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                                                                                                                                               Rev. 9/14
                                                                                                                                     IT 1140

  Check here if amended return                                                   14170102                   2014                     Pass-Through Entity
                                                                                                                                     and Trust Withholding
  Check here if fi nal return                                                                  Use only black ink.                    Tax Return
  Federal employer I.D. no. (FEIN)                                                                                                        For taxable year beginning in
                                                                                Entity Type:  S corporation                    Partnership
                                                                                Check only one
                                                                                              Limited liability corporation    Trust        MM /              2 0 14
  Use UPPERCASE letters.
  Name of pass-through entity

  Address (if address change, check box)

  City                                                                                          State             ZIP code

  E-mail address

  Number of investors               Apportionment ratio, page 3, line 8
                                                                                                1.  File this form with the Ohio Department of Taxation by the 15th 
                                           .                                                                day of the fourth month following the last day of the entity’s tax-
  Schedule B, line 1 – total of columns A and B                                                             able year. See general instructions for automatic extensions of 
                                                                              00                            time to fi le this return. The due date for payment of tax cannot 
                          ,         ,              .                                                        be extended.
  Do not staple or otherwise attach. Place any supporting 
  documents, including K-1’s, after the last page of this return.                               2.  Attach (i) Ohio Schedules B and C or Schedules D and E and 
                                                                                                            (ii) the investor information as indicated in the instructions and 
                                         Mail to:                                                           (iii) Ohio form IT/SD 2210.
                               Ohio Dept. of Taxation
                                    P.O. Box 181140                                                         Instructions for this form are on our Web site at tax.ohio.gov.
                               Columbus, OH 43218-1140
  SCHEDULE A – RECONCILIATION TAX AND PAYMENTS
  DRAFT 9/17/14
                                                                                              Column (I) – Withholding Tax                Column (II) – Entity Tax
  1.  Tax for each column (from Schedule B, line 
  11, columns A and B or from Schedule D, line                                                                               00                                            00
  5) ............................................................................ 1.          ,             ,               .             ,                   ,   .
  2.  Interest penalty on underpayment of tax if the 
  sum of columns A and B on line 9 on page 
  3 exceeds $10,000 (attach Ohio form IT/SD                                                                                  00                                            00
  ......................................................................2210) 2.              ,             ,               .             ,                   ,   .
                                                                                                                             00                                            00
  2a.  Add lines 1 and 2 ................................................. 2a.                ,             ,               .             ,                   ,   .
  3.  Ohio IT 1140ES and IT 1140P payments the 
  entity or trust made and/or 2013 overpayment                                                                               00                                            00
  ...........credited3.to 2014 (see Note 1 on page 7)                                         ,             ,               .             ,                   ,   .
  
 3a.  Payments transferred from Ohio forms IT 
  4708ES and IT 4708P (attach schedule if 
  required; see instructions) and other pay-                                                                                 00
  ments previously made for this taxable year ........ 3a.                                    ,             ,               .
 3b.  Payments transferred to Ohio form IT 4708 
  and refunds, if any, previously claimed for this                                                                           00
  taxable year            .......................................................... 3b.      ,             ,               .

  3c.  Net payments (sum of lines 3 and 3a minus                                                                             00                                            00
  line 3b) not less than zero       .....................................3c.                  ,             ,               .             ,                   ,   .
  4.  For each column, subtract line 3c from line 
    2a (shade the boxes to show negative                                                                                     00                                            00
  amounts if needed) ......................................                      ... 4.       ,             ,               .             ,                   ,   .

