page 1 SSN                                                   9   Numeric
14   Page 1 Name                                                  35  Alpha-Numeric
15   Page 1 Name_Line2                                            35  Alpha-Numeric
16   Page 1 Fiduciary_Name                                        35  Alpha-Numeric
17   Page 1 Address                                               35  Alpha-Numeric
18   Page 1 City                                                  20  Alpha
19   Page 1 State                                                 2   Alpha
20   Page 1 ZipCode                                               5   Numeric
21   Page 1 Simple Trust                                          1   Numeric; 1 = Simple, 0 = Other
22   Page 1 Complex Trust                                         1   Numeric; 1 = Complex, 0 = Other
23   Page 1 Irrevocable Trust                                     1   Numeric; 1 = Irrevocable, 0 = Other
24   Page 1 Testamentary Trust                                    1   Numeric; 1 = Testamentary, 0 = Other
25   Page 1 Resident Trust                                        1   Numeric; 1 = Resident, 0 = Other
26   Page 1 Non_Resident Trust                                    1   Numeric; 1 = Non_Resident, 0 = Other
27   Page 1 Bankruptcy Estate                                     1   Numeric; 1 = Bankruptcy, 0 = Other
28   Page 1 Decedent Estate                                       1   Numeric; 1 = Decedent, 0 = Other
29   Page 1 Line_1_Negative_Indicator                             1   Numeric; 1 - Negative, 0 - Positive
30   Page 1 Line_1                                                9   Numeric; do not put ‘– ‘ negative sign in front of the data
31   Page 1 Line_2_Negative_Indicator                             1   Numeric; 1 - Negative, 0 - Positive
32   Page 1 Line_2                                                9   Numeric; do not put ‘– ‘ negative sign in front of the data
33   Page 1 Line_3_Negative_Indicator                             1   Numeric; 1 - Negative, 0 - Positive
34   Page 1 Line_3                                                9   Numeric; do not put ‘– ‘ negative sign in front of the data
35   Page 1 Line_4_Negative_Indicator                             1   Numeric; 1 - Negative, 0 - Positive
36   Page 1 Line_4                                                9   Numeric; do not put ‘– ‘ negative sign in front of the data
37   Page 1 Line_5_Negative_Indicator                             1   Numeric; 1 - Negative, 0 - Positive
38   Page 1 Line_5                                                9   Numeric; do not put ‘– ‘ negative sign in front of the data
39   Page 1 Line_6_Negative_Indicator                             1   Numeric; 1 - Negative, 0 - Positive
40   Page 1 Line_6                                                9   Numeric; do not put ‘– ‘ negative sign in front of the data
41   Page 1 Line_7                                                9   Numeric
42   Page 1 Line_8                                                9   Numeric
43   Page 1 Line_9                                                9   Numeric
44   Page 1 Line_10                                               9   Numeric
45   Page 1 Line_11                                               9   Numeric
46   Page 1 Line_12                                               9   Numeric
47   Page 1 Line_13                                               9   Numeric
48   N/A    trailer                                               5   Always *EOD* 
                               Total Bytes/Characters             349

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                                         Ohio Department of Taxation
                                         2016 1041 2D Barcode Schema

                                                  Max 
Item Page           Field Name\Line Item          Char                     Field Format
No.                                               s 
1    N/A    header_version_number                 2    Always T1 
2    N/A    developer_code                        4    Vendor’s NACTP code 
3    N/A    jurisdiction                          2    Always: OH 
4    N/A    description                           4    Form code: 1618
5    N/A    spec version                          1    At this time: 0 
6    N/A    form version                          1    At this time: 1 
7    Page 2 FEIN                                  9    Numeric
8    Page 2 Line_14                               9    Numeric
9    Page 2 Line_15                               9    Numeric
10   Page 2 Line_16                               9    Numeric
11   Page 2 Line_17                               9    Numeric
12   Page 2 Line_18                               9    Numeric
13   Page 2 Line_19                               9    Numeric
14   Page 2 Line_20                               9    Numeric
15   Page 2 Line_21                               9    Numeric
16   Page 2 Line_22                               9    Numeric
17   Page 2 Line_23                               9    Numeric
18   Page 2 Line_24                               9    Numeric
19   Page 2 Line_25                               9    Numeric
20   Page 2 Line_26                               9    Numeric
21   Page 2 Line_27                               9    Numeric
22   Page 2 Line_28                               9    Numeric
23   Page 2 Line_29                               9    Numeric
24   Page 2 Line_30                               9    Numeric
25   Page 2 Line_31                               9    Numeric
26   N/A    trailer                               5    Always *EOD* 
                           Total Bytes/Characters 190

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                                         Ohio Department of Taxation
                                         2016 1041 2D Barcode Schema

                                                  Max 
Item Page           Field Name\Line Item          Char                     Field Format
No.                                               s 
1    N/A    header_version_number                 2    Always T1 
2    N/A    developer_code                        4    Vendor’s NACTP code 
3    N/A    jurisdiction                          2    Always: OH 
4    N/A    description                           4    form code: 1618
5    N/A    spec version                          1    At this time: 0 
6    N/A    form version                          1    At this time: 1 
7    Page 3 FEIN                                  9    Numeric
8    Page 3 Line_32                               9    Numeric
9    Page 3 Line_33                               9    Numeric
10   Page 3 Line_34                               9    Numeric
11   Page 3 Line_35                               9    Numeric
12   Page 3 Line_36                               9    Numeric
13   Page 3 Line_37                               9    Numeric
14   Page 3 Line_38                               9    Numeric
15   Page 3 Line_39                               9    Numeric
16   Page 3 Line_40                               9    Numeric
17   Page 3 Line_41                               9    Numeric
18   Page 3 Line_42_Negative_Indicator            1    Numeric; 1 - Negative, 0 - Positive
19   Page 3 Line_42                               9    Numeric
20   Page 3 Line_43                               3    Numeric
21   Page 3 Line_44                               9    Numeric
22   Page 3 Line_45                               2    Numeric
23   Page 3 Line_46                               9    Numeric
24   Page 3 Line_47                               9    Numeric
25   Page 3 Line_48                               9    Numeric
26   Page 3 Line_49                               9    Numeric
27   Page 3 Line_50                               9    Numeric
28   Page 3 Line_51_Negative_Indicator            1    Numeric; 1 - Negative, 0 - Positive
29   Page 3 Line_51                               9    Numeric
30   Page 3 Line_52_Negative_Indicator            1    Numeric; 1 - Negative, 0 - Positive
31   Page 3 Line_52                               9    Numeric
32   Page 3 Line_53                               9    Numeric
33   Page 3 Line_54                               9    Numeric
34   Page 3 Line_55                               9    Numeric
35   N/A    trailer                               5    Always *EOD* 
                           Total Bytes/Characters 234

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                                         Ohio Department of Taxation
                                         2016 1041 2D Barcode Schema

                                                  Max 
Item Page           Field Name\Line Item          Char                     Field Format
No.                                               s 
1    N/A    header_version_number                 2    Always T1 
2    N/A    developer_code                        4    Vendor’s NACTP code 
3    N/A    jurisdiction                          2    Always: OH 
4    N/A    description                           4    form code: 1618
5    N/A    spec version                          1    At this time: 0 
6    N/A    form version                          1    At this time: 1 
7    Page 4 FEIN                                  9    Numeric
8    Page 4 Line_56_Negative_Indicator            1    Numeric; 1 - Negative, 0 - Positive
9    Page 4 Line_56                               9    Numeric
10   Page 4 Line_57_Negative_Indicator            1    Numeric; 1 - Negative, 0 - Positive
11   Page 4 Line_57                               9    Numeric
12   Page 4 Line_58                               9    Numeric
13   Page 4 Line_59_Negative_Indicator            1    Numeric; 1 - Negative, 0 - Positive
14   Page 4 Line_59                               9    Numeric
15   Page 4 Line_60                               5    Numeric; Send as a 5 digit whole number, no decimal point.
16   Page 4 Line_61_Negative_Indicator            1    Numeric; 1 - Negative, 0 - Positive
17   Page 4 Line_61                               9    Numeric
18   Page 4 Line_62_Negative_Indicator            1    Numeric; 1 - Negative, 0 - Positive
19   Page 4 Line_62                               9    Numeric
20   Page 4 Line_63                               7    Numeric; Send as a 7 digit whole number, no decimal point.
21   Page 4 Line_64_Negative_Indicator            1    Numeric; 1 - Negative, 0 - Positive
22   Page 4 Line_64                               9    Numeric
23   Page 4 Line_65_Negative_Indicator            1    Numeric; 1 - Negative, 0 - Positive
24   Page 4 Line_65                               9    Numeric
25   Page 4 Line_66_Negative_Indicator            1    Numeric; 1 - Negative, 0 - Positive
26   Page 4 Line_66                               9    Numeric
27   Page 4 Line_67_Negative_Indicator            1    Numeric; 1 - Negative, 0 - Positive
28   Page 4 Line_67                               9    Numeric
29   Page 4 Line_68_Negative_Indicator            1    Numeric; 1 - Negative, 0 - Positive
30   Page 4 Line_68                               9    Numeric
31   Page 4 Line_69                               9    Numeric
32   Page 4 Line_70                               9    Numeric
33   Page 4 Line_71                               5    Numeric; Send as a 5 digit whole number, no decimal point.
34   Page 4 Line_72_Negative_Indicator            1    Numeric; 1 - Negative, 0 - Positive
35   Page 4 Line_72                               9    Numeric
36   Page 4 Line_73                               9    Numeric
37   Page 4 Line_74                               9    Numeric
38   N/A    trailer                               5    Always *EOD* 
                           Total Bytes/Characters 200

