Form It 1040x - Ohio Amended Individual Income Tax Return

Calendar Year

Ohio Amended Individual

IT 1040X

2 0

Income Tax Return for Year 2014

Rev. 11/14

For Department Use Only

(Check only one box in each column)

Your ﬁ rst name

M.I.

Last name

Your Social Security number

Filing Status:

Original

Amended

If a joint return, spouse's ﬁ rst name

M.I.

Last name

Spouse's SSN (only if MFJ)

Single, head of household or

qualifying widow(er)

Married ﬁ ling jointly (MFJ)

County

Current address (number and street)

Married ﬁ ling separately (MFS)

City, town or post ofﬁ ce, state and ZIP code

Ohio school district #

NOL carryback? If yes, attach

(for the taxable year)

form IT NOL. Yes

Ohio Residency Status – Check applicable box

Nonresident

Part-year resident

As Filed

As Amended

Full-year resident

(indicate state)

or as Last Amended

(Complete and attach Explanation

Check applicable box for spouse (only if married ﬁ ling jointly)

of Corrections on page 2.)

or as Last Corrected

Nonresident

Part-year resident

Full-year resident

(indicate state)

1. Federal adjusted gross income (if NOL, see instructions on pages 4-5) ..

2. Ohio Schedule A net adjustment ............................................................

3. Ohio adjusted gross income (line 2 added to or subtracted from line 1) ....

4. Personal and dependency exemptions, Ohio Schedule J......................

5. Ohio taxable income (line 3 minus line 4) ..............................................

6. Tax on line 5 (see tax tables in Ohio form IT 1040 instructions) ............

7. Ohio Schedule B credits (cannot exceed line 6) ....................................

8. Ohio tax less Schedule B credits (line 6 minus line 7) ...........................

9. Income-based exemption credit .............................................................

10.

00 10.

10. Ohio tax less exemption credit (line 8 minus line 9) ...............................

11.

00 11.

11. Joint ﬁ ling credit (see Ohio form IT 1040 instructions) ...........................

12.

00 12.

12. Ohio tax less joint ﬁ ling credit (line 10 minus line 11) .............................

13.

00 13.

13. Ohio Schedule C, D and E credits and manufacturing grant .................

14.

00 14.

14. Earned income credit .............................................................................

15.

00 15.

15. Ohio adoption credit ...............................................................................

16.

00 16.

16. Ohio income tax (line 12 minus lines 13, 14 and 15) .............................

17.

00 17.

17. Ohio form IT/SD 2210 interest penalty (required) ..................................

18.

00 18.

18. Sales and use tax due on Internet, mail order or other out-of-state purchases

19.

00 19.

19. Total Ohio tax (add lines 16, 17 and 18) ................................................

20.

00 20.

20. Ohio income tax withheld.......................................................................

21. Ohio estimated tax, Ohio form IT 40P extension payments and credit

21.

00 21.

carryover ................................................................................................

22.

22. Refundable credits ...................................................................................................................................

23.

23. Amounts previously paid..........................................................................................................................

24.

24. Total of lines 20 through 23......................................................................................................................

25. Overpayment shown on original return, previously ﬁ led amended returns and previously corrected

25.

returns (even if you have not yet received the refund) ............................................................................

26.

26. Line 24 minus line 25 ...............................................................................................................................

27. If line 26 is less than line 19 (as amended), subtract line 26 from line 19 and enter the amount owed

27.

plus interest. Make your check or money order payable to Ohio Treasurer of State ....

AMOUNT DUE

28. If line 26 is greater than line 19 (as amended), subtract line 19 from line 26 and enter the amount

28.

of your refund ..........................................................................................................

YOUR REFUND

If your refund is $1.00 or less, no refund will be issued. If you owe $1.00 or less, no payment is necessary.

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 received

Code

Interest

Your signature

Date (MM/DD/YYYY)

Mail to:

Spouse's signature (see Ohio form IT 1040 instructions)

Phone number

Ohio Department of Taxation

P.O. Box 1460

Preparer's name (please print)

Phone number