       2014 IT 1140                                                                           pg. 1 of 6
                                                                                                                                       2014 IT 1140



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                                                                                                                                                 Rev. 9/14
                                                                                                                                       IT 1140
                                                                                                    2014                               Pass-Through Entity
 FEIN                                                              14170202                                                            and Trust Withholding
                                                                                                                                       Tax Return
 SCHEDULE A – RECONCILIATION TAX AND PAYMENTS...cont.
                                                                                                                                                                    00
 5. If  the sum of line 4, columns (I) and (II) is an overpayment, enter that sum here ....OVERPAYMENT5.                                ,       ,                 .
                                                                                                                                                                    00
  6.  Amount of line 5 to be CREDITED to year 2015 ................................................. CREDIT TO 20156.                   ,       ,                 .
                                                                                                                                                                    00
  7.  Amount of line 5 to be REFUNDED (line 5 minus line 6) ...................................... YOUR REFUND7.                        ,       ,                 .
                                                                                                                                                                    00
 8.  If the sum of line 4, columns (I) and (II) is a balance due or zero, enter here the amount       due ............ 8.                ,       ,                 .
                                                                                                                                                                    00
  9.  Interest and penalty due on late-paid tax and/or late-fi led return, if any .................................................. 9.   ,       ,                 .
  10.  Total amount due (sum of  lines 8 and 9). Make check payable to Ohio Treasurer of State, include                                                             00
      Ohio form IT 1140P and place FEIN on check ...........................................TOTAL AMOUNT DUE10.                         ,       ,                 .
                    If your refund is $1.00 or less, no refund will be issued. If you owe $1.00 or less, no payment is necessary.
 SIGN HERE (required)
 I declare under penalties of perjury that this report, including any accompanying schedules and 
 statements, has been examined by me and to the best of my knowledge and belief is a true, cor-                                        For Department Use Only
 rect and complete return and report.

 Pass-through entity offi cer or agent (please print) 

 Title of offi cer or agent (please print)                                              Phone number                                    ,      ,           
 Signature of pass-through entity offi cer or agent                                     Date

 Preparer’s name (please print)                                                        Phone number                                        Code
 Do you authorize your preparer to contact us regarding this return?  Yes                   No
 SCHEDULE B – QUALIFYING PASS-THROUGH ENTITIES – TAX DUE
 Use this schedule to calculate the adjusted qualifying amounts and tax due for all qualifying investors in qualifying pass-through entities. Attach federal 
 K-1s and a listing of pass-through credits of participating investors. See “Special Notes” in the instructions, which are available on our Web site at tax.
 ohio.gov.DRAFTIf the amount below is negative, shade the negative sign (“–”) in the9/17/14box provided. 
                                                                                           (A)                                             (B)
                                                                                       Qualifying Investors Who Are                    Qualifying Investors Other 
                                                                                       Nonresident Individuals                         Than Nonresident Individuals
   1. Sum of all qualifying investors’ distributive                                                                 00                                              00
        shares of income, gain, expenses and losses...             ...1.               ,            ,               .                    ,       ,                 .
  2a. Add   2/3,      5/6 or 6/6 (check ap-
        plicable box) of the qualifying investors’ 
        distributive shares of Internal Revenue 
        Code (I.R.C.) sections 168(k) and 179 
        depreciation expense and miscellaneous 
        federal income tax adjustments, if any. At-
        tach a separate schedule showing calcula-                                                                   00                                              00
        tions .................................................................... 2a. ,            ,               .                    ,       ,                 .
  2b. Subtract qualifying investors’ distributive 
        shares of other statutory adjustments and 
        miscellaneous federal income tax adjust-                                                                    00                                              00
        ments, if any ........................................................ 2b.     ,            ,               .                    ,       ,                 .
   3. Qualifying investors’ distributive shares of 
        adjusted qualifying amount: Sum of lines 1                                                                  00                                              00
        and 2a minus line 2b...................................... ...3.               ,            ,               .                    ,       ,                 .
   4.  Add all qualifying investors’ distributive 
        shares of expenses and losses incurred in 
        connection with all direct and indirect trans-
        actions between the qualifying pass-through 
        entity and its related members, including 
        certain investors’ family members (see Note 
        2 on page 7). However, do not add expenses 
        or losses incurred in connection with sales 
        of inventory to the extent that the cost of 
        the inventory and the loss incurred were 
        calculated in accordance with I.R.C. sections                                                               00                                              00
        263A and 482 (see Note 3 on page 7) ...........            ...4.               ,            ,               .                    ,       ,                 .