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                                          Ohio Department of Taxation
                                          2016 1041 2D Barcode Schema

                                                    Max 
Item Page            Field Name\Line Item           Char                     Field Format
No.                                                 s 
1    N/A    header_version_number                   2    Always T1 
2    N/A    developer_code                          4    Vendor’s NACTP code 
3    N/A    jurisdiction                            2    Always: OH 
4    N/A    description                             4    form code: 1618
5    N/A    spec version                            1    At this time: 0 
6    N/A    form version                            1    At this time: 1 
7    Page 5 FEIN                                    9    Numeric
8    Page 5 Line_75_Ohio_A(Owned)                   11   Numeric 
9    Page 5 Line_75_Everywhere_A(Owned)             11   Numeric
10   Page 5 Line_75_Ohio_B(Rented)                  11   Numeric 
11   Page 5 Line_75_Everywhere_B(Rented)            11   Numeric
12   Page 5 Line_75_Ohio_C(Total)                   11   Numeric 
13   Page 5 Line_75_Everywhere_C(Total)             11   Numeric
14   Page 5 Line_75_Ratio                           7    Numeric; Send as a 7 digit whole number, no decimal point.
15   Page 5 Line_75_Weight                          3    Numeric; allowed values 0, 20, 25, 50, 100; send as 3 digit whole number
16   Page 5 Line_75_Wt_Ratio                        7    Numeric; Send as a 7 digit whole number, no decimal point.
17   Page 5 Line_76_Ohio(Payroll)                   11   Numeric 
18   Page 5 Line_76_Everywhere(Payroll)             11   Numeric
19   Page 5 Line_76_Ratio                           7    Numeric; Send as a 7 digit whole number, no decimal point.
20   Page 5 Line_76_Weight                          3    Numeric; allowed values 0, 20, 25, 50, 100; send as 3 digit whole number
21   Page 5 Line_76_Wt_Ratio                        7    Numeric; Send as a 7 digit whole number, no decimal point.
22   Page 5 Line_77_Ohio(Sales)                     11   Numeric 
23   Page 5 Line_77_Everywhere(Sales)               11   Numeric
24   Page 5 Line_77_Ratio                           7    Numeric; Send as a 7 digit whole number, no decimal point.
25   Page 5 Line_77_Weight                          3    Numeric; allowed values 0, 60, 75, 100; send as 3 digit whole number
26   Page 5 Line_77_Wt_Ratio                        7    Numeric; Send as a 7 digit whole number, no decimal point.
27   Page 5 Line_78_Total_Wt_Ratio                  7    Numeric; Send as a 7 digit whole number, no decimal point.
28   Page 5 Line_79A                                8    Numeric
29   Page 5 Line_79B                                8    Numeric
30   Page 5 Line_79C                                8    Numeric
31   Page 5 Line_79D                                8    Numeric
32   Page 5 Line_79E                                8    Numeric
33   Page 5 Line_80                                 9    Numeric
34   N/A    trailer                                 5    Always *EOD* 
                             Total Bytes/Characters 245

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                                                                            2016 Ohio IT 1041 2D Scenarios
                                                                    Testing Information for Paper Returns ONLY 
                                                                    If any questions, please e-mail Forms@tax.state.oh.us
                Note:  If there are any limitations to your software that will not allow you to follow the tests, please indicate what these are on a separate sheet of paper. 
Important Notes 
• The two-digit vendor number is used for the "XX" in the FEIN field
• Vendors must submit a full field version and all test scenarios.
• Please proof the static text and test the 1D barcodes prior to submission
• Data values on the printed form and in the 2D barcode must match each scenario
• For the Date Generated field (new for 2016) use the date the scenario was created by your staff
NEW for Tax Year 2016
• The IT 1041 now includes a 2D barcode 
• Apportionment Worksheet ratio weights are no longer static.  Note section language now includes:  "if only one factor, use 100%"

                                                                           2016 IT-1041
                        ENTITY 
                VERSION TYPE              AMOUNT OWED                      SCHEDULE A WEIGHT              SCHEDULES                        NET PAYMENT
SCENARIO  1     X       DCE                                       X                                X X                                  X                                         X
SCENARIO  2             SRE                                       X                              X                                X X                                             X
SCENARIO 3           X  CNR               X                                     X                                                 X X      X                                   X  X
SCENARIO 4              CRE             X                                         X                                               X X X                                           X
SCENARIO 5              TRE                 X                              X                                             X        X X X                                          X
SCENARIO 6              BKE                                       X                                X      X                               X
SCENARIO 7              DCE                                         X                              X

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2016 IT-1041
TRUST/ESTATE INFORMATION
Test Scenario 1
Check here if final return X
Federal employer I.D. number (FEIN) XX-0104111
Social Security no. of decedent (estates only)
For taxable year beginning on 01/2016
Name of trust or estate ESTATE1
Name of trust or estate (second line)
Fiduciary name and title JONNY FAIR, TRUSTEE
Address 2058 BUCKEYE AVE
City CLEVELAND
State OH
ZIP code 44114
Simple trust
Complex trust
Resident trust
Nonresident trust
Irrevocable trust
Testamentary trust
Bankruptcy estate
Decedent’s estate x

1041 FORM DATA
1. Federal taxable income (from line 22 of IRS form 1041). Attach page 1 of IRS form 1041 128456
2. Net adjustments from Schedule A, line 42 146304
3. Ohio taxable income (line 1 plus or minus line 2). Estates should skip lines 4-7 274760
4. Allocated qualifying trust amount from Schedule F, line 60 (trusts only) 0
5. Apportioned trust income from Schedule G, line 63 (trusts only) 0
6. Allocated trust income from Schedule H, line 66 (trusts only) 0
7. Modifi ed Ohio taxable income (trusts add lines 4, 5 and 6; if less than zero, enter -0-) 0
8. Tax on Ohio taxable income (estates, line 3) or tax on modifi ed Ohio taxable income (trusts, 11279
line 7). See tax table in the instructions
9. Credits from Schedule B, line 50 (estates only) 650
10. Resident credit from Schedule C (estates); nonresident credit from Schedule D (estates); business 5225
credit for estates and trusts from Schedule E (attach Schedule E) and Schedule I credit (resident
trusts)
11. Tax after nonrefundable credits and grant (line 8 minus the amount on lines 9 and 10) 5404
12. Interest penalty on underpayment of estimated tax (attach Ohio form IT/SD 2210) 0
13. Total Ohio tax (sum of lines 11 and 12) 5404
14. Net payments from line 79 on page 5 20000
15. Refundable business credits (attach documentation) 0
16. Total (sum of lines 14 and 15) 20000
17. If line 16 is more than line 13, subtract line 13 from line 16. This is your overpayment 14596
18. Amount of line 17 to be credited to 2017 estimated 0
tax liability
19. Amount of line 17 to be refunded (subtract line 18 from line 17) 14596
20. Net amount due, if any (if line 13 is more than line 16, subtract line 16 from line 13, but not less 0
than -0-)
21. Interest and penalty on late-paid and/or late-fi led return, if any 0

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22. Total amount due, if any (sum of lines 20 and 21). Make check payable to Ohio Treasurer of State, 0
include Ohio form IT 1041P and place FEIN on check

SCHEDULE A – ADJUSTMENTS TO FEDERAL TAXABLE INCOME NET OF RELATED EXPENSES
Additions
23. Federal and/or non-Ohio state or local government interest and dividends not distributed          8238
24. Pass-through entity and financial institutions taxes paid and related member add-back             0
25. Income from an ESBT not shown in federal taxable income                                           0
26. Losses from sale or other disposition of Ohio public obligations                                  0
27. Recovery of amount previously deducted or excluded                                                0
28. Adjustment for Internal Revenue Code sections 168(k) depreciation expense                         0
 2/3, 5/6 or 6/6 (check applicable box)
2/3
5/6
6/6

29. Federal personal exemption (estates only), lump sum distribution add-back and miscellaneous       600
federal tax adjustments
30. Expenses claimed on Ohio estate return (estates only)                                             138465
31. Total additions (add lines 23 through 30)                                                         147303
Deductions
32. Federal interest and dividends exempt from state taxation net of related expenses                 175
33. Certain state and municipal income tax overpayments                                               824
34. Losses from an ESBT not shown in federal taxable income                                           0
35. Wage and salary expense not previously deducted due to the federal targeted jobs credit or        0
the work opportunity credit
36. Interest income from Ohio public obligations and Ohio purchase obligations and gains from         0
the sale or other disposition of Ohio public obligations
37. Refunds or reimbursements of prior year federal itemized deductions and miscellaneous             0
federal tax adjustments
38. Farm income from a farm of at least 10 acres (trusts only)                                        0
39. Adjustment for Internal Revenue Code sections 168(k) and 179 depreciation expense                 0
40. Repayment of income reported in a prior year and not otherwise deducted                           0
41. Total deductions (sum of lines 32 through 40)                                                     999
42. Net adjustments – If line 31 is MORE than line 41, enter the difference here and on line 2 as     146304
positive. If line 31 is LESS than line 41, enter the difference here and on line 2 as negative

