Rev. 10/20/17 

Scan Specifications for the 

          2017 Ohio IT 1041

                              Important Note 

   The following document (2017 Ohio IT 1041) contains grids for place-
   ment of information on this specific tax form. To accurately print, do not  
   reduce the size, rotate or center this document. Doing so jeopardizes 
   the integrity of the grid. When printing from Adobe Reader, select          
   “None” for “Page Scaling,” which is under “Page Handling.” 

   The 2017 Ohio IT 1041 test samples must be completed and sub-
   mitted for approval no later than Dec. 1, 2017.  

       Ohio Department of Taxation 

                                   4485 Northland Ridge Blvd. 

                                   Columbus, OH 43229 

                                   tax.ohio.gov 

Grid layout 

with notations

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85
2
3
4        Do not staple or paper clip. 
5
6                    The date the return was generated                         2017 Ohio IT 1041 
                     by the taxpayer (MM DD YY). 
7                                   Rev. 8/17                       Fiduciary Income Tax Return
                                                                                                                                                                                                                 17180110 
8     88 88 88                                                              Use only black ink and UPPERCASE letters. Placement of the tax year and 1D barcode is critical. 
                                                                                                                                                                       
9                                                                                         Make sure to follow the grid positions for layout. Do 
                                                                                                                                                                                                                 For taxable year beginning in
10                                                  X     Check here if amended returnnot forget toXgetCheckyour barcode(s)here if finalassignmentsreturn        for 
11                                                           X   Check here if the federalevery form,extensionversionwasand page.granted                                                                              88 /2017 
12  FEIN                                                             SSN of decedent (estates only) 
13    88 8888888                                                     888 88 8888 
14
15    Name of trust or estate 
16    JOHNXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 
17
18    Name of trust or estate (second line) 
19    JANEXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 
20
21    Fiduciary name and title 
22    THE NAME  AND T ITLEXXXXXXXXXXXXXXXXX 
23
24    Address (if address change, check box)                          X 
25
      8888 BERRY  AVEXXXXXXXXXXXXXXXXXXXXX 
26    City                                                                                                                    State                   ZIP code 
27
    CI TYXXXXXXXXXXXXXXXX                                                                                                     OH                      88888 
28
29    Foreign State Code                       Country Code            Foreign country (if the mailing address is outside the U.S.)                                         Foreign postal code 
30
      ABC                                                 AB           ANYCOUNTRYXXXXXXXXXX                                                                                 AB88888
31                                                                                                                                                                    Do not                                   place spaces between  
32    Check Applicable Box(es)                                                                                                                                        whole dollar numbers.                                  There 
33                                                                    Number of investors                                                                             is only a space between dollar                                 
34             X     Simple trust                            ORNEW!Thesefieldsmaypossiblybeanegativevalue.includedX Complexon return trust      X  Irrevocable trust  amountsandcentsfields.                     X    Testamentary  trust 
                                                               Include a “-“ sign here if this line has a negative value. 
35             X     Resident trust                          OR       888888X Nonresident trust                                 X                 Bankruptcy estate                                              X    Decedent’s estate 
36
37     1.   Federal  taxable         income (from the federal 1041, line 22).Include page 1 of the federal 1041 ..............................                               1.                                -     888888888 00 
38  
39  2. Net adjustments               from Schedule A, line 40 ......................................................................................................... 2.                                     -     888888888 00 
40    
                                                                                                                                                                                                               -
41 Do    not3. Ohiostaple taxableor paperincomeclip.(line 1 plus or minus line 2). Estates should skip lines 4-7 ............................................... 3.                                                  888888888 00 
42  
43    4. Allocated         qualifying trust amount from Schedule F, line 59 (trusts only) ........................................................... 4.                                                       -
44                                                                   NEW!  For static text use Arial font (black ink) and                                                                                            888888888 00 
                                                                     trytomatchsize.Fordataentryfields(                    shown in 
45       5. Apportioned       trust income from Scheduleredforidentificationpurposesonly G, line 62 (trusts only)     ......................................................................), use Arial font 5.-    888888888 00 
46                                                                   (black ink).All the data  entry fields           must   follow   
                                                                     grid layout. Never hard code a negative sign, and  
47    6. Allocated         trust income from ScheduledoH,notlineinclude65 (truststhe negativeonly) ...........................................................................sign with the amounts. 6.        -     888888888 00 
48                                                                   Thisisnowaseparatefield.         
49       ModifiedOhiotaxableincome(trustsaddlines4,5and6;iflessthanzero,enter-0-)                                                                   ....................................             7.              888888888 00 
50  8. TaxonOhiotaxableincome(estates,line3)ortaxonmodifiedOhiotaxableincome(trusts,line7).                                                                           
51       See tax    table in the instructions.........................................................................................................................       8.                                      888888888 00 
52    9.Credits from Schedule B, line 48 (estates only)2D barcode    .................................................................................................required. Delete this                   9.     888888888 00 
53                                                                    box   with text and replace     it with                                                                
    10.ResidentcreditfromScheduleC(estates);nonresidentcreditfromScheduleD(estates);businesscreditfromthe 2D barcode. 
54       ScheduleE(includeScheduleE)(estatesandtrusts);andtaxcreditfromScheduleI(residenttrusts)   .............   10.                                                                                               888888888 00 
55
56
57                                                                                                                                                                           Target marks or registration marks 
                                                                                                                                                                      For Department Use Onlymust measure 6 mm X 6 mm. The 
58                                                                                                                                                                           four target  marks or registration                            
59                           Software vendors: Place 2D barcode in this location                                                                                             marks on every page must follow 
60                           Do not place a box around the 2D barcode. The box                                                                                               grid/                             layout./ 
61                                             is only here for placement purposes.                                                                                          Postmark date                                   Code 
62
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1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85
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6                                                              2017 Ohio IT 1041 
7                            Rev. 8/17             Fiduciary Income Tax Return
                                                                                                                                                                               17180210 
8   FEIN 
9   88 8888888 
10   11.   Tax after nonrefundable credits (line 8 minus the amount on lines 9 and 10)              .....................................11.                                   888888888 00 
11    
12    12.     Interest penalty on underpayment of estimated tax (include Ohio IT/SD 2210)            ...................................... 12. 
                                                                                                                                                                               888888888 00 
13    13.     Total Ohio tax (add lines 11 and 12)  ................................................................................................... 13.                    888888888 00 
14        14. Net payments  from line 78 on page 5......................14.                888888888 00 
15
     15.   Refundable business credits from line 85 on page 
16         5(includedocumentation/certificates)                   ....................15.  888888888 00 
17    16.     Total  (add lines 14 and 15) .......................................16.      888888888 00 
18        17. Overpayment, if any (line 16 minus line 13, but not less than -0-)........................       17.YOUR REFUND                                                 888888888 00 
19         
      18. Net amount due, if any (if line 13 is more than line 16, subtract line 16 from line 13, but not less 
20       than -0-) .............................................................................................................................................  18.          888888888 00 
      19. Interest andpenaltyonlate-paidand/orlate-filedreturn,if                           .............................................................. 19. 
21                                                                                                                                                                             888888888 00 
22
     20.   Total amount due (add lines 18 and 19). Make check payable to Ohio Treasurer                       of State, include 
23   20.    Ohio UPC and place FEIN on check...................................................................... AMOUNT DUE                                                 888888888 00 
24
25                        If your refund is $1.00 or less, no refund will be issued. If you owe $1.00 or less, no payment is necessary. 

