PDF document
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                                                          Rev. 10/21/19
   Department of
   Taxation
hio

Scan Specifications for the 

2019 Ohio IT 1140

   Important Note

The following document (2019 Ohio IT 1140) contains grids for place-
ment of information on this specific tax form. To accurately print, do not 
reduce the size, rotate or center this document. Doing so jeopardizes 
the integrity of the grid. When printing from Adobe Reader, select 
“None” for “Page Scaling,” which is under “Page Handling.”

The 2019 Ohio IT 1140 test samples must be completed and sub-
mitted for approval no later than Dec. 16, 2019. 

                        Ohio Department of Taxation

                        4485 Northland Ridge Blvd.

                        Columbus, OH 43229

                        tax.ohio.gov



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   Department of
   Taxation
hio

General information 

regarding this form



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        General Information (2019 Ohio IT 1140):
1) Dimensions: 
  
   Target or registration marks - 0.25” diameter circles. Follow grid layout for positioning.

   1D barcode (2 of 5 interleaved) - .375”H x 1.5”W. Follow grid layout for positioning. Center the barcode number 
   directly under the barcode.

   2D barcode (PDF 417) - See 2D instructions and schema. Follow grid layout for positioning. There is one 2D 
   barcode on each page of the Ohio IT 1140.

2) 1D barcode - The last two numbers of the 1D barcode represent the vendor number. Use the same vendor                
number as you did for last year’s return. If you have a question about your barcode assignment, e-mail the Forms 
Unit at Forms@tax.state.oh.us. The first six numbers are constant for this form (191701XX - 191706XX).

   19 = tax year
   17 = Ohio IT 1140 
   01-06 = page number
   XX = vendor number (assigned to you by the Ohio Dept. of Taxation, Forms Unit).

   NOTE: The vendor number also serves as the first two digits of the SSN and FEIN fields in the test 
   scenarios.

3) Use Arial or Courier font for the static text on the form. The static text for all target marks and header informa-
tion (target marks, logo, title and 1D barcode) must match grid.

4) Use Courier, monospaced Arial, or monospaced Sans-Serif font for the variable data fields on the form.

5)Follow the grid layout for the variable data fields shown in red. Ensure that the tax year, target or reg-
istration marks, “For Department Use Only” area and the 1D and 2D barcodes follow grid layout.

6) DO NOT USE COMMAS, HYPHENS OR DECIMALS IN THE VARIABLE DATA FIELDS EXCEPT WHERE
SHOWN IN SPECS.

7) You must include a leading zero on ratio fields. For example, if the ratio is .000026, it should display as 0.000026.

8) The possible negative fields for this return are: both columns of line 4, both columns of line 9, both columns
of line 12, both columns of line 13, 25, and 28. Do not hard-code negative signs.

9) Provide guidance to customers regarding duplex printing that instructs them to print pages 1 and 2 together
and pages 3 and 4 together. Taxpayers have filed returns with pages 2 and 3 duplexed or a worksheet or software
receipt on the back of a page of the return. This slows the processing of the tax return.

10) Any other documentation generate the following message for customers: “Do not enclose other docu-
mentation unless it is specified on the tax return or instructions.” Taxpayers often submit worksheets and
receipts from the vendor product, which slows the processing of tax returns. Any other documentation generated
from the software must include a 1D barcode identifying it as an additional information. The preferred placement
is centered on the top edge of the page within the print area, however placement at any location on the page will
be accepted. Always use the following 1D barcode (2 of 5 interleaved):

        10211411
11) The 1140 Schedule IV pages 4-6 can include up to 7 investors. Generate duplicate copies of page 6 to accom-
modate any additional investors, however omit the standard 1D and 2D barcodes from the duplicate pages and
include the 10211411 barcode indicated above.

12) IMPORTANT NOTE: Add this statement to your software programs. It should print out with the taxpayer’s
return. “Do not hand write in any corrections on the printed paper return. Hand writing in corrections will
result in capturing incorrect data and delaying the processing of this income tax return. Make any cor-
rections to this income tax return within [the software program name], then print and mail.”



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13) For all balance due returns, generate the proper payment voucher.

15) *New for 2019* Reporting period start date field has been added to the return. Follow grid layout for positioning.



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              Department of
              Taxation
hio

Additional instructions for 

the 2D barcode information, 

submission process, testing 

and notifications

              Important Note

It is required that vendors program the Ohio IT 1140 to include 2D barcodes.



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                     2D Barcode Instructions 

General Information 
• The Ohio IT 1140 must be enabled for 2D barcode decoding
• A form enabled for 2D barcode should not allow users or practitioners the option to turn
  off/on the 2D barcode function
• The minimum error correction code level is 4
• Products must not print a 2D barcode prior to being approved in Ohio

2D Barcode Size and Placement on the Form 
• 2D barcode must be placed on each page of form in the designated area indicated in the
  grid layout
• The maximum size of the 2D barcode is 3.5 inches wide by 1 inch in height and must fit
  within the designated space in the grid layout
• 2D barcode must not be bigger than the allocated area

2D Barcode Layout 
• Each field in the barcode is delimited by a single carriage return
  o    <CR> equals single carriage return character
  o    This separates each piece of data so it may be identified and processed.
• Data included in the 2D barcode can be broken down into three general sections