SCHEDULE B – ESTATE CREDITS
43. Retirement income credit (see instructions for credit table) (limit – $200)                       200
44. Lump sum retirement credit (attach Ohio LS WKS, line 6)                                           100
45. Senior citizen’s credit (limit – $50 per return)                                                  50
46. Child and dependent care credit (see instructions and worksheet in Ohio form IT 1040 booklet)     50

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47. Lump sum distribution credit (must be 65 or older to claim this credit; attach Ohio LS WKS, line 3) 100
48. Ohio political contributions credit 100
49. Ohio adoption credit (limit $10,000) 50
50. Total Schedule B credits (sum of lines 43 through 49) – enter here and on line 9 650

SCHEDULE C – ESTATE OHIO RESIDENT CREDIT
51. Enter the portion of line 3 subjected to tax by other states or the District of Columbia 150000
while an Ohio resident. New limitation – see instructions
52. Enter Ohio taxable income (line 3) 274760
53a. Divide line 51 by line 52 and enter percentage here % 0.5459
53b. Multiply the percentage on 53a by the amount shown on line 8 reduced by any amount shown on line 9 5802

54. Enter the 2016 income tax, less all related credits other than withholding and estimated tax payments 5225
and carryforwards from previous years, paid to other states or the District of Columbia. New limitation
– see instructions
55. Enter the smaller of line 53 or line 54. This is your Ohio resident tax credit. Enter here and on 5225
line 10

SCHEDULE D – ESTATE NONRESIDENT CREDIT
56. Enter the portion of Ohio taxable income (line 3) not earned or received in Ohio 0
(attach Ohio form IT 2023)
57. Enter Ohio taxable income (line 3) 0
58a. Divide line 56 by line 57 and enter percentage here % 0.0000
58b. Multiply the percentage on 58a by the amount shown on line 8 reduced by the amount shown on line 9.
Enter here and on line 10 0

SCHEDULE F – ALLOCATED QUALIFYING TRUST AMOUNTS
59. Enter the trust’s portion of capital gains/losses recognized to the extent included in Ohio 0
taxable income (line 3) if the location of the physical assets of the closely held investee is
available
60. Enter the percentage of the closely held investee’s physical assets located within Ohio 0.0000
61. Multiply the amount on line 59 by the percentage on line 60. Enter here and on line 4 0

SCHEDULE G – APPORTIONED INCOME FOR TRUSTS
62. Enter (i) the trust’s business income not included in line 59 and (ii) the trust’s qualifying 0
investment income not otherwise a part of business income and not included in line 58
63. Enter the Ohio apportionment ratio from line 78 of the apportionment worksheet on page 5 0.000000
64. Multiply the amount on line 62 by the apportionment ratio on line 63. Enter here and on 0
line 5

9/30/2016 1041 Scenario 1 Page 3 of 5

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SCHEDULE H – ALLOCATED NONBUSINESS INCOME FOR TRUSTS
65. Resident trusts: Enter the trust’s portion of Ohio taxable income (line 3) not reported on lines 0
59 or 62
66. Nonresident trusts: Enter the trust’s portion of Ohio taxable income (line 3) not reported 0
on lines 59 or 62 to the extent such income (i) was derived from real or tangible property
located in or based in Ohio or (ii) was sitused to Ohio (see instructions for line 66) or (iii)
was described in Ohio Revised Code section 5747.212
67. Add lines 65 and 66 and enter here and on line 6 0

SCHEDULE I – TAX CREDIT FOR RESIDENT TRUSTS
68. Enter the amount of allocated resident trust nonbusiness income (line 65, above) subject 0
to tax in one or more states or in the District of Columbia
69. Enter the amount from line 8 0
70. Enter the amount of modified Ohio taxable income from line 7 0
71. Divide line 69 by line 70 and enter the percentage here. This is the average effective tax 0.0000
rate
72. Multiply the amount on line 68 by the percentage reported on line 71 0
73. Enter the amount of tax actually paid by the resident trust to another state or the District of 0
Columbia on the trust’s allocated nonbusiness income
74. Enter the smaller of the amount on lines 72 and 73. This is the resident trust’s Ohio tax 0
credit. Enter here and on line 10

APPORTIONMENT WORKSHEET
75. Property
a) Owned (average cost) Within Ohio 0
Total Everywhere 0
b) Rented (annual rental X 8) Within Ohio 0
Total Everywhere 0
c) Total (lines 75a and 75b) Within Ohio 0
Total Everywhere 0
Ratio (carry to six decimal places) 0.000000
Weighted Ratio (carry to six decimal places) 0.000000
76. Payroll
Within Ohio 0
Total Everywhere 0
Ratio (carry to six decimal places) 0.000000
Weighted Ratio (carry to six decimal places) 0.000000
77. Sales
Within Ohio 0
Total Everywhere 0

9/30/2016 1041 Scenario 1 Page 4 of 5

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Ratio (carry to six decimal places) 1.00 0.000000
Weighted Ratio (carry to six decimal places) 0.000000
78. Total weighted apportionment ratio (add weighted ratio from lines 75c, 76 and 77). Enter ratio here and on
Schedule G, line 63 (carry to six decimal places). 0.000000
Note: If the denominator of any factor is zero, the weight given to the other factors must be proportionately increased so that the total weight given to the
combined number of factors used is 100%, i.e., if no property/payroll, use 25% and 75%; if no sales, use 50% property/payroll; if only one factor, use 100%.
NET PAYMENT WORKSHEET
79a. Estimated payments 0
79b. Prior year credit carryover 20000
79c. 1099 withholdings 0
79d. W-2 withholdings 0
79e. Refunds previously claimed 0
80. Net payments (sum of lines 78a-d minus line 78e). Enter here and on page 2, line 14. 20000

9/30/2016 1041 Scenario 1 Page 5 of 5

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2016 IT-1041
TRUST/ESTATE INFORMATION
Test Scenario 2
Check here if final return
Federal employer I.D. number (FEIN) XX-0104112
Social Security no. of decedent (estates only)
For taxable year beginning on 02/2016
Name of trust or estate TRUST2
Name of trust or estate (second line)
Fiduciary name and title JONNY THOMAS, TRUSTEE
Address 2058 BUCKEYE AVE
City CLEVELAND
State OH
ZIP code 44114
Simple trust X
Complex trust
Resident trust X
Nonresident trust
Irrevocable trust
Testamentary trust
Bankruptcy estate
Decedent’s estate

1041 FORM DATA
1. Federal taxable income (from line 22 of IRS form 1041). Attach page 1 of IRS form 1041 128456
2. Net adjustments from Schedule A, line 42 145704
3. Ohio taxable income (line 1 plus or minus line 2). Estates should skip lines 4-7 274160
4. Allocated qualifying trust amount from Schedule F, line 60 (trusts only) 0
5. Apportioned trust income from Schedule G, line 63 (trusts only) 9956
6. Allocated trust income from Schedule H, line 66 (trusts only) 135695
7. Modifi ed Ohio taxable income (trusts add lines 4, 5 and 6; if less than zero, enter -0-) 145651
8. Tax on Ohio taxable income (estates, line 3) or tax on modifi ed Ohio taxable income (trusts, 5087
line 7). See tax table in the instructions
9. Credits from Schedule B, line 50 (estates only) 0
10. Resident credit from Schedule C (estates); nonresident credit from Schedule D (estates); business 0
credit for estates and trusts from Schedule E (attach Schedule E) and Schedule I credit (resident
trusts)
11. Tax after nonrefundable credits and grant (line 8 minus the amount on lines 9 and 10) 5087
12. Interest penalty on underpayment of estimated tax (attach Ohio form IT/SD 2210) 0
13. Total Ohio tax (sum of lines 11 and 12) 5087
14. Net payments from line 79 on page 5 2200
15. Refundable business credits (attach documentation) 0
16. Total (sum of lines 14 and 15) 2200
17. If line 16 is more than line 13, subtract line 13 from line 16. This is your overpayment 0
18. Amount of line 17 to be credited to 2017 estimated 0
tax liability
19. Amount of line 17 to be refunded (subtract line 18 from line 17) 0
20. Net amount due, if any (if line 13 is more than line 16, subtract line 16 from line 13, but not less 2887
than -0-)
21. Interest and penalty on late-paid and/or late-fi led return, if any 100

9/30/2016 1041 Scenario 2 Page 1 of 5

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22. Total amount due, if any (sum of lines 20 and 21). Make check payable to Ohio Treasurer of State, 2987
include Ohio form IT 1041P and place FEIN on check

SCHEDULE A – ADJUSTMENTS TO FEDERAL TAXABLE INCOME NET OF RELATED EXPENSES
Additions
23. Federal and/or non-Ohio state or local government interest and dividends not distributed          8238
24. Pass-through entity and financial institutions taxes paid and related member add-back
25. Income from an ESBT not shown in federal taxable income                                           138465
26. Losses from sale or other disposition of Ohio public obligations                                  0
27. Recovery of amount previously deducted or excluded                                                0
28. Adjustment for Internal Revenue Code sections 168(k) depreciation expense                         0