26 Sign Here (required):                                                                                                                                                   Do not staple or paper clip.  
                                    I have read this return. Under penalties of perjury, I declare that, to 
27 the best of my knowledge and belief, the return and all enclosures are true, correct and complete.                   Place any supporting documents, including  
28                                                                                                                      Ohio IT K-1(s), after the last page of this return. 
29
   Signatureoffiduciaryortrustofficer                 Preparer’sname(print)                    
30
                                                                                                                                                                               Mail to: 
31 Title                     Date (MM/DD/YY)          Preparer’s address (include ZIP code) 
32                                                                                                                      Ohio Department of Taxation 
33 Fiduciary’sortrustofficer’sphone                   Preparer’sphonenumber                                                                                                    P.O. Box 2619 
34                                                                                                                      Columbus, OH 43216-2619 
35 Preparer’s e-mail address                          PTIN 
                                                                                                                                                                  Instructions for this form are on 
36 Doyouauthorizeyourpreparertocontactusregardingthis                                       Y X No X                                                                       our website at tax.ohio.gov. 
37
38 Schedule A – Adjustments to Federal Taxable Income Net of Related Expenses 
39  Additions 
40    21.  Federal and/or non-Ohio state or local government interest and dividends not distributed...............                                                21.          888888888 00 
41         Pass-throughentityandfinancialinstitutionstaxespaidandrelatedmemberadd-back                              ................... 22.                                    888888888 00 
42
     23.   Income from an Electing Small Business Trust (ESBT) not shown in federal taxable income 
                                                 ..................................................................................................................... 23. 
43         (include documentation)                                                                                                                                             888888888 00 
44
45    24.  Losses from sale or other disposition of Ohio public obligations.......................................................                                24.          888888888 00 
46
47    25.  Recovery of amount previously deducted or excluded.......................................................................                              25.          888888888 00 
48
     26.   Adjustment for Internal Revenue Code section 168(k) depreciation expense. 
49      2/3,X            X 5/6 or     X 6/6 (check applicable box) ..........................................................................26.                               888888888 00 
50   
      27. Federal personal exemption (estates only) and miscellaneous federal tax adjustments  ................... 27. 
51                                                                                                                                                                             888888888 00 
      28. Expenses claimed on Ohio estate return (estates only)  ..................................................................... 28. 
52                                                    2D barcode required. Delete this                                                                                         888888888 00 
53                                                    box with text and replace it with             
                                                      the 2D barcode. 
54   29.   Total additions (add lines 21 through 28) ........................................................................................... 29.                           888888888 00 
55
56
57
58
59                         Software vendors: Place 2D barcode in this location
60                         Do not place a box around the 2D barcode. The box 
61                                   is only here for placement purposes.
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1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85
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6                                                                                                     2017 Ohio IT 1041 
7                          Rev. 8/17                                                    Fiduciary Income Tax Return
                                                                                                                                                                                         17180310 
8  FEIN 
9  88 8888888 
10
11 Schedule A – Adjustments to Federal Taxable Income Net of Related Expenses...cont. 
12 Deductions – Note: Deduct income items described below only to the extent that those amounts  
13 are not already deducted or excluded from federal taxable income after distributions. 
14  30.  Federal interest and dividends exempt from state taxation net of related expenses                                                           ......................... 30.       888888888 00 
15  
16   31.   Certain state and municipal income tax overpayments......................................................................                                           31.       888888888 00 
17   32.   Losses from an ESBT not shown in federal taxable income (include documentation)  ....................... 32.                                                                  888888888 00 
18
    33. Wage and salary expense not previously deducted due to the federal targeted jobs credit or 
19      the work opportunity credit ................................................................................................................. 33.                                888888888 00 
20
    34.   Interest income from Ohio public obligations and Ohio purchase obligations and gains from the 
21      sale or other disposition of Ohio public obligations ............................................................................ 34.                                            888888888 00 
22
    35.   Refundsorreimbursementsofprioryearfederalitemizeddeductionsandmiscellaneousfederal                                                             
23      tax adjustments .................................................................................................................................. 35.                           888888888 00 
24   36.   Farm income from a farm of at least 10 acres (trusts only)................................................................                                          36.       888888888 00 
25
    37. Adjustment for Internal Revenue Code section 168(k) depreciation expense.Include a separate 
26      schedule showing calculations designatingNumber of investors1/2, 1/5 or 1/6 .......................................................... 37.                                       888888888 00 
                                                                                NEW!Thesefieldsmaypossiblybeanegativevalue.included on return        
27   38. Repayment of income reported in a prior year and not otherwise deductedInclude a “-“ sign here if this line has a negative value.  ...................................... 38.   888888888 00 
28                                                                                      888888
29    39. Total deductions (add lines 30 through 38) ......................................................................................... 39.                                       888888888 00 
30     40..........................................Net adjustments (subtract40.line 39 from line 29). Enter here and on line 2                                                         - 888888888 00 
31
   Schedule B – Estate Credits 
32    41. Retirement income credit (see instructions for credit table) (limit – $200)..........................................                                              41.         888 00 
33
34   42. Lump sum retirement credit (see instructions to calculate the credit)..................................................42.                                                      888888888 00 
35
36      Seniorcitizen’scredit(   limit – $50 per return  )....................................................................................43.                                        88 00 
37
38 44.  Lumpsumdistributioncredit(mustbe65oroldertoclaimthiscredit;seeinstructionsto                                                                    
        calculate this credit) .............................................................................................................................44.                          888888888 00 
39
40   45. Child and dependent care credit (see instructions and worksheet in Ohio IT 1040 booklet)                                                       ...................45.           888888888 00 
41
42     46. Ohio political contributions credit.........................................................................................................46.                               888888888 00 
43   47. Ohio adoption creditlimit(                                $10,000   )....................................................................................................47.    888888888 00 
44
45  48.  Total Schedule B credits (add lines 41 through 47) – enter here and on line 9 .................................. 48.                                                            888888888 00 
46
   Schedule C – Estate Ohio Resident Credit 
47
    49.  Enter the portion of Ohio taxable income (line 3) subjected to tax by other states or the  
48      District of Columbia while an Ohio resident .......................................................................................              49.                           - 888888888 00 
49  50.  Enter Ohio taxable income (line 3).....................................................................................................                             50.       - 888888888 00 
50  51. Divide line 49 by line 50 and enter percentage here                                              888.88      %. Multiply this percentage 
51      by the amount shown on line 8 reduced by any amount shown on line 9 .......................................... 51.                                                               888888888 00 
52                                                                                           2D barcode required. Delete this 
53      and carryforwards from previous years, paidboxtowithothertextstatesand replaceor theitDistrictwith                      of Columbia................................ 52.          888888888 00 
    52.  Enter the 2017 income tax, less all related credits other than withholding and estimated tax payments 
                                                                                             the 2D barcode. 
54  
55  53.  Enter the smaller of line 51 or line 52. This is your Ohio resident tax credit. Enter here and on                                               line 10 ........ 53.888888888 00 
56
57
58
59                   Software vendors: Place 2D barcode in this location
60                   Do not place a box around the 2D barcode. The box 
61                               is only here for placement purposes.
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1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85
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6                                                               2017 Ohio IT 1041 
7                        Rev. 8/17                 Fiduciary Income Tax Return
                                                                                                                                                                                     17180410 
8    FEIN         Number of investors 
9         NEW!Thesefieldsmaypossiblybeanegativevalue.included on return        
     88 8888888 Include a “-“ sign here if this line has a negative value. 
10                888888 
11
    Schedule D – Estate Nonresident Credit 
12
13   54.  Enter the portion of Ohio taxable income (line 3) not earned or received in Ohio (include 
        Ohio IT 2023)  ...................................................................................................................................... 54.                  - 888888888 00 
14
15                                                                                                                                                                                 - 888888888 00 
      55. Enter Ohio taxable income (line 3) ..................................................................................................... 55. 
16  56.    Divide line 54 by line 55 and enter percentage here  888.88 %. Multiply this percentage by the  
17
      amount shown on line 8 reduced by the amount shown on line 9. Enter here and on line 10  ................... 56.                                                               888888888 00 
18  
19  Schedule F – Allocated Qualifying Trust Amounts 
20       Enter the trust’s portion   of capital gains/losses recognized         to   the extent included in   Ohio taxable               
         income (line 3) if the location of the physical assets of the closely held investee is available  .......... 57.                                                          - 888888888 00 
21
22   58. Enter the percentage of the closely held investee’s physical assets located within Ohio             ................. 58.                                                      8. 8888 
23
     59. Multiply the amount on line 57 by the percentage on line 58. Enter here and on line 4  .................... 59. 
24                                                                                                                                                                                 - 888888888 00 
25
26  Schedule G – Apportioned Income for Trusts 
27   60.  Enter (i) the trust’s business income not included in line 57 and (ii) the trust’s qualifying investment 
         income not otherwise a part of business income and not included in line 57  .................................... 60.                                                      - 888888888 00 
28
29   61. Enter the Ohio apportionment ratio from line 76 of the apportionment worksheet on page 5 ........... 61.                                                                    8. 888888 
30
31   62. Multiply the amount on line 60 by the apportionment ratio on line 61. Enter here and on line 5   ....... 62.-                                                               888888888 00 
32
33  Schedule H – Allocated Nonbusiness Income for Trusts 
34  If distributive share is business income from a pass-through entity, use Schedule G. 
     63. Resident trusts: Enter the trust’s portion of Ohio taxable income (line 3) not reported on            ................lines 57 or63.60                                    - 888888888 00 
35
36   64.  Nonresident trusts: Enter the trust’s portion of Ohio taxable income (line 3) not reported on lines 57 
37       or 60 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 64)    ............................................................ 64.                                       - 888888888 00 
38
39  65. Add lines 63 and 64 and enter here and on line 6    ............................................................................. 65.-                                       888888888 00 
40
    Schedule I – Tax Credit for Resident Trusts 
41
     66.  Enter the amount of allocated resident trust nonbusiness income (line 63, above) subject to tax in 
42       one or more states or in the District of Columbia                                                                                                                         - 888888888 00 
                                                              .............................................................................. 66. 
43
44   67. Enter the amount from line 8    .............................................................................................................. 67.                          888888888 00 
45
46       EntertheamountofmodifiedOhiotaxableincomefromline                            ......................................................... 68.                                  888888888 00 
47   
48  69. Divideline67byline68andenterthepercentagehere.Thisistheaverageeffectivetaxrate                             .................. 69.                                            8. 8888 
49
50   70. Multiply the amount on line 66 by the percentage reported on line 69    ..............................................                    70.-                              888888888 00 
51   
     71.  Enter the amount of tax actually paid by the resident trust to another state or the District of Columbia 
52       on the trust’s allocated nonbusiness income 2D barcode required. Delete this    ..................................................................................... 71.   888888888 00 
53                                                    box with text and replace it with          
     72.  Enter the smaller of the amount on lines 70theand2D barcode.71. This is the resident trust’s Ohio tax credit. Enter 
54       here and on line 10  ............................................................................................................................ 72.                       888888888 00 
55
56
57
58
59                    Software vendors: Place 2D barcode in this location
60                      Do not place a box around the 2D barcode. The box 
61                               is only here for placement purposes.
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1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85
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6                                                              2017 Ohio IT 1041 
7                      Rev. 8/17            Fiduciary Income Tax Return
                                                                                                                                   17180510 
8  FEIN 
9  88 8888888 
10 Apportionment Worksheet 
11                                                                                                                                                                                
   Usethisworksheettocalculatetheapportionmentratioforthetrust’smodifiedbusinessincomeandqualifyinginvestmentincomeincluded
12 in Ohio taxable income. Note:  All ratios are to be carried to six decimal places. 
13  73.  Property                                                        Within Ohio                                              Total Everywhere 
14     a) Owned (average cost)                                 88888888888 00                                                88888888888 00 
15
16                                                                       Within Ohio                                              Total Everywhere 
    