Header 
  Header Version Number 
       • Static for all barcodes, value is T1
  Developer Code 
       • A four-digit vendor code identifying the software developer whose application
         produced the barcode
  Jurisdiction 
       • Static for all barcodes, value is OH
  Description 
       • A four-digit form identifier, specific to each form
  Spec Version 
       • A one-digit specification version control number starting with the number zero
       • This number identifies the version of the specifications used to produce the form
         barcode
  Form Version 
       • A one-digit form version control number starting with the number one (1)
       • This number will only be incremented when there are changes made that would
         affect the content of the barcode
  Date Generated 
       • Included on page 1 only
       • Indicates date return was generated from the product

Form Specific Data – Please see encoding schemas for form specific data 
  •    All fields on the form are required and must be included in the 2D barcode
  •    Fields with values are represented by the data followed by a carriagereturn 
  •    Fields with no values are represented by a carriage return only; this results 
       in two adjacent carriage returns



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  •     Note that the data format within the 2D barcode for the Weight, Ratio and Weighted
        Ratio differs from the print version. Do not include the decimal point in the 2D data.
  •     Follow the guidelines about data type and length of each field in the schema,
        especially numeric data in the line items and schedules.

Trailer 
  •     The last field in the barcode data stream is the trailer
  •     The trailer is used to indicate the end of data has been reached
  •     A static string of *EOD* is used as the trailer value

Examples of 2D Barcode data streams 
  Header Version Number     T1<CR> 
  Developer Code            1111<CR> 
  Jurisdiction              OH<CR> 
  Description               1718<CR> 
  Spec Version              0<CR> 
  Form Version              1<CR> 
  Date Generated            011518<CR> 
  Line Item Specific Data   IN<CR> 
  Line Item Specific Data   IT40<CR> 
  Line Item Specific Data   0<CR> 
  Trailer                   *EOD* <CR>

Submission Process 
• The deadline for submitting Ohio IT 1140 test packets is December 16, 2019
• Test packets may be submitted by email to  Forms@tax.state.oh.us
• The email subject line must include the vendor number, product name, tax year and form 
  number in that order e.g. 12_ABCTax_ 1 _11409
• Submissions must include
  •     Ohio form STF- Approval Request for Scannable Tax Forms
  •     One (1) full field sample in a PDF format
  •     Seven (7) test scenarios for the Ohio IT 1140 provided by the Ohio Department of 
        Taxation
        • Each test scenario must be in a separate PDF using the following naming 
          convention: vendor number, product name, tax year, form number, test number
          e.g.12_ABCTax_1 _1140_Test91
• An emailed confirmation is sent to the vendor indicating the packet was received
• Submissions found to be missing any of the items above are rejected

Testing Process 
• Testing of Ohio IT 1140 packets commences on October 25, 2019
• Test packets are reviewed in two (2) content areas- printed forms and 2D barcode data
• A submission is approved in its entirety once all sample documents pass in both areas

Printed forms 
        • Vendor full field matches template provided in the specifications
        • All fields are present, are formatted properly and align with grid layout
        • Test scenarios contain values specified by Ohio Department of Taxation

2D Barcode Data 
        • Barcodes read as valid
        • All test scenarios can be decoded
        • 2D barcode data matches data on printed forms



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Additional instructions 
  • The static text for all target marks and header information (target marks, logo, title and
    1D barcode) must match grid.
  • Any other documentation generated from the software must include a 1D barcode
    identifying it as an additional information. The preferred placement is centered on the top
    edge of the page within the print area, however placement at any location on the page
    will be accepted. Always use the following 1D barcode (2 of 5 interleaved):

  10211411

Notifications 
• Communications from the Ohio Department of Taxation regarding submissions are sent
  from  Forms@tax.state.oh.us to the vendor email address(es) on file for the product
• Vendor contact information is compiled from STF- Approval Request for Scannable Tax
  Forms but may also be submitted by email to the address above.
• If unapproved forms are released in software packages, vendors must include a visual
  indicator signifying the return cannot be filed.
• If unapproved forms are released in software packages, vendors must ensure that
  taxpayers cannot print returns containing 2D barcodes.
• An emailed confirmation is sent to the vendor indicating the packet was approved, at
  which point the product is authorized to print with a 2D barcode.
• An emailed confirmation is sent to the vendor for packets that are rejected
    •  Feedback is provided regarding the errors found
    •     Resubmit packets must include all test scenarios and the full field return
    •  After the third submission of test materials, the department cannot guarantee
       timeliness of the review
• If a tax form changes before January 1, 2020 vendors will be notified and required to
  submit revised test packets.



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   Department of
   Taxation
hio

