Form It 1140ext-2005 - Ohio Withholding Tax Extension Payment Coupon For Pass-Through Entities And Trusts

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2005 Ohio IT 1140EXT
Ohio Withholding Tax
Extension Payment Coupon for
Pass-Through Entities and Trusts
DO NOT USE PENCIL
Please cut on the dotted lines. –
to complete this form.
OHIO IT 1140EXT
Rev. 11/05
Ohio Withholding Tax Extension Payment
For Taxable Year Beginning In
Extension Payment
Coupon for Pass-Through Entities and Trusts
YEAR
2005
Fed. Employer I.D. No.
$ $ $ $ $
,
,
.
1.
Withholding
0 0
Name
Tax
$ $ $ $ $
,
,
.
0 0
2.
Entity Tax
Address
,
,
$ $ $ $ $
,
,
.
0 0
3.
TOTAL DUE
City, state, ZIP code
DO NOT STAPLE CHECK TO COUPON OR ATTACH CHECK STUB. DO
NOT SEND CASH. Return this coupon with check or money order made payable
to OHIO TREASURER OF STATE and mail to OHIO DEPT. OF TAXATION, P.O.
BOX 181140, COLUMBUS, OHIO 43218-1140.
Signature of responsible party
Title
Date

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