17     b) Rented (annual rental X 8)                                                                                              Weight is now a variable data                             
                                                               88888888888 00                                                88888888888 00 
18                                                                   This field requires   a leading zero,                        field and must include                        a   leading 
                                                                     e.g. .000026 should be displayed                             zero. See                          schema for accepted    
19                                                                   as 0.000026. Within Ohio                                     characters. Total Everywhere 
20     c) Total (lines 73a and 73b)                            88888888888 00                                  ÷             88888888888 00 
21                                                                                              Ratio                 Weight                                         Weighted Ratio 
22                                                                        =            8. 888888                x =8.88                                              8. 888888 
23
24                                                                       Within Ohio                                              Total Everywhere 
25  74.  Payroll                                               88888888888 00                                  ÷             88888888888 00 
26
27                                                                                              Ratio                 Weight                                         Weighted Ratio 
28
                                                                          =            8. 888888                x =8.88                                              8. 888888 
29
                                                                                                                       This field requires   a leading zero,                      
30                                                                       Within Ohio                                   e.g. .000026TotalshouldEverywherebe displayed 
31  75.  Sales                                                 88888888888 00                                  ÷       as 0.000026. 88888888888 00 
32
33                                                                                              Ratio                 Weight                                         Weighted Ratio 
34                                                                        =            8. 888888                x =8.88.                                             8. 888888 
35
36  76. Total weighted apportionment ratio (add weighted ratio from lines 73c, 74 and 75). Enter ratio here and on 
       Schedule G, line 61 (carry to six decimal places).......................................................................................................76.   8. 888888 
37
   Note: Ifthedenominatorofanyfactoriszero,theweightgiventotheotherfactorsmustbeproportionatelyincreasedsothatthetotalweightgiventothe                                                    
38 combinednumberoffactorsusedis100%,i.e.,ifnoproperty/payroll,use25%and75%;ifnosales,use50%property/payroll;ifonlyonefactor,use100%.                                                       
39
40 Net Payment Worksheet – Include 1099(s) and W-2(s) 
41 77a. Estimated payments                                    77b. Prior year credit carryover                   77c. 1099 withholdings 
42
          88888888 00                                               88888888 00                                       88888888 00 
43
44 77d. W-2 withholdings                                      77e. Refunds previously claimed                     78. Net payments (sum of lines 77a-d minus line                           77e). 
                                                                                                                      Enter here and on page 2, line 14. 
45
          88888888 00                                               88888888 00 
46
                                                                                                                      888888888 00 
47 Refundable Business Credits 
48 Note: CertificatesfromtheOhioDevelopmentServicesAgencyand/orOhioITK-1(s)mustbeincludedtoverifyeachrefundablecreditclaimed.                                                         
49 79.  Motion picture credit                        80.          Business jobs credit                           81.  Pass-through entity credit 
50
          88888888 00                                               88888888 00                                       88888888 00 
51 82.   Venture capital credit                               83.   Historic preservation credit                 84.  Financial Institutions Tax (FIT) credit 
52                                            2D barcode required. Delete this 
53        88888888 00                                               88888888 00                                       88888888 00 
                                              box with text and replace it with 
   85. Total refundable business credits (add lines 79-84). Enter here and on page 2, line 15. 
54                                            the 2D barcode. 
          888888888 00 
55
56
57
58
59                Software vendors: Place 2D barcode in this location
60                Do not place a box around the 2D barcode. The box 
61                                is only here for placement purposes.
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6                                                   2017 Ohio IT 1041 
7                     Rev. 8/17           Fiduciary Income Tax Return
                                                                                                                               17180610 
8  FEIN 
9  88 8888888 
10                               
   Beneficiary Schedule
11 Providebeneficiaryinformationfor    all(residentandnonresident)beneficiariesintheestateortrust.           Use an additional sheet, if necessary. 
12
13 SSN                                    FEIN                                   Amount distributed 
14
   888 88 8888                            88 8888888                             888888888 00 
15
16 First name/entity                                           M.I.  Last name 
17
   JOHNXXXXXXXXXXX                                             Q  PUBL I CXXXXXXXXXXXXXX 
18 Address 
19 8888 CHERRY LANEXXXXXXXXXXXXXXXXXXX 
                       
20 City                                                                           State    ZIP code 
21
   CITYXXXXXXXXXXXXXXXX                                                           OH       88888 
22
23
24 SSN                                    FEIN                                   Amount distributed 
25
   888 88 8888                            88 8888888                             888888888 00 
26
27 First name/entity                                           M.I.  Last name 
28
   JOHNXXXXXXXXXXX                                             Q  PUBL I CXXXXXXXXXXXXXX 
29 Address 
30
   8888 CHERRY  LANEXXXXXXXXXXXXXXXXXXX 
31 City                                                                           State    ZIP code 
32
   CITYXXXXXXXXXXXXXXXX                                                           OH       88888 
33
34
35 SSN                                    FEIN                                   Amount distributed 
36
   888 88 8888                            88 8888888                             888888888 00 
37
38 First name/entity                                           M.I.  Last name 
39
   JOHNXXXXXXXXXXX                                             Q  PUBL I CXXXXXXXXXXXXXX 
40 Address 
41
   8888 CHERRY          LANEXXXXXXXXXXXXXXXXXXX 
42 City                                                                           State    ZIP code 
43
   CITYXXXXXXXXXXXXXXXX                                                           OH       88888 
44
45
46 SSN                                    FEIN                                   Amount distributed 
47 888 88 8888                            88 8888888                             888888888 00 
48
49 First name/entity                                           M.I.  Last name 
50 JOHNXXXXXXXXXXX                                             Q  PUBL I CXXXXXXXXXXXXXX 
51 Address 
52 8888 CHERRY LANEXXXXXXXXXXXXXXXXXXX2D barcode required. Delete this 
                       
53 City                                        box with text and replace it with  State    ZIP code 
                                               the 2D barcode. 
54                                                                                OH       88888 
   CITYXXXXXXXXXXXXXXXX 
55
56
57
58
59         Software vendors: Place 2D barcode in this location
60                   Do not place a box around the 2D barcode. The box 
61                      is only here for placement purposes.
62
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64                                                                                                           2017 IT 1041 – page  26of 6
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66

Grid layout

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85
2
3
4                                                                  Do not staple or paper clip. 
5
6                                                                                                                     2017 Ohio IT 1041 
7                                                                                    Rev. 8/17           Fiduciary Income Tax Return
                                                                                                                                                                                                                                    17180110 
8                                                             88 88 88                                           Use only black ink and UPPERCASE letters. 
9
10                                                                                               Check here if amended return             X  Check here if final return                                                             For taxable year beginning in
                                                                                               X 
11                                                                                                  X  Check here if the  federal extension was granted                                                                               88 /2017 
12                                                            FEIN                                        SSN of decedent (estates only) 
13                                                            88 8888888                                  888 88 8888 
14
15                                                            Name of trust or estate 
16                                                            JOHNXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 
17
18                                                            Name of trust or estate (second line) 
19                                                            JANEXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 
20
21                                                            Fiduciary name and title 
22                                                            THE NAME  AND T ITLEXXXXXXXXXXXXXXXXX 
23
24                                                            Address (if address change, check box)        X 
25
                                                              8888 BERRY  AVEXXXXXXXXXXXXXXXXXXXXX 
26                                                            City                                                                                 State              ZIP code 
27
                                                              CI TYXXXXXXXXXXXXXXXX                                                              OH                   88888 
28
29                                                            Foreign State Code            Country Code        Foreign country (if the mailing address is outside the U.S.)                     Foreign postal code 
30
                                                              ABC                                AB             ANYCOUNTRYXXXXXXXXXX                                                             AB88888 
31
32                                                            Check Applicable Box(es) 
33                                                                            Simple trust          OR          X   Complex trust                    X   Irrevocable trust                                                          X Testamentary trust 
                                                                      X 
34
35                                                                    X       Resident trust        OR          X   Nonresident trust                X   Bankruptcy estate                                                          X Decedent’s estate 
36
37                                                               1.   Federal taxable income (from the federal 1041, line 22).Include page 1 of the federal 1041 ..............................   1.                             -    888888888 00 
38                                                            
39                                                            2. Net adjustments      from Schedule A, line 40 ......................................................................................................... 2.      -    888888888 00 
40                                                              
41                                                               3.Ohio taxable income (line 1 plus or minus line 2). Estates should skip lines 4-7  ............................................... 3.                          -    888888888 00 
42                              Do not staple or paper clip.  

