Instructions For Filing: Personal & School District Income Tax - Department Of Taxation State Of Ohio - 2014 Page 15
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602014 Ohio Forms IT 1040EZ / IT 1040 / Instructions
Sample 1099-R – This form reports taxpayers' retirement/pension income/withholding
See "Ohio Income Tax Withheld" on page 17 (Ohio form IT 1040EZ) and page 21 (Ohio form IT 1040)
Place all 1099-R documents after the last page of your Ohio income tax return. Do not staple or otherwise attach.
$ XX,XXX.XX
Box 1 or 2a – Your
taxable distribution
$ XX,XXX.XX
Payer's federal
XX-XXXXXXX
identifi cation number
Box 12 – Your state
OH XX-XXXXXX
$ X,XXX.XX
income tax withholding
Box 13 – If this shows
a state other than OHIO
or OH, do not include
the amount in box 12 as
part of your Ohio income
tax withholding.
Box 15 – Do not include
this amount as part of
your Ohio income tax
withholding.
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