2/3
5/6
6/6

29. Federal personal exemption (estates only), lump sum distribution add-back and miscellaneous       0
federal tax adjustments
30. Expenses claimed on Ohio estate return (estates only)                                             0
31. Total additions (add lines 23 through 30)                                                         146703
Deductions
32. Federal interest and dividends exempt from state taxation net of related expenses                 175
33. Certain state and municipal income tax overpayments                                               824
34. Losses from an ESBT not shown in federal taxable income                                           0
35. Wage and salary expense not previously deducted due to the federal targeted jobs credit or        0
the work opportunity credit
36. Interest income from Ohio public obligations and Ohio purchase obligations and gains from         0
the sale or other disposition of Ohio public obligations
37. Refunds or reimbursements of prior year federal itemized deductions and miscellaneous             0
federal tax adjustments
38. Farm income from a farm of at least 10 acres (trusts only)                                        0
39. Adjustment for Internal Revenue Code sections 168(k) and 179 depreciation expense                 0
40. Repayment of income reported in a prior year and not otherwise deducted                           0
41. Total deductions (sum of lines 32 through 40)                                                     999
42. Net adjustments – If line 31 is MORE than line 41, enter the difference here and on line 2 as     145704
positive. If line 31 is LESS than line 41, enter the difference here and on line 2 as negative

SCHEDULE B – ESTATE CREDITS
43. Retirement income credit (see instructions for credit table) (limit – $200)                       0
44. Lump sum retirement credit (attach Ohio LS WKS, line 6)                                           0
45. Senior citizen’s credit (limit – $50 per return)                                                  0
46. Child and dependent care credit (see instructions and worksheet in Ohio form IT 1040 booklet)     0

9/30/2016                                                            1041 Scenario 2                        Page 2 of 5

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47. Lump sum distribution credit (must be 65 or older to claim this credit; attach Ohio LS WKS, line 3) 0
48. Ohio political contributions credit 0
49. Ohio adoption credit (limit $10,000) 0
50. Total Schedule B credits (sum of lines 43 through 49) – enter here and on line 9 0

SCHEDULE C – ESTATE OHIO RESIDENT CREDIT
51. Enter the portion of line 3 subjected to tax by other states or the District of Columbia 0
while an Ohio resident. New limitation – see instructions
52. Enter Ohio taxable income (line 3) 0
53a. Divide line 51 by line 52 and enter percentage here % 0.0000
53b. Multiply the percentage on 53a by the amount shown on line 8 reduced by any amount shown on line 9 0

54. Enter the 2016 income tax, less all related credits other than withholding and estimated tax payments 0
and carryforwards from previous years, paid to other states or the District of Columbia. New limitation
– see instructions
55. Enter the smaller of line 53 or line 54. This is your Ohio resident tax credit. Enter here and on 0
line 10

SCHEDULE G – APPORTIONED INCOME FOR TRUSTS
62. Enter (i) the trust’s business income not included in line 59 and (ii) the trust’s qualifying 114682
investment income not otherwise a part of business income and not included in line 58
63. Enter the Ohio apportionment ratio from line 78 of the apportionment worksheet on page 5 0.086817
64. Multiply the amount on line 62 by the apportionment ratio on line 63. Enter here and on 9956
line 5

9/30/2016 1041 Scenario 2 Page 3 of 5

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SCHEDULE H – ALLOCATED NONBUSINESS INCOME FOR TRUSTS
65. Resident trusts: Enter the trust’s portion of Ohio taxable income (line 3) not reported on lines 135695
59 or 62
66. Nonresident trusts: Enter the trust’s portion of Ohio taxable income (line 3) not reported       0
on lines 59 or 62 to the extent such income (i) was derived from real or tangible property
located in or based in Ohio or (ii) was sitused to Ohio (see instructions for line 66) or (iii)
was described in Ohio Revised Code section 5747.212
67. Add lines 65 and 66 and enter here and on line 6                                                 135695

SCHEDULE I – TAX CREDIT FOR RESIDENT TRUSTS
68. Enter the amount of allocated resident trust nonbusiness income (line 65, above) subject         0
to tax in one or more states or in the District of Columbia
69. Enter the amount from line 8                                                                     0
70. Enter the amount of modified Ohio taxable income from line 7                                     0
71. Divide line 69 by line 70 and enter the percentage here. This is the average effective tax       0.0000
rate
72. Multiply the amount on line 68 by the percentage reported on line 71                             0
73. Enter the amount of tax actually paid by the resident trust to another state or the District of  0
Columbia on the trust’s allocated nonbusiness income
74. Enter the smaller of the amount on lines 72 and 73. This is the resident trust’s Ohio tax        0
credit. Enter here and on line 10

APPORTIONMENT WORKSHEET
75. Property
          a) Owned (average cost)       Within Ohio                                                  0
                                        Total Everywhere                                             0
          b) Rented (annual rental X 8) Within Ohio                                                  0
                                        Total Everywhere                                             0
          c) Total (lines 75a and 75b)  Within Ohio                                                  0
                                        Total Everywhere                                             0
          Ratio (carry to six decimal places)                                                        0.000000
          Weighted Ratio (carry to six decimal places)                                               0.000000
76. Payroll
          Within Ohio                                                                                0
          Total Everywhere                                                                           0
          Ratio (carry to six decimal places)                                                        0.000000
          Weighted Ratio (carry to six decimal places)                                               0.000000
77. Sales
          Within Ohio                                                                                2164589
          Total Everywhere                                                                           24932700

9/30/2016                                                                1041 Scenario 2                     Page 4 of 5

- 20 -

Ratio (carry to six decimal places) 1.00 0.086817
Weighted Ratio (carry to six decimal places) 0.086817
78. Total weighted apportionment ratio (add weighted ratio from lines 75c, 76 and 77). Enter ratio here and on
Schedule G, line 63 (carry to six decimal places). 0.086817
Note: If the denominator of any factor is zero, the weight given to the other factors must be proportionately increased so that the total weight given to the
combined number of factors used is 100%, i.e., if no property/payroll, use 25% and 75%; if no sales, use 50% property/payroll; if only one factor, use 100%.
NET PAYMENT WORKSHEET
79a. Estimated payments 2200
79b. Prior year credit carryover 0
79c. 1099 withholdings 0
79d. W-2 withholdings 0
79e. Refunds previously claimed 0
80. Net payments (sum of lines 78a-d minus line 78e). Enter here and on page 2, line 14. 2200

9/30/2016 1041 Scenario 2 Page 5 of 5

- 21 -

2016 IT-1041
TRUST/ESTATE INFORMATION
Test Scenario 3
Check here if Amended return X
Check here if final return
Federal employer I.D. number (FEIN) XX-0104113
Social Security no. of decedent (estates only)
For taxable year beginning on 01/2016
Name of trust or estate TRUST3
Name of trust or estate (second line)
Fiduciary name and title JONNY FAIR, TRUSTEE
Address 1825 LAKE SHORE DR
City CLEVELAND
State OH
ZIP code 44114
Simple trust
Complex trust X
Resident trust
Nonresident trust X
Irrevocable trust
Testamentary trust
Bankruptcy estate
Decedent’s estate

1041 FORM DATA
1. Federal taxable income (from line 22 of IRS form 1041). Attach page 1 of IRS form 1041 104514
2. Net adjustments from Schedule A, line 42 392990
3. Ohio taxable income (line 1 plus or minus line 2). Estates should skip lines 4-7 497504
4. Allocated qualifying trust amount from Schedule F, line 60 (trusts only) 0
5. Apportioned trust income from Schedule G, line 63 (trusts only) 422616
6. Allocated trust income from Schedule H, line 66 (trusts only) 1652
7. Modifi ed Ohio taxable income (trusts add lines 4, 5 and 6; if less than zero, enter -0-) 424268
8. Tax on Ohio taxable income (estates, line 3) or tax on modifi ed Ohio taxable income (trusts, 18750
line 7). See tax table in the instructions
9. Credits from Schedule B, line 50 (estates only) 0
10. Resident credit from Schedule C (estates); nonresident credit from Schedule D (estates); business 0
credit for estates and trusts from Schedule E (attach Schedule E) and Schedule I credit (resident
trusts)
11. Tax after nonrefundable credits and grant (line 8 minus the amount on lines 9 and 10) 18750
12. Interest penalty on underpayment of estimated tax (attach Ohio form IT/SD 2210) 0
13. Total Ohio tax (sum of lines 11 and 12) 18750
14. Net payments from line 79 on page 5 34641
15. Refundable business credits (attach documentation) 134459
16. Total (sum of lines 14 and 15) 169100
17. If line 16 is more than line 13, subtract line 13 from line 16. This is your overpayment 150350
18. Amount of line 17 to be credited to 2017 estimated 150350
tax liability
19. Amount of line 17 to be refunded (subtract line 18 from line 17) 0
20. Net amount due, if any (if line 13 is more than line 16, subtract line 16 from line 13, but not less 0
than -0-)
21. Interest and penalty on late-paid and/or late-fi led return, if any 0

9/30/2016 1041 Scenario 3 Page 1 of 5

- 22 -

22. Total amount due, if any (sum of lines 20 and 21). Make check payable to Ohio Treasurer of State, 0
include Ohio form IT 1041P and place FEIN on check

SCHEDULE A – ADJUSTMENTS TO FEDERAL TAXABLE INCOME NET OF RELATED EXPENSES
Additions
23. Federal and/or non-Ohio state or local government interest and dividends not distributed          273
24. Pass-through entity and financial institutions taxes paid and related member add-back             0
25. Income from an ESBT not shown in federal taxable income                                           397275
26. Losses from sale or other disposition of Ohio public obligations                                  0
27. Recovery of amount previously deducted or excluded                                                0
28. Adjustment for Internal Revenue Code sections 168(k) depreciation expense                         4822