43                                                              4. Allocated   qualifying trust amount from Schedule F, line 59 (trusts only) ........................................................... 4.                     -    888888888 00 
44                                                             

45                                                               5.Apportioned trust income from Schedule G, line 62 (trusts only)        ...................................................................... 5.-                  888888888 00 
46
47                                                              6.Allocated   trust income from Schedule H, line 65 (trusts only)  ........................................................................... 6.                -    888888888 00 
48                                                            
49                                                                 ModifiedOhiotaxableincome(trustsaddlines4,5and6;iflessthanzero,enter-0-)                      ....................................          7.                     888888888 00 
50                                                            8. TaxonOhiotaxableincome(estates,line3)ortaxonmodifiedOhiotaxableincome(trusts,line7).                                            
51                                                                 See tax table in the instructions   ......................................................................................................................... 8.   888888888 00 
52                                                              9.Credits from Schedule B, line 48 (estates only)    ................................................................................................. 9.             888888888 00 
53                                                            
                                                              10.ResidentcreditfromScheduleC(estates);nonresidentcreditfromScheduleD(estates);businesscreditfrom                                  
54                                                                 ScheduleE(includeScheduleE)(estatesandtrusts);andtaxcreditfromScheduleI(residenttrusts)   .............   10.                                                      888888888 00 
55
56
57
58                                                                                                                                                                                               For Department Use Only 
59                                                                              Software vendors: Place 2D barcode in this location
60                                                                               Do not place a box around the 2D barcode. The box                                                                                       /            / 
61                                                                                          is only here for placement purposes.                                                                  Postmark date                              Code 
62
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64                                                                                                                                                                    2017 IT 1041 – page  21of 6
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1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85
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6                                                              2017 Ohio IT 1041 
7                            Rev. 8/17             Fiduciary Income Tax Return
                                                                                                                                                                               17180210 
8   FEIN 
9   88 8888888 
10   11.   Tax after nonrefundable credits (line 8 minus the amount on lines 9 and 10)             .....................................11.                                    888888888 00 
11    
12    12.     Interest penalty on underpayment of estimated tax (include Ohio IT/SD 2210)            ...................................... 12. 
                                                                                                                                                                               888888888 00 
13    13.     Total Ohio tax (add lines 11 and 12)  ................................................................................................... 13.                    888888888 00 
14        14. Net payments  from line 78 on page 5......................14.                888888888 00 
15
     15.   Refundable business credits from line 85 on page 
16         5(includedocumentation/certificates)                   ....................15.  888888888 00 
17    16.     Total  (add lines 14 and 15) .......................................16.      888888888 00 
18        17. Overpayment, if any (line 16 minus line 13, but not less than -0-)........................       17.YOUR REFUND                                                 888888888 00 
19         
      18. Net amount due, if any (if line 13 is more than line 16, subtract line 16 from line 13, but not less 
20       than -0-) .............................................................................................................................................  18.          888888888 00 
      19. Interest andpenaltyonlate-paidand/orlate-filedreturn,if                           .............................................................. 19. 
21                                                                                                                                                                             888888888 00 
22
     20.   Total amount due (add lines 18 and 19). Make check payable to Ohio Treasurer                       of State, include 
23   20.    Ohio UPC and place FEIN on check...................................................................... AMOUNT DUE                                                 888888888 00 
24
25                        If your refund is $1.00 or less, no refund will be issued. If you owe $1.00 or less, no payment is necessary. 

