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II                         Depa!1ment of                        2016 Ohio IT 1140 
       Ohio I Taxation 
                           Rev. 10/16                   Pass-Through Entity and                                            11111111111111111 1111111   • 
                                                                                                                              16170106
                                                     Trust Withholding Tax Return

                               Check here if amended return                       Check here if ﬁnal return                 For taxable year beginning in
                                                                                                                              MM
FEIN                                                                                                                             /      2 0  16
                                                      Entity Type:     S corporation                         Partnership
                                                      (check only one) 
                                                                       Limited liability company             Trust 
Name of pass-through entity 

Address (if address change, check box) 

City                                                                                    State        ZIP code 

Number of investors            Apportionment ratio, page 3, line 8     Schedule B, line 1 – total of columns A and B 
                                                                                                                        00 
                                                                                                                   .
                                      If the amount on a line is negative, place a negative sign (“–”) in the box provided. 
Schedule A – Reconciliation Tax and Payments
                                                                       Column (I) – Withholding Tax                        Column (II) – Entity Tax
 1. Tax for each column (from Schedule B, line 11,                                                           00                                     00
      columns A and B or from Schedule D, line 5)                                                          .                ,           ,          .
 2.  Interest penalty on underpayment of estimated tax if  
      the sum of columns A  and B, page 3, line 9 exceeds                                                    00                                     00
      $10,000 (include Ohio IT/SD 2210)                                                                    .                ,           ,          .
                                                                                                             00                                     00
 2a. Add lines 1 and 2                                                                                     .                ,           ,          .
  3.  Ohio IT    1140ES and IT 1140P    payments the entity  
      or trust made and/or 2015 overpayment credited to                                                      00                                     00
      2016 (see Note 1 on page 6)                                                                          .                ,           ,          .
 3a. Payments transferred from Ohio IT4708ES            and IT  
      4708P  (include schedule if required; see instruc-
      tions) and other payments previously made for this                                                     00
      taxable year                                                                ,             ,          .
 3b. Payments transferred to Ohio IT  4708 and refunds,                                                      00
      if any, previously claimed for this taxable year                            ,             ,          .
 3c. Net payments (sum of lines 3 and 3a minus line 3b)                                                      00                                     00 
      not less than zero                                                          ,             ,          .                ,           ,          .
                                                                                                             00                                     00 
 4.  For each column, subtract line 3c from line 2a                               ,             ,          .                ,           ,          .
                                                                                                                                                    00 
   5.If   the sum of line 4, columns (I) and (II) is an overpayment, enter that sum here                                    ,           ,          .
                                                                                                                                                    00 
 6. Amount of line 5 to be CREDITED to year 2017                                                                            ,           ,          .
                                                                                                                                                    00 
 7. Amount of line 5 to be REFUNDED (line 5 minus line 6)                                                                   ,           ,          .
                                                                                                                                                    00 
   8.   If the sum of line 4, columns (I) and (II) is a balance due or zero, enter here theamount    due                    ,           ,          .
                                                                                                                                                    00 
   9. Interest and penalty due on late-paid tax and/or late-ﬁled       return, if any                                       ,           ,          .
10. Total amount due (sum of  lines 8 and 9). Make check payable to Ohio Treasurer of State. Include                                                00
    Ohio IT 1140P and place FEIN on check                                                                                   ,           ,          .
                      If your refund is $1.00 or less, no refund will be issued. If you owe $1.00 or less, no payment is necessary.

                      Do not write in this area; for department use only.

                                                                                                                2016 IT 1140 – pg. 1 of 5
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II
Depa~ment of 2016 Ohio IT 1140
Ohio I Taxation
Rev. 10/16 Pass-Through Entity and 11111111111111111 II I IIII •
16170206
FEIN
Trust Withholding Tax Return