        2014 IT 1140                                                                   pg. 2 of 6
                                                                                                                                       2014 IT 1140



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                                                                                                                            Rev. 9/14
                                                                                                            IT 1140
                                                                                           2014             Pass-Through Entity
 FEIN                                                                    14170302                           and Trust Withholding
                                                                                                            Tax Return
 SCHEDULE B – QUALIFYING PASS-THROUGH ENTITIES – TAX DUE...cont.
                                                                                       (A)                                 (B)
                                                                         Qualifying Investors Who Are          Qualifying Investors Other 
   5. If the qualifying pass-through entity is either                      Nonresident Individuals            Than Nonresident Individuals
  a partnership or a limited liability company 
  treated as a partnership, add all qualifying 
  investors’ distributive shares of guaranteed 
  payments that the qualifying pass-through 
  entity made to any qualifying investor di-
  rectly or indirectly owning at least 20% of                                                         00                                    00
  the qualifying pass-through entity ...................5.                        ,        ,       .                  ,       ,            .
   6.  If the qualifying pass-through entity is an 
  S corporation, add all qualifying investors’ 
  distributive shares of compensation that the 
  qualifying pass-through entity S corporation 
  made to any qualifying investor directly or in-
  directly owning at least 20% of the qualifying 
  pass-through entity. Reciprocity agreements 
                                                                                                      00                                    00
  do not apply ....................................................6.             ,        ,       .                  ,       ,            .
   7. Qualifying investors’ adjusted distributive 
  shares. Sum of lines 3, 4, 5 and 6, but not 
                                                                                                      00                                    00
  less than -0- ....................................................7.            ,        ,       .                  ,       ,            .
   8.  Apportionment ratio from Schedule C, line 
  4  on page 4.....................................................8.                  .                                   .
   9. Qualifying investors’ adjusted qualifying 
  amount: Line 7 times line 8. Complete 
  the remainder of this worksheet only if the 
  sum of columns A and B on line 9 exceeds 
                                                                                                      00                                    00
  $1,000 .............................................................9.          ,        ,       .                  ,       ,            .

  10.DRAFTTax rate (see Note 4 on page 7)...................10.                          9/17/14X .05                                    X .085
  11. Tax due: Line 9 times line 10. Round tax to the 
  nearest dollar. Enter the column A amount on 
  page 1, line 1, column I; enter the column B                                                        00                                    00
  amount on page 1, line 1, column II ............... 11.                         ,        ,       .                  ,       ,            .

 SCHEDULE C – QUALIFYING PASS-THROUGH ENTITIES – APPORTIONMENT WORKSHEET
 Use this schedule to calculate the apportionment ratio for a qualifying pass-through entity that is not a fi nancial institution as defi ned in Ohio Re-
 vised Code section (R.C.) 5725.01. If the pass-through entity is a fi nancial institution, refer to the instructions. Note: All ratios are to be carried to 
 six decimal places.

 1.  Property                                                            Within Ohio                                  Total Everywhere
                                                                                             00                                             00
    a) Owned (average cost)                        ,                     ,           ,       .              ,         ,       ,            .
 
                                                                         Within Ohio                                  Total Everywhere
                                                                                             00                                             00
    b) Rented (annual rental X 8)                  ,                     ,           ,       .              ,         ,       ,            .
                                                                         Within Ohio                                  Total Everywhere
                                                                                             00                                             00
    c) Total (lines 1a and 1b)                     ,                     ,           ,       .   ÷          ,         ,       ,            .

                                                                                           Ratio         Weight            Weighted Ratio
                                                                           =                             x  .20  =
                                                                                       .                              .

