Form It 1040 - Individual Income Tax Return - 2013
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4Do not use staples.
IT 1040
Taxable year beginning in
Rev. 11/13
2013
Individual
13000106
Income Tax Return
Use only black ink.
Enter school district # for
Taxpayer Social Security no. (required)
Spouse’s Social Security no.
If deceased
If deceased
(only if joint return)
this return (see pages 43-48).
SD#
check box
check box
Use UPPERCASE letters.
Your fi rst name
M.I.
Last name
Spouse’s fi rst name (only if married fi ling jointly)
M.I.
Last name
Mailing address (for faster processing, use a street address)
Ohio county (fi rst four letters)
City
State
ZIP code
ZIP code
County (fi rst four letters)
Home address (if different from mailing address) – do NOT show city or state
Foreign country (provide this information if the mailing address is outside the U.S.)
Foreign postal code
E-mail address
Ohio Residency Status
– Check applicable box
Check applicable box for spouse (only if married fi ling jointly)
Full-year
Nonresident
Part-year
Full-year
Part-year
Nonresident
Indicate state
resident
resident
resident
resident
Indicate state
Filing Status
– Check one (as reported on federal income tax return,
Do not use staples, tape or glue. Place your W-2(s), check
with limited exceptions – see instructions on page 14)
(payable to Ohio Treasurer of State) and Ohio form
Single, head of household or qualifying widow(er)
IT 40P after the last page of your return. Include forms W-2G
Married fi ling jointly
and 1099-R if tax was withheld. Place any other supporting
Married fi ling separately
documents or statements after the last page of your return.
(enter spouse’s SS#)
Go paperless. It’s FREE!
Required to fi le Schedule IT S (see instructions on page 9)
Visit tax.ohio.gov to try Ohio I-File.
Ohio Political Party Fund
Yes
No
Do you want $1 to go to this fund? ..........................................
Most electronic fi lers receive their refunds
If joint return, does your spouse want $1 to go to this fund? ...
in 5-7 business days by direct deposit!
Note: Checking “Yes” will not increase your tax or decrease your refund.
INCOME AND TAX INFORMATION –
If amount is negative, type a negative sign (“–”) before the fi gure.
1.
Federal adjusted gross income
(from IRS form 1040, line 37; 1040A, line 21;
0 0
.
1040EZ, line 4; 1040NR, line 36; 1040NR-EZ, line 10; or Ohio form IT S, line 31) ............... 1.
0 0
.
2. Adjustments from line 50 on page 3 of Ohio form IT 1040 (enclose page 3) ................. 2.
0 0
.
3. Ohio adjusted gross income (line 2 added to or subtracted from line 1) .......................... 3.
4. Personal exemption and dependent exemption deduction – multiply your personal
0 0
.
and dependent exemptions
times $1,700 and enter the result here ...................... 4.
0 0
.
5. Ohio taxable income (line 3 minus line 4; enter -0- if line 3 is less than line 4) ............... 5.
0 0
.
6. Tax on line 5 (see tax tables on pages 35-41 of the instructions) .................................................. 6.
0 0
.
7. Schedule B credits from line 59 on page 4 of Ohio form IT 1040 (enclose page 4) ..................... 7.
0 0
.
8. Ohio tax less Schedule B credits (line 6 minus line 7; enter -0- if line 6 is less than line 7) ...................8.
0 0
.
9. Income-based exemption credit (see instructions on page 19) ..................................................... 9.
0 0
.
10. Ohio tax less exemption credit (line 8 minus line 9; enter -0- if line 8 is less than line 9) ...................10.
2013 IT 1040
2013 IT 1040
pg. 1 of 4
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