Sign Here (required): I declare under penalties of perjury that this report, including any ac-
companying schedules and statements, has been examined by me and to the best of my knowledge Do not staple or otherwise attach.
and belief is a true, correct and complete return and report.
Place any supporting documents, including
K-1’s, after the last page of this return.
Pass-through entity oﬃ cer or agent (print name)
Mail to:
Title of oﬃcer or agent (print name) Phone number
Ohio Dept. of Taxation
Signature of pass-through oﬃ cer or agent Date P.O. Box 181140
Columbus, OH 43218-1140
Preparer’s name (print name) Phone number
Instructions for this form are on our
Preparer’s e-mail address PTIN Web site attax.ohio.gov.
Do you authorize your preparer to contact us regarding this return? Yes No
If the amount on a line is negative, place a negative sign (“–”) in the box provided.
Schedule B – Qualifying Pass-Through Entities – Tax Due
Use this schedule to calculate the adjusted qualifying amounts and tax due for all qualifying investors in qualifying pass-through entities. Include federal K-1s
and a listing of pass-through credits of participating investors. See “Special Notes” in the instructions, which are available on our Web site at tax.ohio.gov.
(A) (B)
Qualifying Investors Who Are Qualifying Investors Other
Nonresident Individuals Than Nonresident Individuals
1. Sum of all qualifying investors’ distributive 00 00
shares of income, gain, expenses and losses ... ..1. , , . , , .
2a. Add 2/3,  5/6 or 6/6 (check applicable
box) of the qualifying investors’ distributive
shares of Internal Revenue Code (I.R.C.)
sections 168(k) and 179 depreciation expense
and miscellaneous federal income tax adjust-
ments, if any. Include a separate schedule 00 00
showing calculations .................................................2a. , , . , , .
2b. Subtract qualifying investors’distributive shares
of other statutory adjustments and miscella- 00 00
neous federal income tax adjustments, if any.............2b. , , . , , .
3. Qualifying investors’ distributive shares of ad-
justed qualifying amount: Sum of lines 1 and 00 00
2a minus line 2b................................................. ..3. , , . , , .
4. Add all qualifying investors’distributive shares
of expenses and losses incurred in connection
with all direct and indirect transactions between
the qualifying pass-through entity and its related
members, including certain investors’ family
members (see Note 2 on page 6). However, do
not add expenses or losses incurred in connec-
tion with sales of inventory to the extent that the
cost of the inventory and the loss incurred were
calculated in accordance with I.R.C. sections
00 00
263A and 482 (see Note 3 on page 6) ............... ..4. , , . , , .
5. If the qualifying pass-through entity is either
a partnership or a limited liability company
treated as a partnership, add all qualifying
investors’ distributive shares of guaranteed
payments that the qualifying pass-through
entity made to any qualifying investor directly
or indirectly owning at least 20% of the qualify- 00 00
ing pass-through entity ................................................5. , , . , , .

For Department Use Only

/ /
Do not write in this area; for department use only. ITJITJITJ D
Postmark date Code

2016 IT 1140 – pg. 2 of 5
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II                       Depa~ment of                                                                                                                                                 II 
                                                                 2016 Ohio IT 1140 
         Ohio I Taxation 
                         Rev. 10/16                       Pass-Through Entity and                                                                  11111111111111 161703061111111111 
FEIN 
                                                  Trust Withholding Tax Return 

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

  8. Apportionment ratio from Schedule C, line 4, below.....8.                                              .                                                . 
 9. Qualifying investors’  adjusted qualifying amount: 
       Line 7 times line 8. Complete the remainder of this 
       worksheet only if the sum of columns A    and B on                                                                         00                                                 00 
       line 9 exceeds $1,000  ................................................9.             ,                     ,             .                        ,             ,           . 
   10. Tax rate (see Note 4 on page 6)...............................10.                                                X .05                                               X .085
11.   Tax due: Line 9 times line 10. Round tax to the nearest  
       dollar. Enter the column  Aamount on page 1, line 1, 
       column I; enter the column B amount on page 1, line                                                                        00                                                 00 
       1, column II ...............................................................11.       ,                     ,             .                        ,             ,           . 
Schedule C – Qualifying Pass-Through Entities – Apportionment Worksheet 
Use this schedule to calculate the apportionment ratio for a qualifying pass-through entity that is not a ﬁnancial institution as deﬁned                        in Ohio Revised Code  
section (R.C.) 5725.01. If the pass-through entity is a ﬁnancial                         institution, refer to the instructions. Note:  All ratios are to be carried to six decimal places. 
 1. Property                                                                             Within Ohio                                               Total Everywhere 
                                                                                                                     00                                                              00 
    a) Owned (average cost)                              ,                               ,            ,             .                       ,             ,             ,           .
                                                                                         Within Ohio                                               Total Everywhere 
 
                                                                                                                     00                                                              00 
    b) Rented (annual rental X 8)                        ,                               ,            ,             .                       ,             ,             ,           .
                                                                                         Within Ohio                                               Total Everywhere 
                                                                                                                     00                                                              00 
    c) Total (lines 1a and 1b)                           ,                               ,            ,             .   ÷                   ,             ,             ,           .
                                                                                                               Ratio                        Weight            Weighted Ratio 
                                                                                           =           .                           x    0   .          =     . 
                                                                                         Within Ohio                                               Total Everywhere 
                                                                                                                     00                                                              00 
 2. Payroll                                              ,                               ,            ,             .   ÷                   ,             ,             ,           .
                                                                                                               Ratio                        Weight            Weighted Ratio 
 
