Ohio Form It 1140 Ext - Ohio Withholding Tax Extension Payment Coupon For Pass-Through Entities And Trusts - 2012

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2012 Ohio IT 1140EXT
Ohio Withholding Tax
Extension Payment
Coupon for
Pass-Through Entities
and Trusts
DO NOT USE PENCIL
Please cut on the dotted line. –
to complete this form.
OHIO IT 1140 EXT
Do NOT fold check or coupon.
Rev. 5/12
Ohio Withholding Tax Extension Payment
Extension Payment
For Taxable Year Beginning In
Coupon for Pass-Through Entities and Trusts
2012
Reset Form
Federal Employer Identifi cation Number
.
.
$
0 0
Name
1. Withholding Tax
.
$
0 0
2. Entity Tax
Address
$
,
,
.
0 0
3. TOTAL DUE
City, state, ZIP code
DO NOT STAPLE, PAPER CLIP OR OTHERWISE ATTACH YOUR
CHECK OR CHECK STUB TO THIS COUPON. DO NOT SEND CASH.
Return this coupon with check or money order made payable to OHIO
TREASURER OF STATE and mail to OHIO DEPARTMENT OF TAXA-
Signature of responsible party
Title
Date
TION, P.O. BOX 181140, COLUMBUS, OH 43218-1140.


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