2/3                                                                                                   X
5/6
6/6

29. Federal personal exemption (estates only), lump sum distribution add-back and miscellaneous       0
federal tax adjustments
30. Expenses claimed on Ohio estate return (estates only)                                             0
31. Total additions (add lines 23 through 30)                                                         402370
Deductions
32. Federal interest and dividends exempt from state taxation net of related expenses                 9380
33. Certain state and municipal income tax overpayments                                               0
34. Losses from an ESBT not shown in federal taxable income                                           0
35. Wage and salary expense not previously deducted due to the federal targeted jobs credit or        0
the work opportunity credit
36. Interest income from Ohio public obligations and Ohio purchase obligations and gains from         0
the sale or other disposition of Ohio public obligations
37. Refunds or reimbursements of prior year federal itemized deductions and miscellaneous             0
federal tax adjustments
38. Farm income from a farm of at least 10 acres (trusts only)                                        0
39. Adjustment for Internal Revenue Code sections 168(k) and 179 depreciation expense                 0
40. Repayment of income reported in a prior year and not otherwise deducted                           0
41. Total deductions (sum of lines 32 through 40)                                                     9380
42. Net adjustments – If line 31 is MORE than line 41, enter the difference here and on line 2 as     392990
positive. If line 31 is LESS than line 41, enter the difference here and on line 2 as negative

SCHEDULE B – ESTATE CREDITS
43. Retirement income credit (see instructions for credit table) (limit – $200)                       0
44. Lump sum retirement credit (attach Ohio LS WKS, line 6)                                           0
45. Senior citizen’s credit (limit – $50 per return)                                                  0

9/30/2016                                                            1041 Scenario 3                        Page 2 of 5

- 23 -

46. Child and dependent care credit (see instructions and worksheet in Ohio form IT 1040 booklet) 0
47. Lump sum distribution credit (must be 65 or older to claim this credit; attach Ohio LS WKS, line 3) 0
48. Ohio political contributions credit 0
49. Ohio adoption credit (limit $10,000) 0
50. Total Schedule B credits (sum of lines 43 through 49) – enter here and on line 9 0

54. Enter the 2016 income tax, less all related credits other than withholding and estimated tax payments
and carryforwards from previous years, paid to other states or the District of Columbia. New limitation
– see instructions
55. Enter the smaller of line 53 or line 54. This is your Ohio resident tax credit. Enter here and on 0
line 10

SCHEDULE G – APPORTIONED INCOME FOR TRUSTS
62. Enter (i) the trust’s business income not included in line 59 and (ii) the trust’s qualifying 495852
investment income not otherwise a part of business income and not included in line 58
63. Enter the Ohio apportionment ratio from line 78 of the apportionment worksheet on page 5 0.852302
64. Multiply the amount on line 62 by the apportionment ratio on line 63. Enter here and on 422616
line 5

9/30/2016 1041 Scenario 3 Page 3 of 5

- 24 -

SCHEDULE H – ALLOCATED NONBUSINESS INCOME FOR TRUSTS
65. Resident trusts: Enter the trust’s portion of Ohio taxable income (line 3) not reported on lines 0
59 or 62
66. Nonresident trusts: Enter the trust’s portion of Ohio taxable income (line 3) not reported       1652
on lines 59 or 62 to the extent such income (i) was derived from real or tangible property
located in or based in Ohio or (ii) was sitused to Ohio (see instructions for line 66) or (iii)
was described in Ohio Revised Code section 5747.212
67. Add lines 65 and 66 and enter here and on line 6                                                 1652

SCHEDULE I – TAX CREDIT FOR RESIDENT TRUSTS
68. Enter the amount of allocated resident trust nonbusiness income (line 65, above) subject         0
to tax in one or more states or in the District of Columbia
69. Enter the amount from line 8                                                                     0
70. Enter the amount of modified Ohio taxable income from line 7                                     0
71. Divide line 69 by line 70 and enter the percentage here. This is the average effective tax       0.0000
rate
72. Multiply the amount on line 68 by the percentage reported on line 71                             0
73. Enter the amount of tax actually paid by the resident trust to another state or the District of  0
Columbia on the trust’s allocated nonbusiness income
74. Enter the smaller of the amount on lines 72 and 73. This is the resident trust’s Ohio tax        0
credit. Enter here and on line 10

APPORTIONMENT WORKSHEET
75. Property
          a) Owned (average cost)       Within Ohio                                                  0
                                        Total Everywhere                                             0
          b) Rented (annual rental X 8) Within Ohio                                                  0
                                        Total Everywhere                                             0
          c) Total (lines 75a and 75b)  Within Ohio                                                  0
                                        Total Everywhere                                             0
          Ratio (carry to six decimal places)                                                        0.000000
          Weighted Ratio (carry to six decimal places)                                               0.000000
76. Payroll
          Within Ohio                                                                                1249780
          Total Everywhere                                                                           2000000
          Ratio (carry to six decimal places)                                                        0.624890
          Weighted Ratio (carry to six decimal places)                                               0.156223
77. Sales
          Within Ohio                                                                                4640525
          Total Everywhere                                                                           5000000

9/30/2016                                                                1041 Scenario 3                     Page 4 of 5

- 25 -

Ratio (carry to six decimal places) 1.00 0.928105
Weighted Ratio (carry to six decimal places) 0.696079
78. Total weighted apportionment ratio (add weighted ratio from lines 75c, 76 and 77). Enter ratio here and on
Schedule G, line 63 (carry to six decimal places). 0.852302
Note: If the denominator of any factor is zero, the weight given to the other factors must be proportionately increased so that the total weight given to the
combined number of factors used is 100%, i.e., if no property/payroll, use 25% and 75%; if no sales, use 50% property/payroll; if only one factor, use 100%.
NET PAYMENT WORKSHEET
79a. Estimated payments 36657
79b. Prior year credit carryover 0
79c. 1099 withholdings 0
79d. W-2 withholdings 0
79e. Refunds previously claimed 2016
80. Net payments (sum of lines 78a-d minus line 78e). Enter here and on page 2, line 14. 34641

9/30/2016 1041 Scenario 3 Page 5 of 5

- 26 -

2016 IT-1041
TRUST/ESTATE INFORMATION
Test Scenario 4
Check here if final return
Federal employer I.D. number (FEIN) XX-0104114
Social Security no. of decedent (estates only)
For taxable year beginning on 01/2016
Name of trust or estate TRUST4
Name of trust or estate (second line)
Fiduciary name and title JONNY FAIR, TRUSTEE
Address 2058 BUCKEYE AVE
City CLEVELAND
State OH
ZIP code 44114
Simple trust
Complex trust X
Resident trust X
Nonresident trust
Irrevocable trust
Testamentary trust
Bankruptcy estate
Decedent’s estate

1041 FORM DATA
1. Federal taxable income (from line 22 of IRS form 1041). Attach page 1 of IRS form 1041 815452
2. Net adjustments from Schedule A, line 42 -1015
3. Ohio taxable income (line 1 plus or minus line 2). Estates should skip lines 4-7 814437
4. Allocated qualifying trust amount from Schedule F, line 60 (trusts only) 0
5. Apportioned trust income from Schedule G, line 63 (trusts only) 39666
6. Allocated trust income from Schedule H, line 66 (trusts only) 463577
7. Modifi ed Ohio taxable income (trusts add lines 4, 5 and 6; if less than zero, enter -0-) 503243
8. Tax on Ohio taxable income (estates, line 3) or tax on modifi ed Ohio taxable income (trusts, 22696
line 7). See tax table in the instructions
9. Credits from Schedule B, line 50 (estates only) 0
10. Resident credit from Schedule C (estates); nonresident credit from Schedule D (estates); business 20907
credit for estates and trusts from Schedule E (attach Schedule E) and Schedule I credit (resident
trusts)
11. Tax after nonrefundable credits and grant (line 8 minus the amount on lines 9 and 10) 1789
12. Interest penalty on underpayment of estimated tax (attach Ohio form IT/SD 2210) 0
13. Total Ohio tax (sum of lines 11 and 12) 1789
14. Net payments from line 79 on page 5 2500
15. Refundable business credits (attach documentation) 0
16. Total (sum of lines 14 and 15) 2500
17. If line 16 is more than line 13, subtract line 13 from line 16. This is your overpayment 711
18. Amount of line 17 to be credited to 2017 estimated 0
tax liability
19. Amount of line 17 to be refunded (subtract line 18 from line 17) 711
20. Net amount due, if any (if line 13 is more than line 16, subtract line 16 from line 13, but not less 0
than -0-)
21. Interest and penalty on late-paid and/or late-fi led return, if any

9/30/2016 1041 Scenario 4 Page 1 of 5

- 27 -

22. Total amount due, if any (sum of lines 20 and 21). Make check payable to Ohio Treasurer of State, 0
include Ohio form IT 1041P and place FEIN on check

SCHEDULE A – ADJUSTMENTS TO FEDERAL TAXABLE INCOME NET OF RELATED EXPENSES
Additions
23. Federal and/or non-Ohio state or local government interest and dividends not distributed          2328
24. Pass-through entity and financial institutions taxes paid and related member add-back             0
25. Income from an ESBT not shown in federal taxable income                                           0
26. Losses from sale or other disposition of Ohio public obligations                                  0
27. Recovery of amount previously deducted or excluded                                                0
28. Adjustment for Internal Revenue Code sections 168(k) depreciation expense                         0