Grid layout



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1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85
2
3                                                                  Do not staple or paper clip.
4
5                                                                                                               2019 Ohio IT 1140 
6                                                                                       Rev. 10/21/19      Pass-Through Entity and 
7                                                                                                     Trust Withholding Tax Return                                                                   19170110
8
9                                                          88 88 88           Use only black ink and UPPERCASE letters. Amount fields use only whole dollar amounts, no cents.
                                                                                                                                                                                                     Reporting Period Start Date
10                                                                                      Check here if amended return                  Check here if final return
11                                                                                 X                                            X
12                                                                                 X    Check here if the federal extension was granted                                                              XX XX XX
                                                           FEIN
13                                                                                                          Entity Type:        S corporation                                            Partnership Reporting Period End Date
14                                                         88 8888888                                     (check only one)  X                                                     X
15                                                                                                                          X   Limited liability company                         X      Trust       XX XX XX
                                                           Name of pass-through entity
16
17                                                         JOHNXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
18                                                         Address (if address change, check box)
19                                                                                                       X
20                                                         8888 CHERRY LANEXXXXXXXXXXXXXXXXXXX
                                                           City                                                                         State     ZIP code
21
22                                                         CITYXXXXXXXXXXXXXXXX                                                         OH        88888
23                                                         Foreign State Code           Country Code       Foreign country (if the mailing address is outside the U.S.)                              Foreign postal code
24
                                                                                             88
                                                           Total number of investors    Number of investors 
25                                                                 888                                   88888888888888888888Ownership percentage Apportionment ratio, line 24                       8888888
26                                                                                      included on return              of investors on return
27
28                                                         888888                       888888                          8.8888                8.888888
29
30                                                                     If the amount on a line is negative, place a “–” in the box provided. Note: No credits allowed to be claimed in Schedule I.
31                                                         Schedule I – Reconciliation Tax and Payments
32                                                                                                                          Column (A) – Withholding Tax                                      Column (B) – Entity Tax
33                                                           1.  Tax for each column (from Schedule II, line 20, columns
34                                                               A and B or from Schedule IV, line 30)                          888888888888                                                   888888888888
35                                                           2.  Interest penalty on underpayment of tax (include Ohio
36                                                               IT/SD 2210)                                                    888888888888                                                   888888888888
                             Do not staple or paper clip. 
37                                                          2a.  Add lines 1 and 2
38                                                                                                                              888888888888                                                   888888888888
39                                                           3.  Ohio IT 1140  UPC payments the entity or trust made            888888888888                                                   888888888888
                                                            3a. Payments transferred from Ohio IT 4708 UPC (include
40                                                                 schedule if required)
41                                                                                                                              888888888888
42                                                          3b. Payments transferred to Ohio IT 4708 and refunds, if 
43                                                                any, previously claimed for this taxable year                 888888888888
44                                                          3c. Net payments (sum of lines 3 and 3a minus line 3b) if 
45                                                                less than zero, enter zero                                    888888888888                                                   888888888888

46                                                           4. For each column, subtract line 3c from line 2a              -   888888888888                                                -  888888888888
47
48                                                          5. If  the sum of line 4, columns A and B is an overpayment, enter that sum here................YOUR REFUND
49                                                                                                                                                                                             888888888888
50
51                                                           6. If the sum of line 4, columns A and B is a balance due or zero, enter here                                                     888888888888
52
53                                                          Interestandpenaltydueonlate-paidtaxand/orlate-filedreturn,ifany                                                                    888888888888
                                                             8.  Total amount due (add lines 6 and 7). Make check payable to Ohio Treasurer of State. 
54                                                            Include Ohio UPC and place FEIN on check............................................................................AMOUNT DUE
55                                                                                                                                                                                             888888888888
                                                                           If your refund is $1.00 or less, no refund will be issued. If you owe $1.00 or less, no payment is necessary.
56
57
58
59                                                                     Software vendors: Place 2D barcode in this location
60                                                                     Do not place a box around the 2D barcode. The box                                                                      MM DD  YY      CODE
61                                                                                      is only here for placement purposes.
62
63                                                                                                                                                                                2019 IT 1140 pg.  1of 6
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1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85
2
3
4
5                                                   2019 Ohio IT 1140 
6                             Rev. 10/21/19    Pass-Through Entity and 
7                                              Trust Withholding Tax Return                             19170210
8  FEIN
9
10 88 8888888
11 Sign Here (required): I have read this return. Under penalties of perjury, I declare that, to 
12 the best of my knowledge and belief, the return and all enclosures are true, correct and complete.  Do not staple or paper clip. 
13                                                                                                    Place any supporting documents, including 
                                                                                                      Ohio IT K-1’s, after the last page of this return.
14
15 Pass-throughentityofficeroragent(print)
16                                                                                                      Mail to: 
17 Titleofofficeroragent                       Phonenumber
                                                                                                      Ohio Dept. of Taxation
18                                                                                                      P.O. Box 181140
   Signatureofpass-throughofficeror          Date(MM/DD/YY)
19
                                                                                                      Columbus, OH 43218-1140
20 Preparer’s name (print)                     Phone number
21
22 Preparer’s e-mail address                   PTIN                                                   Instructions for this form are on our 
23 DoyouauthorizeyourpreparertocontactusregardingthisYes                   No                           website at tax.ohio.gov. 
24                                                                         X  X  
25
26 Schedule II – Qualifying Pass-Through Entities – Tax Due
27 Use this schedule to calculate the adjusted qualifying amounts and tax due for all qualifying investors in qualifying pass-through entities. Include federal K-1(s) 
28 and a listing of pass-through credits of participating investors. See “Special Notes” in the instructions, which are available on our website at tax.ohio.gov. 
29                                                                       Column (A) – Withholding Tax   Column (B) – Entity Tax
30
     9.  Sum of all qualifying investors’ distributive shares of income, 
31      gain, expenses and losses                                        -                            -
32                                                                         888888888888                 888888888888
33  10.  Add I.R.C. 168(k) and 179 depreciation expense for cur-
34      rent taxable year and any applicable federal conformity 
35      adjustments. Complete Schedule V                                   888888888888                 888888888888

     10a.         X 2/3,   X      X
36                       5/6 or       6/6 
37      (check applicable box)
38
39 11.  Deduct I.R.C. 168(k) and 179 depreciation expense added 
        back in a previous year and any applicable federal confor-
40      mity adjustments. Complete Schedule V
41                                                                         888888888888                 888888888888

42  12.  Sum of lines 9 and 10 minus line 11                             - 888888888888               - 888888888888
43
44 13.  Adjustments for qualifying investors’ share of expenses and 
        losses incurred by the pass-through entity with its related 
45      members, including certain investors’ family members             - 888888888888               - 888888888888
46
47 14. Guaranteed payments the pass-through entity made to 
48      each investor included on this return who directly or indi-
49      rectly owns at least 20% of the entity                             888888888888                 888888888888

