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                                                                 2016 Ohio IT 1140 
                                   Rev. 7/16                 Pass-Through Entity and 
                                                                                                                                            16170106
                                                     Trust Withholding Tax Return

                                    Check here if amended return                    Check here if fi nal return                              For taxable year beginning in
                                                                                                                                            MM / 2  0 16
FEIN
                                                            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 (“–”) before the fi gure. 
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
  ..............columns1.A and B or from Schedule D, line 5)                                                             .00                                        .
  2. Interest penalty on underpayment of estimated tax 
    if the sum of columns A and B on line 9 on page 3                                                                            00                                  00
    exceeds $10,000 (include Ohio IT/SD 2210) .............. 2.                                                          .                                          .
                                                                                                                                 00                                  00
 2a. Add lines 1 and 2 ...................................................... 2a.                                        .                                          .
  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) ....................................... 3.                                               .                                          .
 3a. Payments transferred from Ohio IT 4708ES and IT 
    4708P (include schedule if required; see instruc-
    tions) and other payments previously made for this                                                                           00
    taxable year .............................................................. 3a.                                      .
 3b. Payments transferred to Ohio IT 4708 and refunds,                                                                           00
  ............if any,3b.previously claimed for this taxable year                                                         .
 3c. Net payments (sum of lines 3 and 3a minus line 3b)                                                                          00                                  00
    not less than zero...................................................... 3c.                                         .                                          .
                                                                                                                                 00                                  00
  4. For each column, subtract line 3c from line 2a ........... 4.                                                       .                                          .
                                                                                                                                                                     00
   5.  If the sum of line 4, columns (I) and (II) is an overpayment, enter that sum here ..........OVERPAYMENT5.                                                   .
                                                                                                                                                                     00
  6.  Amount of line 5 to be CREDITED to year 2017               ....................................................... CREDIT TO 20176.                          .
                                                                                                                                                                     00
  7.  Amount of line 5 to be REFUNDED (line 5 minus line 6) ............................................                 YOUR REFUND7.                             .
                                                                                                                                                                     00
   8.  If the sum of line 4, columns (I) and (II) is a balance due or zero, enter here the         amount due .................8.                                   .
                                                                                                                                                                     00
   9. Interest and penalty due on late-paid tax and/or late-fi led return, if any....................................................... 9.                          .
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..........................................................TOTAL AMOUNT DUE10.                                             .
                               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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                                                              2016 Ohio IT 1140 
                   Rev. 7/16                         Pass-Through Entity and 
                                                                                                                             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 offi cer 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 at tax.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 (“–”) before the fi gure.
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.                                             /           /
                                                                                                                 Postmark date                    Code

                                                                                                                 2016 IT 1140 – pg. 2 of 5



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                                                             2016 Ohio IT 1140 
              Rev. 7/16                            Pass-Through Entity and 
FEIN                                                                                                                       16170306
                                                   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 A amount 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 fi nancial institution as defi ned in Ohio Revised Code 
section (R.C.) 5725.01. If the pass-through entity is a fi nancial 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
                                                                                        00                                                        00
 3.  Sales                                                                              .                 ÷                                      .
                                                                                        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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                                                               2016 Ohio IT 1140 
                      Rev. 7/16                  Pass-Through Entity and 
FEIN                                                                                                                                                                  16170406
                                              Trust Withholding Tax Return

                                    If the amount on a line is negative, place a negative sign (“–”) before the fi gure. 
Schedule D – Trusts – Tax Due
Use this schedule to calculate the adjusted qualifying amounts and withholding tax due for nonresident individuals who are benefi ciaries 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 benefi ciaries 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 benefi ciaries 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 for  all(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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                                           2016 Ohio IT 1140 
                  Rev. 7/16                Pass-Through Entity and 
FEIN                                                                                                               16170506
                                           Trust Withholding Tax Return

Schedule E – Investor Information...cont.
Provide investor information for all (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 defi ned 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 led 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 fi nancial 
                                                                             institutions, fi nancial 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 fi nancial 
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 benefi ciaries 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 fi nancial institutions, fi nancial 
defi ned in R.C. 5733.042(A)(6) but is modifi ed by R.C. 5733.40(P).           holding companies, bank holding companies, savings and loan 
For purposes of the line 4 adjustment, a related member is any busi-         holding companies, insurance companies, or persons directly 
ness entity or person directly or indirectly related to the taxpayer if      or indirectly “owned” by such businesses.
the direct and indirect ownership interests equals or exceeds 40% 
of all ownership interests.                                                Defi nition 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. 5733.40(A)(3). Do not show on line 4 any amount             has a benefi cial interest in the entity’s profi ts, surpluses, losses 
required on line 6.                                                          or distributions (partnerships, trusts or other business interests).
Note 4: Instructions for Schedule B, line 10, column (B). For those        Defi nition of “securitization” for this purpose: Transferring one or 
qualifying corporate investors that are not 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         If you use multiple rates for column B, include a schedule refl ecting 
entities, compute the tax at the rate of 8.5%. See R.C. 5733.41.           the computation of tax for each type of investor.
  Financial holding companies as defi ned in the federal “Bank             Fiscal fi lers: Use the rate in effect on the last day of the taxable year. 
    Holding Company Act.”
                                                                           Note 5: Amount of tax credits that will pass through from the qualify-
  Bank holding companies as defi ned in the federal “Bank Hold-            ing pass-through entity or qualifying trust to each qualifying investor 
    ing Company Act.”                                                      or qualifying benefi ciary.

                                                           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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