2/3
5/6
6/6

29. Federal personal exemption (estates only), lump sum distribution add-back and miscellaneous       0
federal tax adjustments
30. Expenses claimed on Ohio estate return (estates only)                                             0
31. Total additions (add lines 23 through 30)                                                         2328
Deductions
32. Federal interest and dividends exempt from state taxation net of related expenses                 3343
33. Certain state and municipal income tax overpayments                                               0
34. Losses from an ESBT not shown in federal taxable income                                           0
35. Wage and salary expense not previously deducted due to the federal targeted jobs credit or        0
the work opportunity credit
36. Interest income from Ohio public obligations and Ohio purchase obligations and gains from         0
the sale or other disposition of Ohio public obligations
37. Refunds or reimbursements of prior year federal itemized deductions and miscellaneous             0
federal tax adjustments
38. Farm income from a farm of at least 10 acres (trusts only)                                        0
39. Adjustment for Internal Revenue Code sections 168(k) and 179 depreciation expense                 0
40. Repayment of income reported in a prior year and not otherwise deducted                           0
41. Total deductions (sum of lines 32 through 40)                                                     3343
42. Net adjustments – If line 31 is MORE than line 41, enter the difference here and on line 2 as     -1015
positive. If line 31 is LESS than line 41, enter the difference here and on line 2 as negative

SCHEDULE B – ESTATE CREDITS
43. Retirement income credit (see instructions for credit table) (limit – $200)                       0
44. Lump sum retirement credit (attach Ohio LS WKS, line 6)                                           0
45. Senior citizen’s credit (limit – $50 per return)                                                  0
46. Child and dependent care credit (see instructions and worksheet in Ohio form IT 1040 booklet)     0

9/30/2016                                                            1041 Scenario 4                       Page 2 of 5

- 28 -

SCHEDULE G – APPORTIONED INCOME FOR TRUSTS
62. Enter (i) the trust’s business income not included in line 59 and (ii) the trust’s qualifying 350860
investment income not otherwise a part of business income and not included in line 58
63. Enter the Ohio apportionment ratio from line 78 of the apportionment worksheet on page 5 0.113055
64. Multiply the amount on line 62 by the apportionment ratio on line 63. Enter here and on 39666
line 5

9/30/2016 1041 Scenario 4 Page 3 of 5

- 29 -

SCHEDULE H – ALLOCATED NONBUSINESS INCOME FOR TRUSTS
65. Resident trusts: Enter the trust’s portion of Ohio taxable income (line 3) not reported on lines 463577
59 or 62
66. Nonresident trusts: Enter the trust’s portion of Ohio taxable income (line 3) not reported       0
on lines 59 or 62 to the extent such income (i) was derived from real or tangible property
located in or based in Ohio or (ii) was sitused to Ohio (see instructions for line 66) or (iii)
was described in Ohio Revised Code section 5747.212
67. Add lines 65 and 66 and enter here and on line 6                                                 463577

SCHEDULE I – TAX CREDIT FOR RESIDENT TRUSTS
68. Enter the amount of allocated resident trust nonbusiness income (line 65, above) subject         463577
to tax in one or more states or in the District of Columbia
69. Enter the amount from line 8                                                                     22696
70. Enter the amount of modified Ohio taxable income from line 7                                     503243
71. Divide line 69 by line 70 and enter the percentage here. This is the average effective tax       0.0451
rate
72. Multiply the amount on line 68 by the percentage reported on line 71                             20907
73. Enter the amount of tax actually paid by the resident trust to another state or the District of  25605
Columbia on the trust’s allocated nonbusiness income
74. Enter the smaller of the amount on lines 72 and 73. This is the resident trust’s Ohio tax        20907
credit. Enter here and on line 10

APPORTIONMENT WORKSHEET
75. Property
          a) Owned (average cost)       Within Ohio                                                  29413
                                        Total Everywhere                                             565241
          b) Rented (annual rental X 8) Within Ohio                                                  8192
                                        Total Everywhere                                             98345
          c) Total (lines 75a and 75b)  Within Ohio                                                  37605
                                        Total Everywhere                                             663586
          Ratio (carry to six decimal places)                                                        0.056669
          Weighted Ratio (carry to six decimal places)                                               0.028335
76. Payroll
          Within Ohio                                                                                243408
          Total Everywhere                                                                           1436542
          Ratio (carry to six decimal places)                                                        0.169440
          Weighted Ratio (carry to six decimal places)                                               0.084720
77. Sales
          Within Ohio                                                                                0
          Total Everywhere                                                                           0

9/30/2016                                                                1041 Scenario 4                     Page 4 of 5

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Ratio (carry to six decimal places) 1.00 0.000000
Weighted Ratio (carry to six decimal places) 0.000000
78. Total weighted apportionment ratio (add weighted ratio from lines 75c, 76 and 77). Enter ratio here and on
Schedule G, line 63 (carry to six decimal places). 0.113055
Note: If the denominator of any factor is zero, the weight given to the other factors must be proportionately increased so that the total weight given to the
combined number of factors used is 100%, i.e., if no property/payroll, use 25% and 75%; if no sales, use 50% property/payroll; if only one factor, use 100%.
NET PAYMENT WORKSHEET
79a. Estimated payments 2500
79b. Prior year credit carryover 0
79c. 1099 withholdings 0
79d. W-2 withholdings 0
79e. Refunds previously claimed 0
80. Net payments (sum of lines 78a-d minus line 78e). Enter here and on page 2, line 14. 2500

9/30/2016 1041 Scenario 4 Page 5 of 5

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2016 IT-1041
TRUST/ESTATE INFORMATION
Test Scenario 5
Check here if final return
Federal employer I.D. number (FEIN) XX-0104115
Social Security no. of decedent (estates only)
For taxable year beginning on 01/2016
Name of trust or estate TRUST5
Name of trust or estate (second line)
Fiduciary name and title MICHAEL J HORVITZ, TRUSTEE
Address 1001 LAKESIDE AVE, STE 900
City CLEVELAND
State OH
ZIP code 44114
Simple trust X
Complex trust
Resident trust X
Nonresident trust
Irrevocable trust
Testamentary trust X
Bankruptcy estate
Decedent’s estate

1041 FORM DATA
1. Federal taxable income (from line 22 of IRS form 1041). Attach page 1 of IRS form 1041 113883
2. Net adjustments from Schedule A, line 42 122192
3. Ohio taxable income (line 1 plus or minus line 2). Estates should skip lines 4-7 236075
4. Allocated qualifying trust amount from Schedule F, line 60 (trusts only) 690
5. Apportioned trust income from Schedule G, line 63 (trusts only) 9902
6. Allocated trust income from Schedule H, line 66 (trusts only) 121393
7. Modifi ed Ohio taxable income (trusts add lines 4, 5 and 6; if less than zero, enter -0-) 131985
8. Tax on Ohio taxable income (estates, line 3) or tax on modifi ed Ohio taxable income (trusts, 4459
line 7). See tax table in the instructions
9. Credits from Schedule B, line 50 (estates only) 0
10. Resident credit from Schedule C (estates); nonresident credit from Schedule D (estates); business 506
credit for estates and trusts from Schedule E (attach Schedule E) and Schedule I credit (resident
trusts)
11. Tax after nonrefundable credits and grant (line 8 minus the amount on lines 9 and 10) 3953
12. Interest penalty on underpayment of estimated tax (attach Ohio form IT/SD 2210) 0
13. Total Ohio tax (sum of lines 11 and 12) 3953
14. Net payments from line 79 on page 5 20000
15. Refundable business credits (attach documentation) 0
16. Total (sum of lines 14 and 15) 20000
17. If line 16 is more than line 13, subtract line 13 from line 16. This is your overpayment 16047
18. Amount of line 17 to be credited to 2017 estimated 250
tax liability
19. Amount of line 17 to be refunded (subtract line 18 from line 17) 15797
20. Net amount due, if any (if line 13 is more than line 16, subtract line 16 from line 13, but not less 0
than -0-)
21. Interest and penalty on late-paid and/or late-fi led return, if any 0

9/30/2016 1041 Scenario 5 Page 1 of 5

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22. Total amount due, if any (sum of lines 20 and 21). Make check payable to Ohio Treasurer of State, 0
include Ohio form IT 1041P and place FEIN on check

SCHEDULE A – ADJUSTMENTS TO FEDERAL TAXABLE INCOME NET OF RELATED EXPENSES
Additions
23. Federal and/or non-Ohio state or local government interest and dividends not distributed          8238
24. Pass-through entity and financial institutions taxes paid and related member add-back             0
25. Income from an ESBT not shown in federal taxable income                                           114682
26. Losses from sale or other disposition of Ohio public obligations                                  0
27. Recovery of amount previously deducted or excluded                                                0
28. Adjustment for Internal Revenue Code sections 168(k) depreciation expense

2/3
5/6
6/6

29. Federal personal exemption (estates only), lump sum distribution add-back and miscellaneous       0
federal tax adjustments
30. Expenses claimed on Ohio estate return (estates only)                                             0
31. Total additions (add lines 23 through 30)                                                         122920
Deductions
32. Federal interest and dividends exempt from state taxation net of related expenses                 63
33. Certain state and municipal income tax overpayments                                               665
34. Losses from an ESBT not shown in federal taxable income                                           0
35. Wage and salary expense not previously deducted due to the federal targeted jobs credit or        0
the work opportunity credit
36. Interest income from Ohio public obligations and Ohio purchase obligations and gains from         0
the sale or other disposition of Ohio public obligations
37. Refunds or reimbursements of prior year federal itemized deductions and miscellaneous             0
federal tax adjustments
38. Farm income from a farm of at least 10 acres (trusts only)                                        0
39. Adjustment for Internal Revenue Code sections 168(k) and 179 depreciation expense                 0
40. Repayment of income reported in a prior year and not otherwise deducted                           0
41. Total deductions (sum of lines 32 through 40)                                                     728
42. Net adjustments – If line 31 is MORE than line 41, enter the difference here and on line 2 as     122192
positive. If line 31 is LESS than line 41, enter the difference here and on line 2 as negative