50 15. Compensation the pass-through entity made to each 
51      investor included on this return who directly or indirectly 
52      owns at least 20% of the entity. Reciprocity agreements 
53      do not apply                                                       888888888888                 888888888888
54
55
56
57
58
59                  Software vendors: Place 2D barcode in this location
60                  Do not place a box around the 2D barcode. The box
61                            is only here for placement purposes.
62
63                                                                               2019 IT 1140 pg.  2             of 6
64
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1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85
2
3
4
5                                                   2019 Ohio IT 1140 
6                     Rev. 10/21/19                 Pass-Through Entity and 
7                                                   Trust Withholding Tax Return                                             19170310
8  FEIN
9
10 88 8888888
11 Schedule II – Qualifying Pass-Through Entities – Tax Due...continued.
12                                                  Column (A) – Withholding Tax                    Column (B) – Entity Tax
13 16.  Sum of lines 12, 13, 14 and 15, but  
14  not less than zero
15                                                  888888888888                                    888888888888
16  17.  Apportionment ratio from line 24
17                                                  8.888888                                                                 8.888888
18 18. Adjusted qualifying amount (line 16 
19  times line 17). If the sum of columns 
20  A and B exceed $1,000 continue to 
21  line 20                                         888888888888                                    888888888888

22 19. Tax rate                                     X .05                                                                    X .085
23
24 20. Tax due (line 18 times line 19). Enter 
25  column A on line 1, column A. Enter 
26  column B on line 1, column B                    888888888888                                    888888888888
27
28
   Schedule III – Qualifying Pass-Through Entities – Apportionment Worksheet
29
   Usethisscheduletocalculatetheapportionmentratioforaqualifyingpass-throughentitythatisnotafinancialinstitutionasdefinedinOhioRevisedCode
30 section(R.C.)5725.01.Ifthepass-throughentityisafinancialinstitution,refertotheinstructions. Note: All ratios are to be carried to six decimal places.
31
32  21.  Property                                   Within Ohio                                            Total Everywhere
33
34   a) Owned (average cost)                        888888888888                                    888888888888
                                                    Within Ohio                                            Total Everywhere
35  
     b) Rented (annual rental X 8)                  888888888888                                    888888888888
36                                                  Within Ohio                                            Total Everywhere
37   c) Total (lines 21a and 21b)                   888888888888                 ÷                  888888888888
38
39                                                               Ratio                              Weight                   Weighted Ratio
40                                                  =                                          x =
41                                                               8.888888                           8.88                     8.888888
                                                    Within Ohio                                            Total Everywhere
42 22.  Payroll                                     888888888888                 ÷
43                                                                                                  888888888888
                                                                 Ratio                              Weight                   Weighted Ratio
44                                                  =            8.888888                      x =  8.88                     8.888888
45                                                  Within Ohio                                            Total Everywhere
46  23.  Sales                                                                   ÷
                                                    888888888888                                    888888888888
47                                                               Ratio                              Weight                   Weighted Ratio
48                                                  =            8.888888                      x =  8.88                     8.888888
49
50                                                                                                                           Weighted Ratio
51
52  24.  Total weighted apportionment ratio (add lines 21c, 22 and 23). Enter ratio here and on line 17 above (both columns) 8.888888
53 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; if only one factor, use 100%.
54
55
56
57
58
59                Software vendors: Place 2D barcode in this location
60                Do not place a box around the 2D barcode. The box
61                    is only here for placement purposes.
62
63                                                                               2019 IT 1140 pg.  3                       of 6
64
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1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85
2
3
4
5                                                                       2019 Ohio IT 1140 
6                                      Rev. 10/21/19                    Pass-Through Entity and 
7                                                         Trust Withholding Tax Return                               19170410
8  FEIN
9
10 88 8888888
11 Schedule IV – Trusts – Tax Due
   Use this schedule to calculate the adjusted qualifying amounts and withholding tax due for nonresident individuals who are beneficiaries of trusts that
12 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 
13 property located in Ohio.
14 25. Sum of all distributions to nonresident individuals of income or gain attributable to the trust’s ownership 
15       of or disposition of either tangible personal property located in Ohio or real property located in Ohio   -
16                                                                                                                   888888888888
   26. Add I.R.C 168(k) depreciation expense for current year and any applicable federal conformity adjust-
17
         ments. Complete Schedule V                                                                                  888888888888
18   26a.            X 2/3           X 5/6            X6/6
19
20  27. Deduct I.R.C. 168(k) depreciation expense added back in a previous year and any applicable federal 
21       conformity adjustments. Complete Schedule V                                                                 888888888888

22 28. Sum of line 25 and 26 minus line 27                                                                         - 888888888888
23
   29. Tax rate                                                                                                                            X .05
24
25 30.  Tax due: Line 28 times line 29. Enter here and on line 1, column A  
26                                                                                                                   888888888888
27
   Schedule V – 168K Bonus Depreciation and 179 Expense Add-back Schedule
28
29
30   X     Check the box if the depreciation add-back has been waived
31 31. Total current year sections 168K bonus depreciation and 179 expense adjustment                                888888888888
   32. Prior years add-back amount and applicable add-back ratio
32                                                        Column (A) – Amount                       Column (B) – Ratio
33
34 32a.YearPrior  .....................................................                                          2/3                 5/6                   6/6
35                                                             888888888888                  X                     X        X
36 32b.2 YearsPrior  ................................................                                            2/3                 5/6                   6/6
37                                                             888888888888                  X                     X        X
38 32c.3 YearsPrior  ................................................                                            2/3                 5/6                   6/6
39                                                             888888888888                  X                     X        X
    