     2014 IT 1140                                                                 pg. 3 of 6                   2014 IT 1140



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                                                                                                                                                                               Rev. 9/14
                                                                                                                                                                     IT 1140
                                                                                       2014                                                                          Pass-Through Entity
   FEIN                                              14170402                                                                                                        and Trust Withholding
                                                                                                                                                                     Tax Return
   SCHEDULE C – QUALIFYING PASS-THROUGH ENTITIES – APPORTIONMENT WORKSHEET...cont.
                                                             Within Ohio                                                                                             Total Everywhere
                                                                                       00                                                                                                   00
 2.  Payroll                                     ,           ,             ,           .       ÷                                                               ,       ,         ,         .
                                                                                    Ratio                                                           Weight               Weighted Ratio

                                                                     =         .                                                                    x  .20  =          .
                                                          Within Ohio                                                                                                Total Everywhere
                                                                                       00                                                                                                   00
                                                 ,           ,             ,           .       ÷                                                               ,       ,         ,         .
 3.  Sales
 
                                                                                    Ratio                                                           Weight               Weighted Ratio

                                                                     =         .                                                                    x  .60  =          .

                                                                                                                                                                         Weighted Ratio

  4.  Total weighted apportionment ratio (add lines 1c, 2 and 3). Enter ratio here and on page 3, line 8 (both columns).                                               .
   Note: If the denominator of any factor is zero, the weight given to the other factors must be proportionately increased so that the total weight given to 
   the combined number of factors used is 100%, i.e., if no property/payroll, use 25% and 75%; if no sales, use 50% property/payroll.
 SCHEDULE D – TRUSTS – TAX DUE
   Use this schedule to calculate the adjusted qualifying amounts and withholding tax due for nonresident individuals who are benefi ciaries of trusts that 
   made distributions of either income or gain attributable to the trust’s ownership of or disposition of either tangible personal property located in Ohio or 
   real property located in Ohio. If the amount below is negative, shade the negative sign (“–”) in the box provided. 
  1.  Sum of all distributions to nonresident individuals of income or gain attributable to the trust’s 
      ownership of or disposition of either tangible personal property located in Ohio or real property                                                                                     00
      located in Ohio  ............................................................................................................................  ... 1.            ,         ,         .
 2a.  AddDRAFT2/3, 5/6 or 6/6 (check applicable box) of the I.R.C. sections9/17/14168(k) and 179 
      depreciation expense and miscellaneous federal income tax adjustments attributed to 
      nonresident individuals who are benefi ciaries of trusts. Attach a separate schedule showing                                                                                           00
      calculations  ......................................................................................................................................... 2a.      ,         ,         .
 
  2b.  Other statutory adjustments and miscellaneous federal income tax adjustments attributed to                                                                                           00
      nonresident individuals who are benefi ciaries of trusts  ....................................................................... 2b.                             ,         ,         .
  3.  Adjusted qualifying amount: sum of lines 1 and 2a minus line 2b. Complete the remainder of                                                                                            00
      the worksheet only if line 3 exceeds $1,000 ...............................................................................                   ... 3.             ,         ,         .
 4.  Tax rate  .................................................................................................................................................. 4.                     X .05

   5. Tax due: Line 3 times line 4. Round tax to the nearest dollar. Enter here and on page 1, line                                                                                         00
      1, column I ............................................................................................................................................ 5.      ,         ,         .
 SCHEDULE E – INVESTOR INFORMATION
      Check the box if this year’s investor information either (i) includes names that were not listed on last year’s return or (ii) excludes names that were listed 
      on last year’s return. Provide investor information forall (resident and nonresident) investors in the pass-through entity or trust. List investors by high-
      est to lowest ownership percentage. Use an additional sheet, if necessary. See Note 5 on page 7 for the amount of pass-through entity tax credits.
   Social Security no.                    FEIN                                   Percent of ownership                                               Amount of PTE tax credit
                                                                                                                                                                                         00
                                                                                    .                                                                                ,         ,        .
   First name/entity                                             M.I.  Last name