SCHEDULE B – ESTATE CREDITS
43. Retirement income credit (see instructions for credit table) (limit – $200)                       0
44. Lump sum retirement credit (attach Ohio LS WKS, line 6)                                           0
45. Senior citizen’s credit (limit – $50 per return)                                                  0
46. Child and dependent care credit (see instructions and worksheet in Ohio form IT 1040 booklet)     0

9/30/2016                                                            1041 Scenario 5                        Page 2 of 5

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SCHEDULE F – ALLOCATED QUALIFYING TRUST AMOUNTS
59. Enter the trust’s portion of capital gains/losses recognized to the extent included in Ohio 8000
taxable income (line 3) if the location of the physical assets of the closely held investee is
available
60. Enter the percentage of the closely held investee’s physical assets located within Ohio 0.0863
61. Multiply the amount on line 59 by the percentage on line 60. Enter here and on line 4 690

SCHEDULE G – APPORTIONED INCOME FOR TRUSTS
62. Enter (i) the trust’s business income not included in line 59 and (ii) the trust’s qualifying 114682
investment income not otherwise a part of business income and not included in line 58
63. Enter the Ohio apportionment ratio from line 78 of the apportionment worksheet on page 5 0.086344
64. Multiply the amount on line 62 by the apportionment ratio on line 63. Enter here and on 9902
line 5

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SCHEDULE H – ALLOCATED NONBUSINESS INCOME FOR TRUSTS
65. Resident trusts: Enter the trust’s portion of Ohio taxable income (line 3) not reported on lines 121393
59 or 62
66. Nonresident trusts: Enter the trust’s portion of Ohio taxable income (line 3) not reported       0
on lines 59 or 62 to the extent such income (i) was derived from real or tangible property
located in or based in Ohio or (ii) was sitused to Ohio (see instructions for line 66) or (iii)
was described in Ohio Revised Code section 5747.212
67. Add lines 65 and 66 and enter here and on line 6                                                 121393

SCHEDULE I – TAX CREDIT FOR RESIDENT TRUSTS
68. Enter the amount of allocated resident trust nonbusiness income (line 65, above) subject         18590
to tax in one or more states or in the District of Columbia
69. Enter the amount from line 8                                                                     4459
70. Enter the amount of modified Ohio taxable income from line 7                                     131985
71. Divide line 69 by line 70 and enter the percentage here. This is the average effective tax       0.0338
rate
72. Multiply the amount on line 68 by the percentage reported on line 71                             628
73. Enter the amount of tax actually paid by the resident trust to another state or the District of  506
Columbia on the trust’s allocated nonbusiness income
74. Enter the smaller of the amount on lines 72 and 73. This is the resident trust’s Ohio tax        506
credit. Enter here and on line 10

APPORTIONMENT WORKSHEET
75. Property
          a) Owned (average cost)       Within Ohio                                                  27632
                                        Total Everywhere                                             538260
          b) Rented (annual rental X 8) Within Ohio                                                  7210
                                        Total Everywhere                                             96360
          c) Total (lines 75a and 75b)  Within Ohio                                                  34842
                                        Total Everywhere                                             634620
          Ratio (carry to six decimal places)                                                        0.054902
          Weighted Ratio (carry to six decimal places)                                               0.010980
76. Payroll
          Within Ohio                                                                                184525
          Total Everywhere                                                                           1268915
          Ratio (carry to six decimal places)                                                        0.145420
          Weighted Ratio (carry to six decimal places)                                               0.029084
77. Sales
          Within Ohio                                                                                1989624
          Total Everywhere                                                                           25794534

9/30/2016                                                                1041 Scenario 5                     Page 4 of 5

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Ratio (carry to six decimal places) 1.00 0.077134
Weighted Ratio (carry to six decimal places) 0.046280
78. Total weighted apportionment ratio (add weighted ratio from lines 75c, 76 and 77). Enter ratio here and on
Schedule G, line 63 (carry to six decimal places). 0.086344
Note: If the denominator of any factor is zero, the weight given to the other factors must be proportionately increased so that the total weight given to the
combined number of factors used is 100%, i.e., if no property/payroll, use 25% and 75%; if no sales, use 50% property/payroll; if only one factor, use 100%.
NET PAYMENT WORKSHEET
79a. Estimated payments 0
79b. Prior year credit carryover 20000
79c. 1099 withholdings 0
79d. W-2 withholdings 0
79e. Refunds previously claimed 0
80. Net payments (sum of lines 78a-d minus line 78e). Enter here and on page 2, line 14. 20000

9/30/2016 1041 Scenario 5 Page 5 of 5

- 36 -

2016 IT-1041
TRUST/ESTATE INFORMATION
Test Scenario 6
Check here if final return
Federal employer I.D. number (FEIN) XX-0104116
Social Security no. of decedent (estates only)
For taxable year beginning on 01/2016
Name of trust or estate ESTATE6
Name of trust or estate (second line)
Fiduciary name and title JEFF DONALD, EXECUTOR
Address 1353 DEADWOOD AVE
City CLEVELAND
State OH
ZIP code 44114
Simple trust
Complex trust
Resident trust
Nonresident trust
Irrevocable trust
Testamentary trust
Bankruptcy estate X
Decedent’s estate

1041 FORM DATA
1. Federal taxable income (from line 22 of IRS form 1041). Attach page 1 of IRS form 1041 365441
2. Net adjustments from Schedule A, line 42 43074
3. Ohio taxable income (line 1 plus or minus line 2). Estates should skip lines 4-7 408515
4. Allocated qualifying trust amount from Schedule F, line 60 (trusts only) 0
5. Apportioned trust income from Schedule G, line 63 (trusts only) 0
6. Allocated trust income from Schedule H, line 66 (trusts only) 0
7. Modifi ed Ohio taxable income (trusts add lines 4, 5 and 6; if less than zero, enter -0-) 0
8. Tax on Ohio taxable income (estates, line 3) or tax on modifi ed Ohio taxable income (trusts, 17962
line 7). See tax table in the instructions
9. Credits from Schedule B, line 50 (estates only) 350
10. Resident credit from Schedule C (estates); nonresident credit from Schedule D (estates); business 798
credit for estates and trusts from Schedule E (attach Schedule E) and Schedule I credit (resident
trusts)
11. Tax after nonrefundable credits and grant (line 8 minus the amount on lines 9 and 10) 16814
12. Interest penalty on underpayment of estimated tax (attach Ohio form IT/SD 2210) 0
13. Total Ohio tax (sum of lines 11 and 12) 16814
14. Net payments from line 79 on page 5 3200
15. Refundable business credits (attach documentation) 0
16. Total (sum of lines 14 and 15) 3200
17. If line 16 is more than line 13, subtract line 13 from line 16. This is your overpayment 0
18. Amount of line 17 to be credited to 2017 estimated 0
tax liability
19. Amount of line 17 to be refunded (subtract line 18 from line 17) 0
20. Net amount due, if any (if line 13 is more than line 16, subtract line 16 from line 13, but not less 13614
than -0-)
21. Interest and penalty on late-paid and/or late-fi led return, if any 0

9/30/2016 1041 Scenario 6 Page 1 of 5

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22. Total amount due, if any (sum of lines 20 and 21). Make check payable to Ohio Treasurer of State, 13614
include Ohio form IT 1041P and place FEIN on check

SCHEDULE A – ADJUSTMENTS TO FEDERAL TAXABLE INCOME NET OF RELATED EXPENSES
Additions
23. Federal and/or non-Ohio state or local government interest and dividends not distributed          5678
24. Pass-through entity and financial institutions taxes paid and related member add-back             0
25. Income from an ESBT not shown in federal taxable income                                           0
26. Losses from sale or other disposition of Ohio public obligations                                  0
27. Recovery of amount previously deducted or excluded                                                0
28. Adjustment for Internal Revenue Code sections 168(k) depreciation expense                         0

2/3
5/6
6/6

29. Federal personal exemption (estates only), lump sum distribution add-back and miscellaneous       600
federal tax adjustments
30. Expenses claimed on Ohio estate return (estates only)                                             37708
31. Total additions (add lines 23 through 30)                                                         43986
Deductions
32. Federal interest and dividends exempt from state taxation net of related expenses                 250
33. Certain state and municipal income tax overpayments                                               662
34. Losses from an ESBT not shown in federal taxable income                                           0
35. Wage and salary expense not previously deducted due to the federal targeted jobs credit or        0
the work opportunity credit
36. Interest income from Ohio public obligations and Ohio purchase obligations and gains from         0
the sale or other disposition of Ohio public obligations
37. Refunds or reimbursements of prior year federal itemized deductions and miscellaneous             0
federal tax adjustments
38. Farm income from a farm of at least 10 acres (trusts only)                                        0
39. Adjustment for Internal Revenue Code sections 168(k) and 179 depreciation expense                 0
40. Repayment of income reported in a prior year and not otherwise deducted                           0
41. Total deductions (sum of lines 32 through 40)                                                     912
42. Net adjustments – If line 31 is MORE than line 41, enter the difference here and on line 2 as     43074
positive. If line 31 is LESS than line 41, enter the difference here and on line 2 as negative