26 Sign Here (required):                                                                                                                                                   Do not staple or paper clip.  
                                    I have read this return. Under penalties of perjury, I declare that, to 
27 the best of my knowledge and belief, the return and all enclosures are true, correct and complete.                   Place any supporting documents, including  
28                                                                                                                      Ohio IT K-1(s), after the last page of this return. 
29
   Signatureoffiduciaryortrustofficer                 Preparer’sname(print)                    
30
                                                                                                                                                                               Mail to: 
31 Title                     Date (MM/DD/YY)          Preparer’s address (include ZIP code) 
32                                                                                                                      Ohio Department of Taxation 
33 Fiduciary’sortrustofficer’sphone                   Preparer’sphonenumber                                                                                                    P.O. Box 2619 
34                                                                                                                      Columbus, OH 43216-2619 
35 Preparer’s e-mail address                          PTIN 
                                                                                                                                                                  Instructions for this form are on 
36 Doyouauthorizeyourpreparertocontactusregardingthis                                       Y X No X                                                                       our website at tax.ohio.gov. 
37
38 Schedule A – Adjustments to Federal Taxable Income Net of Related Expenses 
39  Additions 
40    21.  Federal and/or non-Ohio state or local government interest and dividends not distributed...............                                                21.          888888888 00 
41         Pass-throughentityandfinancialinstitutionstaxespaidandrelatedmemberadd-back                              ................... 22.                                    888888888 00 
42
     23.   Income from an Electing Small Business Trust (ESBT) not shown in federal taxable income 
                                                 ..................................................................................................................... 23. 
43         (include documentation)                                                                                                                                             888888888 00 
44
45    24.  Losses from sale or other disposition of Ohio public obligations.......................................................                                24.          888888888 00 
46
47    25.  Recovery of amount previously deducted or excluded.......................................................................                              25.          888888888 00 
48
     26.   Adjustment for Internal Revenue Code section 168(k) depreciation expense. 
49      2/3,X            X 5/6 or     X 6/6 (check applicable box) ..........................................................................26.                               888888888 00 
50   
      27. Federal personal exemption (estates only) and miscellaneous federal tax adjustments...................                                                  27. 
51                                                                                                                                                                             888888888 00 
      28. Expenses claimed on Ohio estate return (estates only).....................................................................                              28. 
52                                                                                                                                                                             888888888 00 
53
54   29.   Total additions (add lines 21 through 28)  ........................................................................................... 29.                          888888888 00 
55
56
57
58
59                         Software vendors: Place 2D barcode in this location
60                         Do not place a box around the 2D barcode. The box 
61                                   is only here for placement purposes.
62
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64                                                                                                                      2017 IT 1041 – page  22of 6
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1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85
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6                                                                                                     2017 Ohio IT 1041 
7                          Rev. 8/17                                                    Fiduciary Income Tax Return
                                                                                                                                                                                                    17180310 
8  FEIN 
9  88 8888888 
10
11 Schedule A – Adjustments to Federal Taxable Income Net of Related Expenses...cont. 
12 Deductions – Note: Deduct income items described below only to the extent that those amounts  
13 are not already deducted or excluded from federal taxable income after distributions. 
14  30.  Federal interest and dividends exempt from state taxation net of related expenses                                            ......................... 30.                                 888888888 00 
15  
16   31.   Certain state and municipal income tax overpayments ...................................................................... 31.                                                           888888888 00 
17   32.   Losses from an ESBT not shown in federal taxable income (include documentation)....................... 32.                                                                               888888888 00 
18
    33. Wage and salary expense not previously deducted due to the federal targeted jobs credit or 
19      the work opportunity credit ................................................................................................................. 33.                                           888888888 00 
20
    34.   Interest income from Ohio public obligations and Ohio purchase obligations and gains from the 
21      sale or other disposition of Ohio public obligations ............................................................................ 34.                                                       888888888 00 
22
    35.   Refundsorreimbursementsofprioryearfederalitemizeddeductionsandmiscellaneousfederal                                              
23      tax adjustments .................................................................................................................................. 35.                                      888888888 00 
24   36.   Farm income from a farm of at least 10 acres (trusts only) ................................................................ 36.                                                          888888888 00 
25
    37. Adjustment for Internal Revenue Code section 168(k) depreciation expense.Include a separate 
26      schedule showing calculations designating 1/2, 1/5 or 1/6  .......................................................... 37.                                                                   888888888 00 
27   38. Repayment of income reported in a prior year and not otherwise deducted......................................                                                                        38.   888888888 00 
28
29    39. Total deductions (add lines 30 through 38) ......................................................................................... 39.                                                  888888888 00 
30     40..........................................Net adjustments (subtract40.line 39 from line 29). Enter here and on line 2                                                                    - 888888888 00 
31
   Schedule B – Estate Credits 
32    41. Retirement income credit (see instructions for credit table) (limit – $200) ..........................................                  41.                                               888 00 
33
34   42. Lump sum retirement credit (see instructions to calculate the credit) ..................................................42.                                                                888888888 00 
35
36      Seniorcitizen’scredit(   limit – $50 per return) ....................................................................................43.                                                    88 00 
37
38 44.  Lumpsumdistributioncredit(mustbe65oroldertoclaimthiscredit;seeinstructionsto                                                     
        calculate this credit) .............................................................................................................................44.                                     888888888 00 
39
40   45. Child and dependent care credit (see instructions and worksheet in Ohio IT 1040 booklet)                                        ...................45.                                     888888888 00 
41
42     46. Ohio political contributions credit..... ....................................................................................................46.                                         888888888 00 
43   47. Ohio adoption creditlimit(                                $10,000) ....................................................................................................47.                 888888888 00 
44
45  48.  Total Schedule B credits (add lines 41 through 47) – enter here and on line 9 .................................. 48.                                                                       888888888 00 
46
   Schedule C – Estate Ohio Resident Credit 
47
    49.  Enter the portion of Ohio taxable income (line 3) subjected to tax by other states or the  
48      District of Columbia while an Ohio resident .......................................................................................      49.                                              - 888888888 00 
49  50.  Enter Ohio taxable income (line 3)                                             ..................................................................................................... 50. - 888888888 00 
50  51. Divide line 49 by line 50 and enter percentage here                    888.88                                %. Multiply this percentage 
51      by the amount shown on line 8 reduced by any amount shown on line 9 .......................................... 51.                                                                          888888888 00 
52
    52.   Enter the 2017 income tax, less all related credits other than withholding and estimated tax payments  
53      and carryforwards from previous years, paid to other states or the District of Columbia ................................ 52.                                                                888888888 00 
54  
55  53.  Enter the smaller of line 51 or line 52. This is your Ohio resident tax credit. Enter here and on ........line 1053.                                                                       888888888 00 
56
57
58
59                   Software vendors: Place 2D barcode in this location
60                   Do not place a box around the 2D barcode. The box 
61                               is only here for placement purposes.
62
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64                                                                                                                                       2017 IT 1041 – page  23of 6
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1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85
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6                                                               2017 Ohio IT 1041 
7                         Rev. 8/17                Fiduciary Income Tax Return
                                                                                                                                                                    17180410 
8    FEIN 
9    88 8888888 
10
11
    Schedule D – Estate Nonresident Credit 
12
13   54.  Enter the portion of Ohio taxable income (line 3) not earned or received in Ohio (include 
        Ohio IT 2023)  ...................................................................................................................................... 54. - 888888888 00 
14
15                                                                                                                                                                - 888888888 00 
      55. Enter Ohio taxable income (line 3) ..................................................................................................... 55. 
16  56.    Divide line 54 by line 55 and enter percentage here  888.88 %. Multiply this percentage by the  
17
      amount shown on line 8 reduced by the amount shown on line 9. Enter here and on line               10................... 56.                                  888888888 00 
18  
19  Schedule F – Allocated Qualifying Trust Amounts 
20       Enter the trust’s portion   of capital gains/losses recognized to   the extent included in   Ohio taxable                  
         income (line 3) if the location of the physical assets of the closely held investee is available .......... 57.                                          - 888888888 00 
21
22   58. Enter the percentage of the closely held investee’s physical assets located within Ohio              ................. 58.                                    8. 8888 
23
     59. Multiply the amount on line 57 by the percentage on line 58. Enter here and on line 4....................                    59. 
24                                                                                                                                                                - 888888888 00 
25
26  Schedule G – Apportioned Income for Trusts 
27   60.  Enter (i) the trust’s business income not included in line 57 and (ii) the trust’s qualifying investment 
         income not otherwise a part of business income and not included in line 57 .................................... 60.                                      - 888888888 00 
28
29   61. Enter the Ohio apportionment ratio from line 76 of the apportionment worksheet on page 5...........                       61.                              8. 888888 
30
31   62. Multiply the amount on line 60 by the apportionment ratio on line 61. Enter here and on line 5.......                        62.                         - 888888888 00 
32
33  Schedule H – Allocated Nonbusiness Income for Trusts 
34  If distributive share is business income from a pass-through entity, use Schedule G. 
     63. Resident trusts: Enter the trust’s portion of Ohio taxable income (line 3) not reported on            lines 57 or 60  ................-                    88888888863. 00 
35
36   64.  Nonresident trusts: Enter the trust’s portion of Ohio taxable income (line 3) not reported on lines 57 
37       or 60 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 64)............................................................  64.                         - 888888888 00 
38
39  65. Add lines 63 and 64 and enter here and on line 6   ............................................................................. 65.                      - 888888888 00 
40
    Schedule I – Tax Credit for Resident Trusts 
41
     66.  Enter the amount of allocated resident trust nonbusiness income (line 63, above) subject to tax in 
42       one or more states or in the District of Columbia                                                                                                        - 888888888 00 
                                                              .............................................................................. 66. 
43
44   67. Enter the amount from line 8   .............................................................................................................. 67.          888888888 00 
45
46       EntertheamountofmodifiedOhiotaxableincomefromline                 ......................................................... 68.                            888888888 00 
47   
48  69. Divideline67byline68andenterthepercentagehere.Thisistheaverageeffectivetaxrate                  ..................     69.                                  8. 8888 
49
50   70. Multiply the amount on line 66 by the percentage reported on line 69..............................................           70.                         - 888888888 00 
51   
     71.  Enter the amount of tax actually paid by the resident trust to another state or the District of Columbia 
52       on the trust’s allocated nonbusiness income    ..................................................................................... 71.                   888888888 00 
53   
     72.  Enter the smaller of the amount on lines 70 and 71. This is the resident trust’s Ohio tax credit. Enter 
54       here and on line 10 ............................................................................................................................ 72.       888888888 00 
55
56
57
58
59                      Software vendors: Place 2D barcode in this location
60                      Do not place a box around the 2D barcode. The box 
61                               is only here for placement purposes.
62
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64                                                                                                           2017 IT 1041 – page  24of 6
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1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85
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6                                                              2017 Ohio IT 1041 
7                      Rev. 8/17            Fiduciary Income Tax Return
                                                                                                                              17180510 
8  FEIN 
9  88 8888888 
10 Apportionment Worksheet 
11                                                                                                                                                                             
   Usethisworksheettocalculatetheapportionmentratioforthetrust’smodifiedbusinessincomeandqualifyinginvestmentincomeincluded
12 in Ohio taxable income. Note:  All ratios are to be carried to six decimal places. 
13  73.  Property                                                        Within Ohio                                      Total Everywhere 
14     a) Owned (average cost)                                 88888888888 00                                           88888888888 00 
15
16                                                                       Within Ohio                                      Total Everywhere 
    
17     b) Rented (annual rental X 8)                           88888888888 00                                           88888888888 00 
18
19                                                                       Within Ohio                                      Total Everywhere 
20     c) Total (lines 73a and 73b)                            88888888888 00                             ÷             88888888888 00 
21                                                                                        Ratio                  Weight                                              Weighted Ratio 
22                                                                       =             8. 888888           x =8.88                                                   8. 888888 
23
24                                                                       Within Ohio                                      Total Everywhere 
25  74.  Payroll                                               88888888888 00                             ÷             88888888888 00 
26
27                                                                                        Ratio                  Weight                                              Weighted Ratio 
28
                                                                         =             8. 888888           x =8.88                                                   8. 888888 
29
30                                                                       Within Ohio                                      Total Everywhere 
31  75.  Sales                                                 88888888888 00                             ÷             88888888888 00 
32
33                                                                                        Ratio                  Weight                                              Weighted Ratio 
34                                                                       =             8. 888888           x =8.88.                                                  8. 888888 
35
36  76. Total weighted apportionment ratio (add weighted ratio from lines 73c, 74 and 75). Enter ratio here and on 
       Schedule G, line 61 (carry to six decimal places).......................................................................................................76.   8. 888888 
37
   Note: Ifthedenominatorofanyfactoriszero,theweightgiventotheotherfactorsmustbeproportionatelyincreasedsothatthetotalweightgiventothe                                                
38 combinednumberoffactorsusedis100%,i.e.,ifnoproperty/payroll,use25%and75%;ifnosales,use50%property/payroll;ifonlyonefactor,use100%.                                                  
39
40 Net Payment Worksheet – Include 1099(s) and W-2(s) 
41 77a. Estimated payments                                    77b. Prior year credit carryover              77c. 1099 withholdings 
42
         88888888 00                                                88888888 00                                  88888888 00 
43
44 77d. W-2 withholdings                                      77e. Refunds previously claimed                78. Net payments (sum of lines 77a-d minus line                          77e). 
                                                                                                                 Enter here and on page 2, line 14. 
45
         88888888 00                                                88888888 00 
46
                                                                                                                 888888888 00 
47 Refundable Business Credits 
48 Note: CertificatesfromtheOhioDevelopmentServicesAgencyand/orOhioITK-1(s)mustbeincludedtoverifyeachrefundablecreditclaimed.                                                        
49 79.  Motion picture credit                        80.          Business jobs credit                      81.  Pass-through entity credit 
50
         88888888 00                                                88888888 00                                  88888888 00 
51 82.   Venture capital credit                               83.   Historic preservation credit             84.  Financial Institutions Tax (FIT) credit 
52
         88888888 00                                                88888888 00                                  88888888 00 
53 85. Total refundable business credits (add lines 79-84). Enter here and on page 2, line 15. 
54
         888888888 00 
55
56
57
58
59                Software vendors: Place 2D barcode in this location
60                Do not place a box around the 2D barcode. The box 
61                                is only here for placement purposes.
62
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64                                                                                                        2017 IT 1041 – page  25of 6
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1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85
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5
6                                               2017 Ohio IT 1041 
7                     Rev. 8/17           Fiduciary Income Tax Return
                                                                                                                               17180610 
8  FEIN 
9  88 8888888 
10                               
   Beneficiary Schedule
11 Providebeneficiaryinformationfor    all(residentandnonresident)beneficiariesintheestateortrust.           Use an additional sheet, if necessary. 
12
13 SSN                                    FEIN              Amount distributed 
14
   888 88 8888                            88 8888888        888888888 00 
15
16 First name/entity                                 M.I.  Last name 
17
   JOHNXXXXXXXXXXX                              Q     PUBL I CXXXXXXXXXXXXXX 
18 Address 
19 8888 CHERRY LANEXXXXXXXXXXXXXXXXXXX 
                       