   Address

   City                                                                             State      ZIP code

         2014 IT 1140                                                 pg. 4 of 6
                                                                                                                                                                     2014 IT 1140



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                                                                                                                          Rev. 9/14
                                                                                  IT 1140
                                                                     2014         Pass-Through Entity
FEIN                                              14170502                        and Trust Withholding
                                                                                  Tax Return
SCHEDULE E – INVESTOR INFORMATION...cont.
Provide investor information for all (resident and nonresident) investors in the pass-through entity or trust. List investors by highest to lowest ownership 
percentage. Use an additional sheet, if necessary. See Note 5 on page 7 for the amount of pass-through entity tax credits.
Social Security no.                 FEIN                   Percent of ownership   Amount of PTE tax credit
                                                                                                                                    00
                                                                    .             ,                                       ,        .
First name/entity                                 M.I.     Last name

Address

City                                                                State ZIP code

Social Security no.                 FEIN                   Percent of ownership   Amount of PTE tax credit
                                                                                                                                    00
                                                                    .             ,                                       ,        .
First name/entity                                 M.I.     Last name

Address

City                                                                State ZIP code

Social Security no.                 FEIN                   Percent of ownership   Amount of PTE tax credit
DRAFT 9/17/1400
                                                                    .             ,                                       ,        .
First name/entity                                 M.I.     Last name

Address

City                                                                State ZIP code

Social Security no.                 FEIN                   Percent of ownership   Amount of PTE tax credit
                                                                                                                                    00
                                                                    .             ,                                       ,        .
First name/entity                                 M.I.     Last name

Address

City                                                                State ZIP code

                                                           pg. 5 of 6
     2014 IT 1140                                                                 2014 IT 1140



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                                                                                                                          Rev. 9/14
                                                                                  IT 1140
                                                                     2014         Pass-Through Entity
FEIN                                              14170602                        and Trust Withholding
                                                                                  Tax Return
SCHEDULE E – INVESTOR INFORMATION...cont.
Provide investor information for all (resident and nonresident) investors in the pass-through entity or trust. List investors by highest to lowest ownership 
percentage. Use an additional sheet, if necessary. See Note 5 on page 7 for the amount of pass-through entity tax credits.
Social Security no.                 FEIN                   Percent of ownership   Amount of PTE tax credit
                                                                                                                                    00
                                                                    .             ,                                       ,        .
First name/entity                                 M.I.     Last name

Address

City                                                                State ZIP code

Social Security no.                 FEIN                   Percent of ownership   Amount of PTE tax credit
                                                                                                                                    00
                                                                    .             ,                                       ,        .
First name/entity                                 M.I.     Last name

Address

City                                                                State ZIP code

Social Security no.                 FEIN                   Percent of ownership   Amount of PTE tax credit
DRAFT 9/17/1400
                                                                    .             ,                                       ,        .
First name/entity                                 M.I.     Last name

Address

City                                                                State ZIP code

Social Security no.                 FEIN                   Percent of ownership   Amount of PTE tax credit
                                                                                                                                    00
                                                                    .             ,                                       ,        .
First name/entity                                 M.I.     Last name

Address

City                                                                State ZIP code

                                                           pg. 6 of 6
     2014 IT 1140                                                                 2014 IT 1140



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                            Do not submit this page with your IT 1140 return.

