Form Sd 100x - Amended School District Income Tax Return - Ohio
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SD 100X
Amended School District Income Tax Return
(Rev. 1/07) For fiscal year ending
,
Calendar Year
For Departmental Use Only
Your first name
Initial
Last name
Your Social Security number
Filing Status: (Check only one box in each
column)
Original
Amended
If a joint return, spouse's first name
Initial
Last name
Spouse's Social Security
Single, head of household
or qualifying widow(er)
Home address (number and street)
Ohio county
Married filing joint return
Married filing separately
City, town or post office, state and ZIP code
School district number
(from original SD 100 return)
Have you moved since you filed your last tax return? If yes, please check the box.
As Filed
As Amended
(Please complete and
SD Residency Status:
Resident
Part-year resident
Nonresident
enclose "Explanation of
(check only one box)
Part-year from
t o
Corrections" on page 2)
1. Adjusted gross income (from IT 1040, IT 1040EZ or TeleFile
1.
1.
worksheet) ...............................................................................................
2.
2.
2. Adjustments .............................................................................................
3.
3.
3. School district adjusted gross income (line 1 plus or minus line 2) ......
4.
4.
4. Personal and dependency exemptions ..................................................
5.
5.
5. School district taxable income (subtract line 4 from line 3) ....................
6.
6.
6. School district tax (enter tax rate ______% times line 5) ........................
7.
7.
7. Senior citizen credit ($50 limit) ................................................................
8.
8.
8. School district tax less credit (subtract line 7 from line 6) ......................
9.
9.
9. Interest penalty (enclose form SD 2210-100) .........................................
10.
10.
10. Total due before withholding and payments (add lines 8 and 9) ...........
11.
11.
11. School district income tax withheld .........................................................
12.
12.
12. School district estimated tax, SD 40P payments and credit carryover ....
13.
13.
13. Amount paid with previously filed returns ................................................
14.
14. Total of lines 11 through 13 ................................................................................................................
15. Overpayment shown on original return and on previously filed amended returns (even if you
15.
have not yet received the refund) .......................................................................................................
16.
16. Subtract line 15 from line 14 ..............................................................................................................
17. If line 16 is less than line 10 (as amended), subtract line 16
from line 10 and enter the amount owed. Make your check or
AMOUNT YOU OWE
17.
money order payable to school district income tax. ..........................................................................
18. If line 16 is greater than line 10 (as amended), subtract
YOUR REFUND
18.
line 10 from line 16. Enter the amount of your refund .......................................................................
If the balance due is less than $1.01, payment need not be made, and if the overpayment is less than $1.01, no refund will
be issued.
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my
knowledge and belief it is true, correct and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer
has any knowledge.
Date Rec'd.
Code
Interest
Your signature
Date
Spouse's signature (if filing joint, BOTH must sign)
Telephone number (optional)
Mail to: School District Income Tax
P.O. Box 182389
Columbus, OH 43218-2389
Preparer's signature and address (including ZIP code)
Date
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