20 City                                                              State    ZIP code 
21
   CITYXXXXXXXXXXXXXXXX                                              OH       88888 
22
23
24 SSN                                    FEIN              Amount distributed 
25
   888 88 8888                            88 8888888        888888888 00 
26
27 First name/entity                                 M.I.  Last name 
28
   JOHNXXXXXXXXXXX                                   Q  PUBL I CXXXXXXXXXXXXXX 
29 Address 
30
   8888 CHERRY  LANEXXXXXXXXXXXXXXXXXXX 
31 City                                                              State    ZIP code 
32
   CITYXXXXXXXXXXXXXXXX                                              OH       88888 
33
34
35 SSN                                    FEIN              Amount distributed 
36
   888 88 8888                            88 8888888        888888888 00 
37
38 First name/entity                                 M.I.  Last name 
39
   JOHNXXXXXXXXXXX                                   Q  PUBL I CXXXXXXXXXXXXXX 
40 Address 
41
   8888 CHERRY          LANEXXXXXXXXXXXXXXXXXXX 
42 City                                                              State    ZIP code 
43
   CITYXXXXXXXXXXXXXXXX                                              OH       88888 
44
45
46 SSN                                    FEIN            Amount distributed 
47 888 88 8888                            88 8888888      888888888 00 
48
49 First name/entity                                 M.I.  Last name 
50 JOHNXXXXXXXXXXX                              Q     PUBL I CXXXXXXXXXXXXXX 
51 Address 
52 8888 CHERRY LANEXXXXXXXXXXXXXXXXXXX 
                       
53 City                                                              State    ZIP code 
54                                                                   OH       88888 
   CITYXXXXXXXXXXXXXXXX 
55
56
57
58
59         Software vendors: Place 2D barcode in this location
60                   Do not place a box around the 2D barcode. The box 
61                      is only here for placement purposes.
62
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64                                                                                                           2017 IT 1041 – page  26of 6
65
66

Layout 

without grid

Do not staple or paper clip. 
2017 Ohio IT 1041 
Rev. 8/17 Fiduciary Income Tax Return
17180110 
88 88 88 Use only black ink and UPPERCASE letters. 

Check here if amended return X Check here if final return For taxable year beginning in
X 
X Check here if the  federal extension was granted 88 /2017 
FEIN SSN of decedent (estates only) 
88 8888888 888 88 8888 
Name of trust or estate 
JOHNXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 
Name of trust or estate (second line) 
JANEXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 
Fiduciary name and title 
THE NAME  AND T ITLEXXXXXXXXXXXXXXXXX 

Address (if address change, check box) X 
8888 BERRY  AVEXXXXXXXXXXXXXXXXXXXXX 
City State ZIP code 
CI TYXXXXXXXXXXXXXXXX OH 88888 
Foreign State Code Country Code Foreign country (if the mailing address is outside the U.S.) Foreign postal code 
ABC AB ANYCOUNTRYXXXXXXXXXX AB88888 
Check Applicable Box(es) 
X Simple trust OR X Complex trust X Irrevocable trust X Testamentary trust 

X Resident trust OR X Nonresident trust X Bankruptcy estate X Decedent’s estate 

    1.   Federal taxable income (from the federal 1041, line 22).Include page 1 of the federal 1041 .............................. 1. - 888888888 00 
 
 2. Net adjustments from Schedule A, line 40 ......................................................................................................... 2. - 888888888 00 
   
    3.Ohio taxable income (line 1 plus or minus line 2). Estates should skip lines 4-7  ............................................... 3. - 888888888 00 
Do not staple or paper clip.  

   4. Allocated qualifying trust amount from Schedule F, line 59 (trusts only) ........................................................... 4. - 888888888 00 
  
    5.Apportioned trust income from Schedule G, line 62 (trusts only)     ...................................................................... 5.- 888888888 00 

   6.Allocated trust income from Schedule H, line 65 (trusts only)  ........................................................................... 6. - 888888888 00 
 
  ModifiedOhiotaxableincome(trustsaddlines4,5and6;iflessthanzero,enter-0-)                      .................................... 7. 888888888 00 
 8. TaxonOhiotaxableincome(estates,line3)ortaxonmodifiedOhiotaxableincome(trusts,line7).                    
      See tax table in the instructions   ......................................................................................................................... 8. 888888888 00 
   9.Credits from Schedule B, line 48 (estates only)    ................................................................................................. 9. 888888888 00 
 
 10.ResidentcreditfromScheduleC(estates);nonresidentcreditfromScheduleD(estates);businesscreditfrom                  
ScheduleE(includeScheduleE)(estatesandtrusts);andtaxcreditfromScheduleI(residenttrusts)   .............   10.                888888888 00 

For Department Use Only 
Software vendors: Place 2D barcode in this location
Do not place a box around the 2D barcode. The box / / 
is only here for placement purposes. Postmark date Code 

2017 IT 1041 – page  21of 6

                                                                                            2017 Ohio IT 1041 
                          Rev. 8/17                                             Fiduciary Income Tax Return
                                                                                                                                                                                                   17180210 
 FEIN 
 88 8888888 
  11.   Tax after nonrefundable credits (line 8 minus the amount on lines 9 and 10)                                      .....................................11.                                  888888888 00 
   
   12.     Interest penalty on underpayment of estimated tax (include Ohio IT/SD 2210)                                     ...................................... 12. 
                                                                                                                                                                                                   888888888 00 
   13.     Total Ohio tax (add lines 11 and 12)                                 ................................................................................................... 13.            888888888 00 
       14. Net payments  from line 78 on page 5......................14.                                         888888888 00 
  15.   Refundable business credits from line 85 on page 
        5(includedocumentation/certificates)                                           ....................15.   888888888 00 
   16.     Total  (add lines 14 and 15) .......................................16.                               888888888 00 
       17. Overpayment, if any (line 16 minus line 13, but not less than -0-)........................                       17.YOUR REFUND                                                        888888888 00 
   18.     Net amount due, if any (if line 13 is more than line 16, subtract line 16 from line 13, but not less 
      than -0-) .............................................................................................................................................  18.                                 888888888 00 
   19.     Interest andpenaltyonlate-paidand/orlate-filedreturn,if                                               .............................................................. 19.                888888888 00 
  20.   Total amount due (add lines 18 and 19). Make check payable to Ohio Treasurer                                       of State, include 
  20.    Ohio UPC and place FEIN on check......................................................................            AMOUNT DUE                                                             888888888 00 
                       If your refund is $1.00 or less, no refund will be issued. If you owe $1.00 or less, no payment is necessary. 

Sign Here (required):  I have read this return. Under penalties of perjury, I declare that, to                                                                                                 Do not staple or paper clip.  
the best of my knowledge and belief, the return and all enclosures are true, correct and complete.                                   Place any supporting documents, including  
                                                                                                                                     Ohio IT K-1(s), after the last page of this return. 
Signatureoffiduciaryortrustofficer                                                Preparer’sname(print)              
                                                                                                                                                                                                   Mail to: 
Title                     Date (MM/DD/YY)                                         Preparer’s address (include ZIP code) 
                                                                                                                                     Ohio Department of Taxation 
Fiduciary’sortrustofficer’sphone                                                  Preparer’sphonenumber                                                                                            P.O. Box 2619 
                                                                                                                                     Columbus, OH 43216-2619 
Preparer’s e-mail address                                                         PTIN 
                                                                                                                                                                                           Instructions for this form are on 
Doyouauthorizeyourpreparertocontactusregardingthis                                                                Y X No X                                                                     our website at tax.ohio.gov. 
Schedule A – Adjustments to Federal Taxable Income Net of Related Expenses 
 Additions 
   21.  Federal and/or non-Ohio state or local government interest and dividends not distributed...............                                                                            21.     888888888 00 
        Pass-throughentityandfinancialinstitutionstaxespaidandrelatedmemberadd-back                                              ................... 22.                                           888888888 00 
  23.   Income from an Electing Small Business Trust (ESBT) not shown in federal taxable income 
                                              (include documentation)..................................................................................................................... 23.     888888888 00 