40 32d.4 YearsPrior  ................................................                                            2/3                 5/6                   6/6
41                                                             888888888888                  X                     X        X
    
42 32e.5 YearsPrior  ................................................                                            2/3                 5/6                   6/6
43                                                             888888888888                  X                     X        X
44 Schedule VI – Investor Information
45 Provide investor information for all (resident and nonresident) investors in the pass-through entity or trust. List investors by highest to lowest ownership percent-
   age. Use an additional sheet, if necessary. 
46
47         Check the box if the investor is included on the return.
48   X  
   SSN                                                    FEIN                        Percent of ownership         Amount of PTE tax credit
49
50 888 88 8888                                            88 8888888                  8.8888                       888888888
   First name / entity                                                  M.I. Last name
51                                                                           PUBLICXXXXXXXXXXXXXX
52 JOHNXXXXXXXXXXX                                                      Q
   Address
53
54 8888 CHERRY LANEXXXXXXXXXXXXXXXXXXX
   City                                                                               State ZIP code
55
56 CITYXXXXXXXXXXXXXXXX                                                               OH    88888
57
58
59                     Software vendors: Place 2D barcode in this location
60                     Do not place a box around the 2D barcode. The box
61                                     is only here for placement purposes.
62
63                                                                                          2019 IT 1140 pg.  4                          of 6
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1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85
2
3
4
5                                                    2019 Ohio IT 1140 
6                                 Rev. 10/21/19      Pass-Through Entity and 
7                                               Trust Withholding Tax Return                       19170510

8  FEIN
9
10 88 8888888
11
   Schedule VI – Investor Information...continued
12
13 Provide investor information for all (resident and nonresident) investors in the pass-through entity or trust. List investors by highest to lowest ownership percent-
   age. Use an additional sheet, if necessary. 
14
15     Check the box if the investor is included on the return.
16 X  
17 SSN                                          FEIN                          Percent of ownership Amount of PTE tax credit
18
19 888 88 8888                                  88 8888888                    8.8888               888888888
   First name / entity                                         M.I. Last name
21 JOHNXXXXXXXXXXX                                             Q
20 Address                                                          PUBLICXXXXXXXXXXXXXX
22
23 City8888 CHERRY LANEXXXXXXXXXXXXXXXXXXX                                    State
                                                                                    ZIP code
24
25 CITYXXXXXXXXXXXXXXXX                                                       OH    88888
26     Check the box if the investor is included on the return.
27 X  
28 SSN                                          FEIN                          Percent of ownership Amount of PTE tax credit
29
30 First name / entity888 88 8888                              M.I. Last name 8.8888               888888888
                                                88 8888888

31                                                                  PUBLICXXXXXXXXXXXXXX
32 AddressJOHNXXXXXXXXXXX                                      Q
33
34 City8888 CHERRY LANEXXXXXXXXXXXXXXXXXXX                                    State ZIP code
35
36 CITYXXXXXXXXXXXXXXXX                                                       OH    88888
37     Check the box if the investor is included on the return.
38 X  
39 SSN                                          FEIN                          Percent of ownership Amount of PTE tax credit
40
   888 88 8888                                  88 8888888                    8.8888               888888888
41 First name / entity                                         M.I. Last name
42                                                                  PUBLICXXXXXXXXXXXXXX
   JOHNXXXXXXXXXXX
43 Address                                                     Q
44
45 City8888 CHERRY LANEXXXXXXXXXXXXXXXXXXX                                    State ZIP code
46
47 CITYXXXXXXXXXXXXXXXX                                                       OH    88888
48
49
50
51
52
53
54
55
56
57
58
59         Software vendors: Place 2D barcode in this location
60         Do not place a box around the 2D barcode. The box
61                                is only here for placement purposes.
62
63                                                                                  2019 IT 1140 pg.  5                  of 6
64
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1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85
2
3
4
5                                                    2019 Ohio IT 1140 
6                                 Rev. 10/21/19      Pass-Through Entity and 
7                                               Trust Withholding Tax Return                                          19170610

8  FEIN
9
10 88 8888888
11
   Schedule VI – Investor Information...continued
12
13 Provide investor information for all (resident and nonresident) investors in the pass-through entity or trust. List investors by highest to lowest ownership percent-
   age. Use an additional sheet, if necessary. See Note 5 on page 7 for the amount of pass-through entity tax credits.
14
15      Check the box if the investor is included on the return.
16 X  
17 SSN                                          FEIN                           Percent of ownership Amount of PTE tax credit
18
   888 88 8888                                  88 8888888                     8.8888               888888888
19 First name / entity                                          M.I. Last name
20                                                                   PUBLICXXXXXXXXXXXXXX
21 AddressJOHNXXXXXXXXXXX                                       Q
22
23 City8888 CHERRY LANEXXXXXXXXXXXXXXXXXXX                                     State ZIP code
24
25 CITYXXXXXXXXXXXXXXXX                                                        OH    88888
26      Check the box if the investor is included on the return.
27 X  
28 SSN                                          FEIN                           Percent of ownership Amount of PTE tax credit
29
30 First name / entity888 88 8888               88 8888888M.I.       Last name 8.8888               888888888