Important Notes:                                                             Savings and loan holding companies as defi ned in the federal 
                                                                             “Home Owners Loan Act” that are engaging only in activities 
Note 1: Instructions for page 1, Schedule A, line 3. If this pass-           permissible under 12 United States Code (U.S.C.) 1843(k).
through entity or trust has invested in a partnership or limited liability 
companyNOTESthat also led Ohio form IT 1140, this pass-through entity       Persons, other than persons held pursuant to merchant banking 
or trust is not entitled to any payment or credit for this pass-through      authority under 12 U.S.C. 1843(k)(4)(H) or 12 U.S.C. 1843(k)
entity’s or this trust’s proportionate share of tax paid by that investee    (4)(I), directly or indirectly “owned” by one or more fi nancial 
partnership or investee limited liability company.                           institutions, fi nancial holding companies, bank holding compa-
                                                                             nies, or savings and loan holding companies, but only if those 
Furthermore, this pass-through entity or trust cannot claim such             persons are engaged in activities permissible for a fi nancial 
payment as an estimated payment for this pass-through entity’s or            holding company under 12 U.S.C. 1843(k).
trust’s taxable year. However, the pass-through entity or trust can 
“pass through” (via the K-1s it will issue) to its qualifying investors       Persons directly or indirectly “owned” by one or more insurance 
or to its qualifying benefi ciaries the pass-through entity’s or trust’s      companies, but only if those persons are authorized to conduct 
proportionate share of such tax payment that the investee partner-           the business of insurance in this state. 
ship or investee limited liability company paid on behalf of this 
pass-through entity or trust.                                                 Persons that solely facilitate or service one or more “securitiza-
                                                                             tions” or similar transactions for fi nancial institutions, fi nancial 
Note 2: Instructions for page 2, line 4. “Related member” is defi ned         holding companies, bank holding companies, savings and loan 
in R.C. 5733.042(A)(6) but is modifi ed by R.C. 5733.40(P). For               holding companies, insurance companies, or persons directly 
purposes of the line 4 adjustment, a related member is any busi-             or indirectly “owned” by such businesses.
ness entity or person directly or indirectly related to the taxpayer if 
the direct and indirect ownership interests equals or exceeds 40%          Defi nition of “owned” for this purpose: a person “owns” another 
of all ownership interests.                                                entity if the person:
Note 3: Instructions for page 2, line 4. Include on this line all             owns at least 50% of the entity’s voting stock (corporations);
compensation paid to or for family member employees if the pass-              owns at least 50% of the entity’s membership interests (LLCs); 
                                                                            
through entity owner who is a member of family directly, indirectly 
                                                                             OR
and/or by attribution owns at least 40% of the pass-through entity. 
See R.C. 5733.40(A)(3). Do not show on line 6 any amount you                 has a benefi cial interest in the entity’s profi ts, surpluses, losses 
show on line 4.                                                              or distributions (partnerships, trusts or other business interests).
Note 4: Instructions for page 3, line 10, column (B). For those            Defi nition of “securitization” for this purpose: Transferring one or 
qualifying corporate investors that are not listed below, the tax rate     more assets to one or more persons and then issuing securities 
for the taxable year beginning in 2014 is 0%; therefore the pass-          backed by the right to receive payment from the asset or assets 
throughDRAFTentity should pay no tax with respect to these corporations.   so9/17/14transferred.
For those qualifying corporate investors that are listed below and 
for qualifying investors that are estates, trusts and pass-through         If you use multiple rates for column B, attach a schedule refl ecting 
entities, compute the tax at the rate of 8.5%. See R.C. 5733.41.           the computation of tax for each type of investor.
  Financial holding companies as defi ned in the federal “Bank             Fiscal fi lers: Use the rate in effect on the last day of the taxable year. 
  Holding Company Act.”
                                                                           Note 5: Amount of tax credits that will pass through from the qualify-
  Bank holding companies as defi ned in the federal “Bank Hold-            ing pass-through entity or qualifying trust to each qualifying investor 
  ing Company Act.”                                                        or qualifying benefi ciary.

                                                    Federal Privacy Act Notice
                        Because we require you to provide us with a Social Security number, the      Federal Privacy 
                        Act of 1974 requires us to inform you that providing us with your Social Security number is 
                        mandatory. Ohio Revised Code sections 5703.05, 5703.057 and 5747.08 authorize us to 
                        request this information. We need your Social Security number in order to administer this tax.

                                                                 pg. 7






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