                                                                                           =           .                           x    0   .          =     . 
                                                                                         Within Ohio                                               Total Everywhere 
 3. Sales                                                ,                               ,            ,             .   ÷                   ,             ,             ,           . 00 
                                                                                                                     00 
                                                                                                               Ratio
                                                                                                                                            Weight            Weighted Ratio 
                                                                                           =           .                           x    0   .          =     . 
                                                                                                                                                              Weighted Ratio 

 4. Total weighted apportionment ratio (add lines 1c, 2 and 3). Enter ratio here and on line 8, above (both columns).                                        . 
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%. 

                     Do not write in this area; for department use only. 

                                                                                                                                     2016 IT 1140 – pg. 3 of 5 
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II Depa~ment of II
2016 Ohio IT 1140
Ohio I Taxation
Rev. 10/16 Pass-Through Entity and 111111111111111 II II I IIII
16170406
FEIN
Trust Withholding Tax Return

If the amount on a line is negative, place a negative sign (“–”) in the box provided.
Schedule D – Trusts – Tax Due
Use this schedule to calculate the adjusted qualifying amounts and withholding tax due for nonresident individuals who are beneﬁciaries of trusts that
made distributions of either income or gain attributable to the trust’s ownership of or disposition of either tangible personal property located in Ohio or real
property located in Ohio.
1. Sum of all distributions to nonresident individuals of income or gain attributable to the trust’s
ownership of or disposition of either tangible personal property located in Ohio or real property 00
located in Ohio.............................................................................................................................. ...1. , , .
2a. Add 2/3, 5/6 or 6/6 (check applicable box) of the I.R.C. section 168(k) depreciation
expense and miscellaneous federal income tax adjustments attributed to nonresident individu- 00
als who are beneﬁciaries of trusts. Include a separate schedule showing calculations ......................2a. , , .
2b. Other statutory adjustments and miscellaneous federal income tax adjustments attributed to 00
nonresident individuals who are beneﬁciaries of trusts .........................................................................2b. , , .
3. Adjusted qualifying amount: sum of lines 1 and 2a minus line 2b. Complete the remainder of 00
the worksheet only if line 3 exceeds $1,000 ................................................................................. ...3. , , .
4. Tax rate ...................................................................................................................................................4. X .05
5. Tax due: Line 3 times line 4. Round tax to the nearest dollar. Enter here and on page 1, line 1, 00
column I ...................................................................................................................................................5. , , .
Schedule E – Investor Information
Check the box if this year’s investor information either (i) includes names that were not listed on last year’s return or (ii) excludes names that were listed on
last year’s return.Provide investor information forall (resident and nonresident) investors in the pass-through entity or trust. List investors by highest to lowest
ownership percentage. Use an additional sheet, if necessary. See Note 5 on page 6 for the amount of pass-through entity tax credits.
SSN FEIN Percent of ownership Amount of PTE tax credit
00
. , , .
First name/entity M.I. Last name

Address

City State ZIP code

SSN FEIN Percent of ownership Amount of PTE tax credit
00
. , , .
First name/entity M.I. Last name

Address

City State ZIP code

Do not write in this area; for department use only.

2016 IT 1140 – pg. 4 of 5
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II Depa~ment of 2016 Ohio IT 1140
Ohio I Taxation
Rev. 10/16 Pass-Through Entity and 111111111111111 IIII I IIII •
16170506
FEIN
Trust Withholding Tax Return

Schedule E – Investor Information
Provide investor information forall (resident and nonresident) investors in the pass-through entity or trust. List investors by highest to lowest ownership percent-
age. Use an additional sheet, if necessary. See Note 5 on page 6 for the amount of pass-through entity tax credits.
SSN FEIN Percent of ownership Amount of PTE tax credit
00
. , , .
First name/entity M.I. Last name

Address

City State ZIP code

SSN FEIN Percent of ownership Amount of PTE tax credit
00
. , , .
First name/entity M.I. Last name

Address

City State ZIP code

SSN FEIN Percent of ownership Amount of PTE tax credit
00
. , , .
First name/entity M.I. Last name

Address

City State ZIP code

SSN FEIN Percent of ownership Amount of PTE tax credit
00
. , , .
First name/entity M.I. Last name

Address

City State ZIP code

Do not write in this area; for department use only.