   JOHNXXXXXXXXXXX
31                                                                   PUBLICXXXXXXXXXXXXXX
32 Address                                                      Q
33
   8888 CHERRY LANEXXXXXXXXXXXXXXXXXXX
34 City                                                                        State ZIP code
35
36 CITYXXXXXXXXXXXXXXXX                                                        OH    88888
37      Check the box if the investor is included on the return.
38 X 
39 SSN                                          FEIN                           Percent of ownership Amount of PTE tax credit
40
   888 88 8888                                  88 8888888                     8.8888               888888888
41 First name / entity                                          M.I. Last name
   JOHNXXXXXXXXXXX
42                                                                   PUBLICXXXXXXXXXXXXXX
43 Address                                                      Q
44
45 City8888 CHERRY LANEXXXXXXXXXXXXXXXXXXX                                     State ZIP code
46
47 CITYXXXXXXXXXXXXXXXX                                                        OH    88888
48
49
50
51
52
53
54
55
56
57
58
59         Software vendors: Place 2D barcode in this location
60         Do not place a box around the 2D barcode. The box
61                                is only here for placement purposes.
62
63                                                                                   2019 IT 1140 pg.  6                  of 6
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- 16 -
   Department of
   Taxation
hio

   Layout 

without grid



- 17 -
Do not staple or paper clip.
2019 Ohio IT 1140 
Rev. 10/21/19 Pass-Through Entity and 
Trust Withholding Tax Return 19170110

88 88 88 Use only black ink and UPPERCASE letters. Amount fields use only whole dollar amounts, no cents.
Reporting Period Start Date
Check here if amended return Check here if final return
X X
X Check here if the federal extension was granted XX XX XX
FEIN
Entity Type: S corporation   Partnership Reporting Period End Date
88 8888888 (check only one) X X
X Limited liability company X   Trust XX XX XX
Name of pass-through entity
JOHNXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
Address (if address change, check box)
X
8888 CHERRY LANEXXXXXXXXXXXXXXXXXXX
City State ZIP code
CITYXXXXXXXXXXXXXXXX OH 88888
Foreign State Code Country Code Foreign country (if the mailing address is outside the U.S.) Foreign postal code

Total number of investors Number of investors 
888 88 88888888888888888888Ownership percentage Apportionment ratio, line 24 8888888
included on return of investors on return

888888 888888 8.8888 8.888888

If the amount on a line is negative, place a “–” in the box provided. Note: No credits allowed to be claimed in Schedule I.
Schedule I – Reconciliation Tax and Payments
Column (A) – Withholding Tax Column (B) – Entity Tax
 1.  Tax for each column (from Schedule II, line 20, columns
     A and B or from Schedule IV, line 30) 888888888888 888888888888
 2.  Interest penalty on underpayment of tax (include Ohio
     IT/SD 2210) 888888888888 888888888888
Do not staple or paper clip. 
 2a.  Add lines 1 and 2 888888888888 888888888888
 3.  Ohio IT 1140  UPC payments the entity or trust made 888888888888 888888888888
 3a. Payments transferred from Ohio IT 4708 UPC (include
        schedule if required) 888888888888
 3b. Payments transferred to Ohio IT 4708 and refunds, if 
       any, previously claimed for this taxable year 888888888888
 3c. Net payments (sum of lines 3 and 3a minus line 3b) if 
       less than zero, enter zero 888888888888 888888888888

  4. For each column, subtract line 3c from line 2a - 888888888888 - 888888888888

 5. If  the sum of line 4, columns A and B is an overpayment, enter that sum here................YOUR REFUND888888888888

  6. If the sum of line 4, columns A and B is a balance due or zero, enter here888888888888

Interestandpenaltydueonlate-paidtaxand/orlate-filedreturn,ifany 888888888888
  8.  Total amount due (add lines 6 and 7). Make check payable to Ohio Treasurer of State. 
  Include Ohio UPC and place FEIN on check............................................................................AMOUNT DUE888888888888
 If your refund is $1.00 or less, no refund will be issued. If you owe $1.00 or less, no payment is necessary.

Software vendors: Place 2D barcode in this location
Do not place a box around the 2D barcode. The box MM DD YY CODE
is only here for placement purposes.

2019 IT 1140 pg.  1of 6



- 18 -
                                                    2019 Ohio IT 1140 
                             Rev. 10/21/19     Pass-Through Entity and 
                                               Trust Withholding Tax Return                          19170210
FEIN
88 8888888
Sign Here (required): I have read this return. Under penalties of perjury, I declare that, to      Do not staple or paper clip. 
the best of my knowledge and belief, the return and all enclosures are true, correct and complete.
                                                                                                   Place any supporting documents, including 
                                                                                                   Ohio IT K-1’s, after the last page of this return.
Pass-throughentityofficeroragent(print)
Titleofofficeroragent                          Phonenumber                                           Mail to: 
                                                                                                   Ohio Dept. of Taxation
Signatureofpass-throughofficeror               Date(MM/DD/YY)                                        P.O. Box 181140
                                                                                                   Columbus, OH 43218-1140
Preparer’s name (print)                        Phone number

Preparer’s e-mail address                      PTIN                                                Instructions for this form are on our 
DoyouauthorizeyourpreparertocontactusregardingthisYes                   No                           website at tax.ohio.gov. 
                                                                        X  X  

Schedule II – 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. Include federal K-1(s) 
and a listing of pass-through credits of participating investors. See “Special Notes” in the instructions, which are available on our website at tax.ohio.gov. 
                                                                      Column (A) – Withholding Tax   Column (B) – Entity Tax
  9.  Sum of all qualifying investors’ distributive shares of income, 
     gain, expenses and losses                                        - 888888888888               - 888888888888
 10.  Add I.R.C. 168(k) and 179 depreciation expense for cur-
     rent taxable year and any applicable federal conformity 
     adjustments. Complete Schedule V                                   888888888888                 888888888888