   24.  Losses from sale or other disposition of Ohio public obligations.......................................................                                                            24.     888888888 00 

   25.  Recovery of amount previously deducted or excluded.......................................................................                                                          25.     888888888 00 
  26.   Adjustment for Internal Revenue Code section 168(k) depreciation expense. 
     2/3,X            X 5/6 or     X                                 6/6 (check applicable box) ..........................................................................26.                      888888888 00 
  
   27.  Federal personal exemption (estates only) and miscellaneous federal tax adjustments...................                                                                             27.     888888888 00 
   28.  Expenses claimed on Ohio estate return (estates only).....................................................................                                                         28.     888888888 00 

  29.   Total additions (add lines 21 through 28)                                 ........................................................................................... 29.                  888888888 00 

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

                                                                                                                                     2017 IT 1041 – page  22of 6

                                                                                                   2017 Ohio IT 1041 
                        Rev. 8/17                                                    Fiduciary Income Tax Return
                                                                                                                                                                                                 17180310 
FEIN 
88 8888888 

Schedule A – Adjustments to Federal Taxable Income Net of Related Expenses...cont. 
Deductions – Note: Deduct income items described below only to the extent that those amounts  
are not already deducted or excluded from federal taxable income after distributions. 
 30.  Federal interest and dividends exempt from state taxation net of related expenses                                            ......................... 30.                                 888888888 00 
 
  31.   Certain state and municipal income tax overpayments ...................................................................... 31.                                                           888888888 00 
  32.   Losses from an ESBT not shown in federal taxable income (include documentation)....................... 32.                                                                               888888888 00 
 33. Wage and salary expense not previously deducted due to the federal targeted jobs credit or 
     the work opportunity credit ................................................................................................................. 33.                                           888888888 00 
 34.   Interest income from Ohio public obligations and Ohio purchase obligations and gains from the 
     sale or other disposition of Ohio public obligations ............................................................................ 34.                                                       888888888 00 
 35.   Refundsorreimbursementsofprioryearfederalitemizeddeductionsandmiscellaneousfederal                                              
     tax adjustments .................................................................................................................................. 35.                                      888888888 00 
  36.   Farm income from a farm of at least 10 acres (trusts only) ................................................................ 36.                                                          888888888 00 
 37. Adjustment for Internal Revenue Code section 168(k) depreciation expense.Include a separate 
     schedule showing calculations designating 1/2, 1/5 or 1/6  .......................................................... 37.                                                                   888888888 00 
  38. Repayment of income reported in a prior year and not otherwise deducted......................................                                                                        38.   888888888 00 

   39. Total deductions (add lines 30 through 38) ......................................................................................... 39.                                                  888888888 00 
    40..........................................Net adjustments (subtract40.line 39 from line 29). Enter here and on line 2                                                                    - 888888888 00 
Schedule B – Estate Credits 
   41. Retirement income credit (see instructions for credit table) (limit – $200) ..........................................                  41.                                               888 00 

  42. Lump sum retirement credit (see instructions to calculate the credit) ..................................................42.                                                                888888888 00 

     Seniorcitizen’scredit(   limit – $50 per return) ....................................................................................43.                                                    88 00 
44.  Lumpsumdistributioncredit(mustbe65oroldertoclaimthiscredit;seeinstructionsto                                                     
     calculate this credit) .............................................................................................................................44.                                     888888888 00 

  45. Child and dependent care credit (see instructions and worksheet in Ohio IT 1040 booklet)                                        ...................45.                                     888888888 00 

    46. Ohio political contributions credit..... ....................................................................................................46.                                         888888888 00 
  47. Ohio adoption creditlimit(                                $10,000) ....................................................................................................47.                 888888888 00 

 48.  Total Schedule B credits (add lines 41 through 47) – enter here and on line 9 .................................. 48.                                                                       888888888 00 
Schedule C – Estate Ohio Resident Credit 
 49.  Enter the portion of Ohio taxable income (line 3) subjected to tax by other states or the  
     District of Columbia while an Ohio resident .......................................................................................      49.                                              - 888888888 00 
 50.  Enter Ohio taxable income (line 3)                                             ..................................................................................................... 50. - 888888888 00 
 51. Divide line 49 by line 50 and enter percentage here                    888.88                                %. Multiply this percentage 
     by the amount shown on line 8 reduced by any amount shown on line 9 .......................................... 51.                                                                          888888888 00 
 52.   Enter the 2017 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 ................................ 52.                                                                888888888 00 
 
 53.  Enter the smaller of line 51 or line 52. This is your Ohio resident tax credit. Enter here and on ........line 1053.                                                                       888888888 00 

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

                                                                                                                                      2017 IT 1041 – page  23of 6

                                                             2017 Ohio IT 1041 
                        Rev. 8/17                Fiduciary Income Tax Return
                                                                                                                                                                 17180410 
  FEIN 
  88 8888888 

 Schedule D – Estate Nonresident Credit 
  54.  Enter the portion of Ohio taxable income (line 3) not earned or received in Ohio (include 
     Ohio IT 2023)  ...................................................................................................................................... 54. - 888888888 00 

   55. Enter Ohio taxable income (line 3) ..................................................................................................... 55.            - 888888888 00 
 56.    Divide line 54 by line 55 and enter percentage here  888.88 %. Multiply this percentage by the  
   amount shown on line 8 reduced by the amount shown on line 9. Enter here and on line               10................... 56.                                  888888888 00 
 
 Schedule F – Allocated Qualifying Trust Amounts 
       Enter the trust’s portion   of capital gains/losses recognized to   the extent included in   Ohio taxable                 
       income (line 3) if the location of the physical assets of the closely held investee is available .......... 57.                                         - 888888888 00 

  58. Enter the percentage of the closely held investee’s physical assets located within Ohio              ................. 58.                                    8. 8888 

   59. Multiply the amount on line 57 by the percentage on line 58. Enter here and on line 4....................                    59.                        - 888888888 00 
 Schedule G – Apportioned Income for Trusts 
  60.  Enter (i) the trust’s business income not included in line 57 and (ii) the trust’s qualifying investment 
       income not otherwise a part of business income and not included in line 57 .................................... 60.                                     - 888888888 00 

  61. Enter the Ohio apportionment ratio from line 76 of the apportionment worksheet on page 5...........                       61.                              8. 888888 

  62. Multiply the amount on line 60 by the apportionment ratio on line 61. Enter here and on line 5.......                         62.                        - 888888888 00 
 Schedule H – Allocated Nonbusiness Income for Trusts 
 If distributive share is business income from a pass-through entity, use Schedule G. 
  63.  Resident trusts: Enter the trust’s portion of Ohio taxable income (line 3) not reported on            lines 57 or 60  ................-                   88888888863. 00 
  64.  Nonresident trusts: Enter the trust’s portion of Ohio taxable income (line 3) not reported on lines 57 
       or 60 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 64)............................................................  64.                        - 888888888 00 

 65. Add lines 63 and 64 and enter here and on line 6   ............................................................................. 65.                      - 888888888 00 
 Schedule I – Tax Credit for Resident Trusts 
  66.  Enter the amount of allocated resident trust nonbusiness income (line 63, above) subject to tax in 
       one or more states or in the District of Columbia  ..............................................................................          66.          - 888888888 00 

  67. Enter the amount from line 8   .............................................................................................................. 67.          888888888 00 

       EntertheamountofmodifiedOhiotaxableincomefromline                 ......................................................... 68.                           888888888 00 
  
 69. Divideline67byline68andenterthepercentagehere.Thisistheaverageeffectivetaxrate                  ..................     69.                                  8. 8888 

  70. Multiply the amount on line 66 by the percentage reported on line 69..............................................            70.                        - 888888888 00 
  
  71.  Enter the amount of tax actually paid by the resident trust to another state or the District of Columbia 
       on the trust’s allocated nonbusiness income    ..................................................................................... 71.                  888888888 00 
  
  72.  Enter the smaller of the amount on lines 70 and 71. This is the resident trust’s Ohio tax credit. Enter 
       here and on line 10 ............................................................................................................................ 72.      888888888 00 

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

                                                                                                          2017 IT 1041 – page  24of 6

                                                            2017 Ohio IT 1041 
                    Rev. 8/17            Fiduciary Income Tax Return
                                                                                                                           17180510 
FEIN 
88 8888888 
Apportionment Worksheet 
Usethisworksheettocalculatetheapportionmentratioforthetrust’smodifiedbusinessincomeandqualifyinginvestmentincomeincluded                                                    
in Ohio taxable income. Note:  All ratios are to be carried to six decimal places. 
 73.  Property                                                        Within Ohio                                      Total Everywhere 
    a) Owned (average cost)                                 88888888888 00                                           88888888888 00 
                                                                      Within Ohio 
                                                                                                                       Total Everywhere 
    b) Rented (annual rental X 8)                           88888888888 00                                           88888888888 00 