2016 IT 1140 – pg. 5 of 5
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Do not submit this page with your IT 1140 return.

Important Notes:
 Savings and loan holding companies as deﬁned in the federal
Note 1: Instructions for Schedule A, line 3. If this pass-through entity “Home Owners Loan Act” that are engaging only in activities
or trust has invested in a partnership or limited liability company permissible under 12 United States Code (U.S.C.) 1843(k).
thatNOTESalso ﬁled Ohio IT 1140, this pass-through entity or trust is not
entitled to any payment or credit for this pass-through entity’s or this  Persons, other than persons held pursuant to merchant banking
trust’s proportionate share of tax paid by that investee partnership authority under 12 U.S.C. 1843(k)(4)(H) or 12 U.S.C. 1843(k)
or investee limited liability company. (4)(I), directly or indirectly “owned” by one or more ﬁnancial
institutions, ﬁnancial holding companies, bank holding compa-
Furthermore, this pass-through entity or trust cannot claim such nies, or savings and loan holding companies, but only if those
payment as an estimated payment for this pass-through entity’s or persons are engaged in activities permissible for a ﬁnancial
trust’s taxable year. However, the pass-through entity or trust can holding company under 12 U.S.C. 1843(k).
“pass through” (via the K-1s it will issue) to its qualifying investors
or to its qualifying beneﬁciaries the pass-through entity’s or trust’s  Persons directly or indirectly “owned” by one or more insurance
proportionate share of such tax payment that the investee partner- companies, but only if those persons are authorized to conduct
ship or investee limited liability company paid on behalf of this the business of insurance in this state.
pass-through entity or trust.
 Persons that solely facilitate or service one or more “securitiza-
Note 2: Instructions for Schedule B, line 4. “Related member” is tions” or similar transactions for ﬁnancial institutions, ﬁnancial
deﬁned in R.C. section 5733.042(A)(6) but is modiﬁed by R.C. sec- holding companies, bank holding companies, savings and loan
tion 5733.40(P). For purposes of the line 4 adjustment, a related holding companies, insurance companies, or persons directly
member is any business entity or person directly or indirectly related or indirectly “owned” by such businesses.
to the taxpayer if the direct and indirect ownership interests equals
or exceeds 40% of all ownership interests. Deﬁnition of “owned” for this purpose: a person “owns” another
entity if the person:
Note 3: Instructions for Schedule B, lines 4 and 6. Include on line
4 all compensation paid to or for family member employees if the  owns at least 50% of the entity’s voting stock (corporations);
pass-through entity owner who is a member of family directly, indi-
 owns at least 50% of the entity’s membership interests (LLCs);
rectly and/or by attribution owns at least 40% of the pass-through
OR
entity unless the compensation is subject to (A)(7) and included on
line 6. See R.C. section 5733.40(A)(3). Do not show on line 4 any  has a beneﬁcial interest in the entity’s proﬁts, surpluses, losses
amount required on line 6. or distributions (partnerships, trusts or other business interests).
Note 4: Instructions for Schedule B, line 10, column (B). For those Deﬁnition of “securitization” for this purpose: Transferring one or
qualifying corporate investors that arenot listed below, the tax rate more assets to one or more persons and then issuing securities
for the taxable year beginning in 2016 is 0%; therefore the pass- backed by the right to receive payment from the asset or assets
through entity should pay no tax with respect to these corporations. so transferred.
For those qualifying corporate investors that are listed below and for
qualifying investors that are estates, trusts and pass-through enti- If you use multiple rates for column B, include a schedule reﬂ ecting
ties, compute the tax at the rate of 8.5%. See R.C. section 5733.41. the computation of tax for each type of investor.
 Financial holding companies as deﬁned in the federal “Bank Fiscal ﬁlers: Use the rate in eﬀ ect on the lastday of the taxable year.
Holding Company Act.”
Note 5: Amount of tax credits that will pass through from the qualify-
 Bank holding companies as deﬁned in the federal “Bank Hold- ing pass-through entity or qualifying trust to each qualifying investor
ing Company Act.” or qualifying beneﬁciary.

Federal Privacy Act Notice
Because we require you to provide us with a Social Security number, the Federal Privacy Act of 1974 requires us to inform you that
providing us with your Social Security number is mandatory. Ohio Revised Code sections 5703.05, 5703.057 and 5747.08 authorize
us to request this information. We need your Social Security number in order to administer this tax.

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