Form It-1040 Ez - Income Tax Return
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1IT-1040 EZ
OHIO
Income Tax Return
1998
For Full Year Ohio Residents
FOR DEPARTMENTAL USE ONLY
Your first name
Initial
Last Name
Your Social
Sec. #
If a joint return, spouse’s first name
Initial
Last Name
Spouse’s
Social Sec. #
Home address (number and street)
Apt. Number
(if joint filing)
City, state and zip code
Ohio County
Public School District Number >
Ohio Political Party Fund
Filing Status
Single or Head
Married Filing
Married Filing
Yes
No
Do you want $1 to go to this fund? . . . . . . . . . . . .
of Household
Joint
Separate
(check only
Does your spouse want $1 to go to this fund? . . .
Yes
No
one)
X
X
X
Note: Checking “Yes” will not increase your tax or reduce your refund.
Dollars
Cents
1 Federal Adjusted Gross Income from Federal Form 1040, line 33, or
0 0
1040A, line 18, or 1040EZ, line 4 or 1040-TEL . . . . . . . . . . . . . . . . . . . . . . . . 1
,
.
0 0
2 State or Municipal Income Tax Overpayments (see instructions) . . . . . . . . 2
,
.
0 0
3 Ohio Adjusted Gross Income (line 1 minus line 2) . . . . . . . . . . . . . . . . . . . . 3
,
.
4 Personal and Dependency Exemption Deduction - Enter the amount
0 0
from the exemption worksheet on page 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
,
.
0 0
5 Ohio Taxable Income (line 3 minus line 4) . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
,
.
6 Ohio Tax Before Credits (see tax tables) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
0 0
,
.
7 Exemption Credit - Multiply the number of your personal and dependent
0 0
exemptions ______ times $20 and enter the result here . . . . . . . . . . . . . . . . . 7
.
8 Tax Less Exemption Credit (line 6 minus line 7) . . . . . . . . . . . . . . . . . . . . . . 8
0 0
,
.
9 Joint Filing Credit (see instructions on page 10 and attach
0 0
documentation). ______% times line 8 (LIMIT $650) . . . . . . . . . . . . . . . . . . . 9
.
10 Ohio Income Tax (line 8 minus line 9) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
0 0
,
.
11 Ohio Tax Withheld Enter the amount of Ohio income taxes withheld
0 0
(Indicate the number of W-2’s attached ____) . . . . . . . . . .WITHHOLDING
11
,
.
12 Refund (if line 11 is more than line 10, subtract line 10 from line 11).
0 0
This is your refund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .YOUR REFUND
12
,
.
13 Amount You Owe (if line 11 is less than line 10, subtract line 11 from line 10). This is the
amount you owe. Attach payment made payable to: Treasurer of State of Ohio. Write your
0 0
,
.
social security number on your check or money order . . . . . . .AMOUNT YOU OWE
13
IF THE AMOUNT YOU OWE IS LESS THAN $1.01 PAYMENT NEED NOT BE MADE, AND IF THE REFUND IS LESS THAN $1.01 NO REFUND WILL BE ISSUED.
WILDLIFE AND NATURAL AREAS DONATIONS (THESE WILL REDUCE YOUR REFUND)
Do not complete lines 14 and 15
14 Amount of line 12 you wish to DONATE for conservation of endangered species
unless you want to donate all or
0 0
and wildlife diversity: $3
$5
$10
other
. . . . . . . . . . . . . . . 14
.
part of your refund on line 12 to
Wildlife and Natural Areas.
15 Amount of line 12 you wish to DONATE to nature preserves, scenic rivers
0 0
Your refund will be automatically
and endangered species protection: $3
$5
$10
other
. . . . 15
.
reduced by the amount donated.
I have read this return. Under penalties of perjury, I declare that to the best of my knowledge and belief, the return is true, correct, and complete.
Your Signature
Date
FOR DEPARTMENTAL USE ONLY
Spouse’s Signature (if joint return )
Phone No. (optional)
11A
U
Paid Preparer’s Name and Signature
MAIL REFUNDS TO:
MAIL TAX DUES TO:
OHIO DEPARTMENT OF TAXATION
OHIO DEPARTMENT OF TAXATION
Paid Preparer’s Address (including zip code)
P.O. BOX 182294
P.O. BOX 182850
COLUMBUS, OHIO 43218-2294
COLUMBUS, OHIO 43218-2850
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