Form Sd 100 - School District Income Tax Return - Draft 10/16/06

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SD 100
Rev. 10/06
2006
School District
Do not use staples,
06020100
Income Tax Return
paper clips or tape.
Enter school district # for this return
Your Social Security number (required)
Spouse’s Social Security number (only if joint return)
(see pages 9-10).
Check if
Check if
SD #
deceased
deceased
Please use only UPPERCASE letters.
Your first name
M.I.
Last name
Spouse’s first name (only if joint return)
M.I.
Last name
Home address (number and street)
City
State
ZIP code
Ohio county (first four letters)
Foreign country
Foreign postal code
In care of/executor’s name (must indicate if refund will be issued in decedent’s name)
Filing Status
– Check only one
(same as reported on federal income tax return)
Single or head of household
Please do not use staples, paper clips or tape.
Married filing jointly
Draft 10/16/06
or qualifying widow(er)
Place your W-2 on top of your return.
Married filing separately –
Place any other supporting documents or statements after
enter spouse’s SS#
the last page of your return and place in an envelope.
School District Residency –
Y
ou must file a separate form SD 100 for
Please do not staple, paper clip or tape to (but do enclose with)
each school district in which you reside.
this return any payment or form SD 40P (see page 7).
Full-year resident
Nonresident of SD # above
If you are enclosing a check or money order, you must complete
Part-year resident of SD # above from ...
and enclose form SD 40P (see page 7).
/
/
/
2 0
0
6
6
2 0
0 6
to
INCOME INFORMATION
1. Ohio adjusted gross income reported on line 3 of Ohio form IT 1040 or IT 1040EZ. If
you filed your Ohio income tax return by telephone, see instructions on page 3. If this
0 0
,
,
.
amount is a loss, please shade the negative sign “–” in the box provided .............................
... 1.
2. Adjustments, if any, from Schedule A or B on page 2 of this form. If the amount on
0 0
,
,
.
line 2 comes from line 18 or 21, shade the negative sign “–” in the box provided .................
... 2.
3. School district adjusted gross income (line 2 added to line 1 unless you have shaded
the negative sign “–” in the box provided, in which case subtract line 2 from line 1;
0 0
,
,
.
cannot be less than -0-) .............................................................................................................................. 3.
4. Exemptions (multiply the number of your exemptions times $1,400). Note: If you entered
0 0
,
.
school district number 6501 on the top of this form, you must enter -0- on line 4 .............................. 4.
0 0
,
,
.
5. School district taxable income (line 3 minus line 4; cannot be less than -0-) ...................................... 5.
SIGN HERE (required)
Continue to SD 100 – pg. 2
I have read this return. Under penalties of perjury, I declare that, to the best of my knowledge and
For Departmental Use Only
belief, the return and all enclosures are true, correct and complete.
Your signature
Date
Processing
Code
Spouse’s signature (if filing jointly, BOTH must sign)
Phone number
Preparer’s signature
Phone number
Mail to School District Income Tax, P.O. Box 182389, Columbus, OH 43218-2389.
SD 100 – pg. 1 of 2

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