  10a.         X 2/3,      X 5/6 or      X 6/6 
     (check applicable box)
11.  Deduct I.R.C. 168(k) and 179 depreciation expense added 
     back in a previous year and any applicable federal confor-
     mity adjustments. Complete Schedule V                              888888888888                 888888888888

 12.  Sum of lines 9 and 10 minus line 11                             - 888888888888               - 888888888888
13.  Adjustments for qualifying investors’ share of expenses and 
     losses incurred by the pass-through entity with its related 
     members, including certain investors’ family members             - 888888888888               - 888888888888
14. Guaranteed payments the pass-through entity made to 
     each investor included on this return who directly or indi-
     rectly owns at least 20% of the entity                             888888888888                 888888888888

15. Compensation the pass-through entity made to each 
     investor included on this return who directly or indirectly 
     owns at least 20% of the entity. Reciprocity agreements 
     do not apply                                                       888888888888                 888888888888

                 Software vendors: Place 2D barcode in this location
                 Do not place a box around the 2D barcode. The box
                             is only here for placement purposes.

                                                                              2019 IT 1140 pg.  2             of 6



- 19 -
                                                 2019 Ohio IT 1140 
                    Rev. 10/21/19                Pass-Through Entity and 
                                                 Trust Withholding Tax Return                                             19170310
FEIN
88 8888888
Schedule II – Qualifying Pass-Through Entities – Tax Due...continued.
                                                 Column (A) – Withholding Tax                    Column (B) – Entity Tax
16.  Sum of lines 12, 13, 14 and 15, but  
 not less than zero                              888888888888                                    888888888888

 17.  Apportionment ratio from line 24           8.888888                                                                 8.888888

18. Adjusted qualifying amount (line 16 
 times line 17). If the sum of columns 
 A and B exceed $1,000 continue to 
 line 20                                         888888888888                                    888888888888

19. Tax rate                                     X .05                                                                    X .085
20. Tax due (line 18 times line 19). Enter 
 column A on line 1, column A. Enter 
 column B on line 1, column B                    888888888888                                    888888888888

Schedule III – Qualifying Pass-Through Entities – Apportionment Worksheet
Usethisscheduletocalculatetheapportionmentratioforaqualifyingpass-throughentitythatisnotafinancialinstitutionasdefinedinOhioRevisedCode
section(R.C.)5725.01.Ifthepass-throughentityisafinancialinstitution,refertotheinstructions. Note: All ratios are to be carried to six decimal places.

 21.  Property                                   Within Ohio                                            Total Everywhere
  a) Owned (average cost)                        888888888888                                    888888888888
                                                 Within Ohio                                            Total Everywhere
  b) Rented (annual rental X 8)                  888888888888                                    888888888888
                                                 Within Ohio                                            Total Everywhere
  c) Total (lines 21a and 21b)                   888888888888                 ÷                  888888888888

                                                              Ratio                              Weight                   Weighted Ratio
                                                 =                                          x =
                                                              8.888888                           8.88                     8.888888
                                                 Within Ohio                                            Total Everywhere
22.  Payroll                                     888888888888                 ÷                  888888888888
                                                              Ratio                              Weight                   Weighted Ratio
                                                 =            8.888888                      x =  8.88                     8.888888
                                                 Within Ohio                                            Total Everywhere
 23.  Sales                                                                   ÷
                                                 888888888888                                    888888888888
                                                              Ratio                              Weight                   Weighted Ratio
                                                 =            8.888888                      x =  8.88                     8.888888
                                                                                                                          Weighted Ratio
 24.  Total weighted apportionment ratio (add lines 21c, 22 and 23). Enter ratio here and on line 17 above (both columns) 8.888888
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; if only one factor, use 100%.

               Software vendors: Place 2D barcode in this location
               Do not place a box around the 2D barcode. The box
                    is only here for placement purposes.

                                                                              2019 IT 1140 pg.  3                       of 6



- 20 -
                                                                     2019 Ohio IT 1140 
                                    Rev. 10/21/19                    Pass-Through Entity and 
                                                       Trust Withholding Tax Return                               19170410
FEIN
88 8888888
Schedule IV – Trusts – Tax Due
Use this schedule to calculate the adjusted qualifying amounts and withholding tax due for nonresident individuals who are beneficiaries 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.
25. 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 located in Ohio   - 888888888888
26. Add I.R.C 168(k) depreciation expense for current year and any applicable federal conformity adjust-
      ments. Complete Schedule V                                                                                  888888888888
  26a.            X 2/3           X 5/6            X6/6
 27. Deduct I.R.C. 168(k) depreciation expense added back in a previous year and any applicable federal 
      conformity adjustments. Complete Schedule V                                                                 888888888888

28. Sum of line 25 and 26 minus line 27                                                                         - 888888888888
29. Tax rate                                                                                                                            X .05

30.  Tax due: Line 28 times line 29. Enter here and on line 1, column A                                           888888888888

Schedule V – 168K Bonus Depreciation and 179 Expense Add-back Schedule

  X     Check the box if the depreciation add-back has been waived
31. Total current year sections 168K bonus depreciation and 179 expense adjustment                                888888888888
32. Prior years add-back amount and applicable add-back ratio
                                                       Column (A) – Amount                       Column (B) – Ratio

32a.YearPrior  .....................................................                                          2/3                 5/6                   6/6
                                                            888888888888                  X                     X        X
32b.2 YearsPrior  ................................................                                            2/3                 5/6                   6/6
                                                            888888888888                  X                     X        X
32c.3 YearsPrior  ................................................                                            2/3                 5/6                   6/6
                                                            888888888888                  X                     X        X
 
32d.4 YearsPrior  ................................................                                            2/3                 5/6                   6/6
                                                            888888888888                  X                     X        X
 
32e.5 YearsPrior  ................................................                                            2/3                 5/6                   6/6
                                                            888888888888                  X                     X        X
Schedule VI – Investor Information
Provide investor information for all (resident and nonresident) investors in the pass-through entity or trust. List investors by highest to lowest ownership percent-
age. Use an additional sheet, if necessary. 