SCHEDULE B – ESTATE CREDITS
43. Retirement income credit (see instructions for credit table) (limit – $200)                       200
44. Lump sum retirement credit (attach Ohio LS WKS, line 6)                                           0
45. Senior citizen’s credit (limit – $50 per return)                                                  50
46. Child and dependent care credit (see instructions and worksheet in Ohio form IT 1040 booklet)     0

9/30/2016                                                            1041 Scenario 6                       Page 2 of 5

- 38 -

47. Lump sum distribution credit (must be 65 or older to claim this credit; attach Ohio LS WKS, line 3) 0
48. Ohio political contributions credit 100
49. Ohio adoption credit (limit $10,000) 0
50. Total Schedule B credits (sum of lines 43 through 49) – enter here and on line 9 350

SCHEDULE D – ESTATE NONRESIDENT CREDIT
56. Enter the portion of Ohio taxable income (line 3) not earned or received in Ohio 18500
(attach Ohio form IT 2023)
57. Enter Ohio taxable income (line 3) 408515
58a. Divide line 56 by line 57 and enter percentage here % 0.0453
58b. Multiply the percentage on 58a by the amount shown on line 8 reduced by the amount shown on line 9.
Enter here and on line 10 798

9/30/2016 1041 Scenario 6 Page 3 of 5

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9/30/2016 1041 Scenario 6 Page 4 of 5

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Ratio (carry to six decimal places) 1.00 0.000000
Weighted Ratio (carry to six decimal places) 0.000000
78. Total weighted apportionment ratio (add weighted ratio from lines 75c, 76 and 77). Enter ratio here and on
Schedule G, line 63 (carry to six decimal places). 0.000000
Note: If the denominator of any factor is zero, the weight given to the other factors must be proportionately increased so that the total weight given to the
combined number of factors used is 100%, i.e., if no property/payroll, use 25% and 75%; if no sales, use 50% property/payroll; if only one factor, use 100%.
NET PAYMENT WORKSHEET
79a. Estimated payments 0
79b. Prior year credit carryover 0
79c. 1099 withholdings 0
79d. W-2 withholdings 3200
79e. Refunds previously claimed 0
80. Net payments (sum of lines 78a-d minus line 78e). Enter here and on page 2, line 14. 3200

9/30/2016 1041 Scenario 6 Page 5 of 5

- 41 -

2016 IT-1041
TRUST/ESTATE INFORMATION
Test Scenario 7
Check here if final return
Federal employer I.D. number (FEIN) XX-0104117
Social Security no. of decedent (estates only)
For taxable year beginning on 01/2016
Name of trust or estate ESTATE7
Name of trust or estate (second line)
Fiduciary name and title JEFF DONALD, EXECUTOR
Address 1353 DEADWOOD AVE
City CLEVELAND
State OH
ZIP code 44114
Simple trust
Complex trust
Resident trust
Nonresident trust
Irrevocable trust
Testamentary trust
Bankruptcy estate
Decedent’s estate X

1041 FORM DATA
1. Federal taxable income (from line 22 of IRS form 1041). Attach page 1 of IRS form 1041 0
2. Net adjustments from Schedule A, line 42 600
3. Ohio taxable income (line 1 plus or minus line 2). Estates should skip lines 4-7 600
4. Allocated qualifying trust amount from Schedule F, line 60 (trusts only) 0
5. Apportioned trust income from Schedule G, line 63 (trusts only) 0
6. Allocated trust income from Schedule H, line 66 (trusts only) 0
7. Modifi ed Ohio taxable income (trusts add lines 4, 5 and 6; if less than zero, enter -0-) 0
8. Tax on Ohio taxable income (estates, line 3) or tax on modifi ed Ohio taxable income (trusts, 3
line 7). See tax table in the instructions
9. Credits from Schedule B, line 50 (estates only) 350
10. Resident credit from Schedule C (estates); nonresident credit from Schedule D (estates); business 0
credit for estates and trusts from Schedule E (attach Schedule E) and Schedule I credit (resident
trusts)
11. Tax after nonrefundable credits and grant (line 8 minus the amount on lines 9 and 10) 0
12. Interest penalty on underpayment of estimated tax (attach Ohio form IT/SD 2210) 0
13. Total Ohio tax (sum of lines 11 and 12) 0
14. Net payments from line 79 on page 5 0
15. Refundable business credits (attach documentation) 0
16. Total (sum of lines 14 and 15) 0
17. If line 16 is more than line 13, subtract line 13 from line 16. This is your overpayment 0
18. Amount of line 17 to be credited to 2017 estimated 0
tax liability
19. Amount of line 17 to be refunded (subtract line 18 from line 17) 0
20. Net amount due, if any (if line 13 is more than line 16, subtract line 16 from line 13, but not less 0
than -0-)
21. Interest and penalty on late-paid and/or late-fi led return, if any 0

9/30/2016 1041 Scenario 7 Page 1 of 5

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22. Total amount due, if any (sum of lines 20 and 21). Make check payable to Ohio Treasurer of State, 0
include Ohio form IT 1041P and place FEIN on check

SCHEDULE A – ADJUSTMENTS TO FEDERAL TAXABLE INCOME NET OF RELATED EXPENSES
Additions
23. Federal and/or non-Ohio state or local government interest and dividends not distributed          0.00
24. Pass-through entity and financial institutions taxes paid and related member add-back             0
25. Income from an ESBT not shown in federal taxable income                                           0.00
26. Losses from sale or other disposition of Ohio public obligations                                  0
27. Recovery of amount previously deducted or excluded                                                0
28. Adjustment for Internal Revenue Code sections 168(k) depreciation expense                         0

2/3
5/6
6/6

29. Federal personal exemption (estates only), lump sum distribution add-back and miscellaneous       600
federal tax adjustments
30. Expenses claimed on Ohio estate return (estates only)                                             0
31. Total additions (add lines 23 through 30)                                                         600
Deductions
32. Federal interest and dividends exempt from state taxation net of related expenses                 0
33. Certain state and municipal income tax overpayments                                               0
34. Losses from an ESBT not shown in federal taxable income                                           0
35. Wage and salary expense not previously deducted due to the federal targeted jobs credit or        0
the work opportunity credit
36. Interest income from Ohio public obligations and Ohio purchase obligations and gains from         0
the sale or other disposition of Ohio public obligations
37. Refunds or reimbursements of prior year federal itemized deductions and miscellaneous             0
federal tax adjustments
38. Farm income from a farm of at least 10 acres (trusts only)                                        0
39. Adjustment for Internal Revenue Code sections 168(k) and 179 depreciation expense                 0
40. Repayment of income reported in a prior year and not otherwise deducted                           0
41. Total deductions (sum of lines 32 through 40)                                                     0
42. Net adjustments – If line 31 is MORE than line 41, enter the difference here and on line 2 as     600
positive. If line 31 is LESS than line 41, enter the difference here and on line 2 as negative

SCHEDULE B – ESTATE CREDITS
43. Retirement income credit (see instructions for credit table) (limit – $200)                       200
44. Lump sum retirement credit (attach Ohio LS WKS, line 6)                                           0
45. Senior citizen’s credit (limit – $50 per return)                                                  50
46. Child and dependent care credit (see instructions and worksheet in Ohio form IT 1040 booklet)     0

9/30/2016                                                            1041 Scenario 7                      Page 2 of 5

- 43 -

47. Lump sum distribution credit (must be 65 or older to claim this credit; attach Ohio LS WKS, line 3) 0
48. Ohio political contributions credit 100
49. Ohio adoption credit (limit $10,000)
50. Total Schedule B credits (sum of lines 43 through 49) – enter here and on line 9 350

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- 44 -

APPORTIONMENT WORKSHEET
75. Property
a) Owned (average cost) Within Ohio 0
Total Everywhere 0
b) Rented (annual rental X 8) Within Ohio 0
Total Everywhere 0
c) Total (lines 75a and 75b) Within Ohio 0
Total Everywhere 0
Ratio (carry to six decimal places) 0.000000
Weighted Ratio (carry to six decimal places) 0.000000
76. Payroll
Within Ohio
Total Everywhere
Ratio (carry to six decimal places) 0.000000
Weighted Ratio (carry to six decimal places) 0.000000
77. Sales
Within Ohio 0
Total Everywhere 0

9/30/2016 1041 Scenario 7 Page 4 of 5

- 45 -

Ratio (carry to six decimal places) 1.00 0.000000
Weighted Ratio (carry to six decimal places) 0.000000
78. Total weighted apportionment ratio (add weighted ratio from lines 75c, 76 and 77). Enter ratio here and on
Schedule G, line 63 (carry to six decimal places). 0.000000
Note: If the denominator of any factor is zero, the weight given to the other factors must be proportionately increased so that the total weight given to the
combined number of factors used is 100%, i.e., if no property/payroll, use 25% and 75%; if no sales, use 50% property/payroll; if only one factor, use 100%.
NET PAYMENT WORKSHEET
79a. Estimated payments 0
79b. Prior year credit carryover 0
79c. 1099 withholdings 0
79d. W-2 withholdings 0
79e. Refunds previously claimed 0
80. Net payments (sum of lines 78a-d minus line 78e). Enter here and on page 2, line 14. 0

9/30/2016 1041 Scenario 7 Page 5 of 5

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