                                                                      Within Ohio                                      Total Everywhere 
    c) Total (lines 73a and 73b)                            88888888888 00                             ÷             88888888888 00 
                                                                                       Ratio                  Weight                                              Weighted Ratio 
                                                                      =             8. 888888           x =8.88                                                   8. 888888 

                                                                      Within Ohio                                      Total Everywhere 
 74.  Payroll                                               88888888888 00                             ÷             88888888888 00 

                                                                                       Ratio                  Weight                                              Weighted Ratio 
                                                                      =             8. 888888           x =8.88                                                   8. 888888 

                                                                      Within Ohio                                      Total Everywhere 
 75.  Sales                                                 88888888888 00                             ÷             88888888888 00 
                                                                                       Ratio                  Weight                                              Weighted Ratio 
                                                                      =             8. 888888           x =8.88.                                                  8. 888888 
 76. Total weighted apportionment ratio (add weighted ratio from lines 73c, 74 and 75). Enter ratio here and on 
    Schedule G, line 61 (carry to six decimal places).......................................................................................................76.   8. 888888 
Note: Ifthedenominatorofanyfactoriszero,theweightgiventotheotherfactorsmustbeproportionatelyincreasedsothatthetotalweightgiventothe                                                
combinednumberoffactorsusedis100%,i.e.,ifnoproperty/payroll,use25%and75%;ifnosales,use50%property/payroll;ifonlyonefactor,use100%.                                                  
Net Payment Worksheet – Include 1099(s) and W-2(s) 
77a. Estimated payments                                    77b. Prior year credit carryover              77c. 1099 withholdings 

      88888888 00                                                88888888 00                                  88888888 00 
77d. W-2 withholdings                                      77e. Refunds previously claimed                78. Net payments (sum of lines 77a-d minus line                          77e). 
                                                                                                              Enter here and on page 2, line 14. 
      88888888 00                                                88888888 00 
                                                                                                              888888888 00 
Refundable Business Credits 
Note: CertificatesfromtheOhioDevelopmentServicesAgencyand/orOhioITK-1(s)mustbeincludedtoverifyeachrefundablecreditclaimed.                                                        
79.  Motion picture credit                        80.          Business jobs credit                      81.  Pass-through entity credit 
      88888888 00                                                88888888 00                                  88888888 00 
82.   Venture capital credit                               83.   Historic preservation credit             84.  Financial Institutions Tax (FIT) credit 
      88888888 00                                                88888888 00                                  88888888 00 
85. Total refundable business credits (add lines 79-84). Enter here and on page 2, line 15. 
      888888888 00 

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

                                                                                                       2017 IT 1041 – page  25of 6

                                             2017 Ohio IT 1041 
                   Rev. 8/17           Fiduciary Income Tax Return
                                                                                                                            17180610 
FEIN 
88 8888888 
Beneficiary Schedule 
Providebeneficiaryinformationfor    all(residentandnonresident)beneficiariesintheestateortrust.           Use an additional sheet, if necessary. 

SSN                                    FEIN              Amount distributed 
888 88 8888                            88 8888888        888888888 00 

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

SSN                                    FEIN              Amount distributed 
888 88 8888                            88 8888888        888888888 00 

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

SSN                                    FEIN              Amount distributed 
888 88 8888                            88 8888888        888888888 00 

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

SSN                                    FEIN            Amount distributed 
888 88 8888                            88 8888888      888888888 00 

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

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

                                                                                                          2017 IT 1041 – page  26of 6

General information 

regarding this form

        General Information (2017 Ohio IT 1041): 
1) Dimensions:  
  
  Target or registration marks - 6 mm X  6 mm. Follow grid layout for positioning. 

  1D barcode (2 of 5 interleaved) - .375”H x 1.5”W. Follow grid layout for positioning. Center the barcode number 
    directly under the barcode. 

  2D barcode (PDF 417) - See 2D instructions and schema. Follow grid layout for positioning. There is one 2D 
    barcode on each page of the Ohio IT 1041. 

2) 1D barcode - The last two numbers of the 1D barcode represent the vendor number. Use the same vendor 
number as you did for last year’s return. If you have a question about your barcode assignment, e-mail the Forms 
Unit at Forms@tax.state.oh.us. The first six numbers are constant for this form (171801XX - 171806XX). 

  17 = tax year 
  18 = IT 1041 
  01-06 = page number 
  XX = vendor number (assigned to you by the Ohio Dept. of Taxation, Forms Unit). 

    NOTE: The vendor number also serves as the first two digits of the SSN and FEIN fields in the test 
    scenarios. 

3)  New! Use Arial font for the static text on the form. The static text for all target marks and header information 
(target marks, logo, title and 1D barcode) must match grid. 

4) Use monospaced Arial or similar monospaced san serif font for the variable data fields on the form. 

5) Follow the grid layout for the variable data fields shown in red. Ensure that the tax year, target or reg-
istration marks, “For Department Use Only” area and the 1D and 2D barcodes follow grid layout. 

6) Do not use commas, hyphens or decimals in the variable data fields except where shown in specs. 

7)   All monetary fields must always show “00” in the cents field even though there may not be a value for that line. 

8) You mustinclude  a leading zero on ratio fields.For  example,ifthe      ratio is .000026,itshould      display as 0.000026. 

9)  The possible negative fields for this return are lines 1, 2, 3, 4, 5 and 6; Schedule A, line 40; Schedule C, lines 
49 and 50; Schedule D, lines 54 and 55; Schedule F, lines 57 and 59; Schedule G, lines 60 and 62; Schedule H, 
lines 63, 64 and 65 and Schedule I, lines 66 and 70. Do not hard-code negative signs. 

10)  Provide guidance to customers regarding duplex printing that instructs them to print pages 1 and 2 together 
and pages 3 and 4 together. Taxpayers have filed returns with pages 2 and 3 duplexed or a worksheet or software 
receipt on the back of a page of the return. This slows the processing of the tax return. 

11)  New! Generate the following message for customers: “Do not enclose other documentation unless it is 
specified on the tax return or instructions.” Taxpayers often submit worksheets and receipts from the vendor 
product, which slows the processing of tax returns. Any other documentation generated from the software must 
include a 1D barcode identifying it as an additional information. The preferred placement is centered on the top 
edge of the page within the print area, however placement at any location on the page will be accepted. Always 
use the following 1D barcode (2 of 5 interleaved): 

                                                            10211411 

12) IMPORTANT NOTE:  Add this statement to your software programs. It should print out with the taxpayer’s return.  
“Do not hand write in any corrections on the printed paper return. Hand writing in corrections will result  
in capturing incorrect data and delaying the processing of this income tax return. Make any corrections to  
this income tax return within [the software program name], then print and mail.” 

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

       Additional Instructions 

    for the 2D barcode and 

 regarding submissions, 

 testing and notifications 

 for the 2017 Ohio IT 1041

                      Important Note 

 It is required  that vendors program the Ohio IT1041 to include 2D barcodes. 

                                   2017 Ohio IT  1041  

                   Fiduciary Income Tax Return 

                        2D Barcode Instructions  
 
 General Information 
    •  The Ohio   IT 1041 must be enabled for 2D barcode decoding 
    •     A form enabled       for 2D barcode should not     allow users   or practitioners the option   to turn 
       off/on the 2D barcode function 
    •  The minimum error correction code level is   4 
    •  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 

    •    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                     1718<CR> 
    Spec Version                    0<CR> 
    Form Version                    1<CR> 
    Date Generated                  011517<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   IT 1041 test packets   is December 1, 2017 
 •  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_   17_1041 
 •  Submissions must include 
    •    Ohio form STF- Approval Request for Scannable Tax Forms 
    •    One (1) full field sample     in a PDF format 
    •    Eight (8) test scenarios for the Ohio IT 1041 provided by the Ohio Department of 
         Taxation 
         •  Each test scenario must be     in a separate PDF using the following naming 
            convention: vendor number, product name, tax year, form number, test number 
            e.g.12_ABCTax_17_1041_Test    1 
 •  An emailed confirmation   is sent to the vendor indicating the packet was received 
 •  Submissions found   to be missing any of the items above are rejected 
 
 Testing Process  
 •  Testing   of Ohio   IT 1041     packets  commences    on   November 17, 2017 
 •  Test packets are reviewed   in two (2) content areas- printed forms and 2D barcode data 
 •  A submission   is approved   in its     entirety once all  sample documents pass   in both areas 
 
 Printed forms  
         •  Vendor full field matches template provided   in the specifications 
         •  All fields are present, are formatted    properly and  align with grid layout 
         •  Test scenarios contain values specified by Ohio        Department of Taxation 
 
 2D Barcode  Data  
         •  Barcodes read as valid 
         •  All test scenarios can be decoded 
         •  2D barcode data matches data on printed forms 
 

 Additional  instructions  
    •    The static text for all target marks and header information (target marks,    logo, title and 
         1D  barcode) must match grid.  
    •    Any other documentation  generated from the software must include a 1D barcode  
         identifying it as an additional  information. The preferred placement is centered on the top 
         edge of the page within the print area, however placement at any location on the page 
         will  be accepted. Always use the following 1D barcode (2 of 5 interleaved):  

 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, 2018  vendors    will be notified and required to 
     submit revised test packets.