        Check the box if the investor is included on the return.
  X  
SSN                                                    FEIN                        Percent of ownership         Amount of PTE tax credit
888 88 8888                                            88 8888888                  8.8888                       888888888
First name / entity                                                  M.I. Last name
JOHNXXXXXXXXXXX                                                      Q    PUBLICXXXXXXXXXXXXXX
Address
8888 CHERRY LANEXXXXXXXXXXXXXXXXXXX
City                                                                               State ZIP code
CITYXXXXXXXXXXXXXXXX                                                               OH    88888

                    Software vendors: Place 2D barcode in this location
                    Do not place a box around the 2D barcode. The box
                                    is only here for placement purposes.

                                                                                         2019 IT 1140 pg.  4                          of 6



- 21 -
                                                  2019 Ohio IT 1140 
                               Rev. 10/21/19      Pass-Through Entity and 
                                             Trust Withholding Tax Return                       19170510

FEIN
88 8888888

Schedule VI – Investor Information...continued
Provide investor information for all (resident and nonresident) investors in the pass-through entity or trust. List investors by highest to lowest ownership percent-
age. Use an additional sheet, if necessary. 

    Check the box if the investor is included on the return.
X  
SSN                                          FEIN                          Percent of ownership Amount of PTE tax credit
888 88 8888                                  88 8888888                    8.8888               888888888
First name / entity                                         M.I. Last name

AddressJOHNXXXXXXXXXXX                                      Q    PUBLICXXXXXXXXXXXXXX

City8888 CHERRY LANEXXXXXXXXXXXXXXXXXXX                                    State
                                                                                 ZIP code
CITYXXXXXXXXXXXXXXXX                                                       OH    88888
    Check the box if the investor is included on the return.
X  
SSN                                          FEIN                          Percent of ownership Amount of PTE tax credit
First name / entity888 88 8888                              M.I. Last name 8.8888               888888888
                                             88 8888888

AddressJOHNXXXXXXXXXXX                                      Q    PUBLICXXXXXXXXXXXXXX

City8888 CHERRY LANEXXXXXXXXXXXXXXXXXXX                                    State ZIP code

CITYXXXXXXXXXXXXXXXX                                                       OH    88888
    Check the box if the investor is included on the return.
X  
SSN                                          FEIN                          Percent of ownership Amount of PTE tax credit
888 88 8888                                  88 8888888                    8.8888               888888888
First name / entity                                         M.I. Last name
Address                                                     Q    PUBLICXXXXXXXXXXXXXX
JOHNXXXXXXXXXXX

City8888 CHERRY LANEXXXXXXXXXXXXXXXXXXX                                    State ZIP code

CITYXXXXXXXXXXXXXXXX                                                       OH    88888

        Software vendors: Place 2D barcode in this location
        Do not place a box around the 2D barcode. The box
                               is only here for placement purposes.

                                                                                 2019 IT 1140 pg.  5                  of 6



- 22 -
                                                  2019 Ohio IT 1140 
                               Rev. 10/21/19      Pass-Through Entity and 
                                             Trust Withholding Tax Return                                          19170610

FEIN
88 8888888

Schedule VI – Investor Information...continued
Provide investor information for all (resident and nonresident) investors in the pass-through entity or trust. List investors by highest to lowest ownership percent-
age. Use an additional sheet, if necessary. See Note 5 on page 7 for the amount of pass-through entity tax credits.

     Check the box if the investor is included on the return.
X  
SSN                                          FEIN                           Percent of ownership Amount of PTE tax credit
888 88 8888                                  88 8888888                     8.8888               888888888
First name / entity                                          M.I. Last name
AddressJOHNXXXXXXXXXXX                                       Q    PUBLICXXXXXXXXXXXXXX

City8888 CHERRY LANEXXXXXXXXXXXXXXXXXXX                                     State ZIP code

CITYXXXXXXXXXXXXXXXX                                                        OH    88888
     Check the box if the investor is included on the return.
X  
SSN                                          FEIN                           Percent of ownership Amount of PTE tax credit
First name / entity888 88 8888               88 8888888M.I.       Last name 8.8888               888888888

JOHNXXXXXXXXXXX
Address                                                      Q    PUBLICXXXXXXXXXXXXXX

8888 CHERRY LANEXXXXXXXXXXXXXXXXXXX
City                                                                        State ZIP code
CITYXXXXXXXXXXXXXXXX                                                        OH    88888
     Check the box if the investor is included on the return.
X 
SSN                                          FEIN                           Percent of ownership Amount of PTE tax credit
888 88 8888                                  88 8888888                     8.8888               888888888
First name / entity                                          M.I. Last name
JOHNXXXXXXXXXXX
Address                                                      Q    PUBLICXXXXXXXXXXXXXX

City8888 CHERRY LANEXXXXXXXXXXXXXXXXXXX                                     State ZIP code

CITYXXXXXXXXXXXXXXXX                                                        OH    88888

        Software vendors: Place 2D barcode in this location
        Do not place a box around the 2D barcode. The box
                               is only here for placement purposes.

                                                                                  2019 IT 1140 pg.  6                  of 6






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