Form IT 1040EZ Fillable Ohio Individual Income Tax EZ Return
(all forms fillable on Windows, Mac, Android tablets, and iPad using Adobe Reader XI)

00 00 If deceased If deceased Spouse s Social Security no (only if joint return) INTEREST AND PENALTY 23 (: 1) Unchecked (: 1) Unchecked (: 2) Unchecked (: 2) Unchecked (: 3) Unchecked (checkbox) Unchecked (enter spouse s SS#) (payable to Ohio Treasurer of State) and Ohio form (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) 0 (text) 650 (text) 650 (text) 650 (this credit is for married filing jointly status only) % times line 10a (limit $650) 11 1 Federal adjusted gross income (from IRS form 1040 line 37; 1040A line 21; 10 Ohio tax less exemption credit (line 8 minus line 9; enter 0 if line 8 is less than line 9) 10 10a Amount from line 10 on page 1 10a 11 Joint filing credit See instructions on page 17 for eligibility and documentation requirements 12 Ohio income tax less joint filing credit (line 10a minus line 11) 12 13 Earned income credit (see the worksheet on page 20 of the instructions) 13 13010106 13010206 14 Ohio income tax less earned income credit (line 12 minus line 13) 14 15 Interest penalty on underpayment of income tax Enclose Ohio form IT/SD 2210 (see page 16 Unpaid Ohio use tax (see the worksheet on page 33 of the instructions) 16 17 Total Ohio tax liability (add lines 14 15 and 16) TOTAL TAX 17 18 of the instructions) 15 18 Ohio income tax withheld (box 17 on W 2; box 15 on W 2G; and box 12 on 1099 R) 19 If line 18 is MORE THAN line 17 subtract line 17 from line 18 AMOUNT OVERPAID 19 2 Enter the amount from the worksheet on page 17 of the instructions 2 20 Amount of line 19 that you wish to donate to the following fund(s): 2013 IT 1040EZ pg 1 of 2 2013 IT 1040EZ 21 Line 19 minus the sum of lines 20a b c and d Enter the amount here then skip to line 23 21 22 If line 18 is LESS THAN line 17 subtract line 18 from line 17 AMOUNT DUE 22 23 Interest and penalty due on late paid tax and/or late filed return (see page 18 of the instructions) 24 Amount due plus interest and penalty (add lines 22 and 23) If payment is enclosed make 25 Refund less interest and penalty (line 21 minus line 23) Enter the amount 3 Ohio adjusted gross income (line 1 minus line 2) 3 4 Personal exemption and dependent exemption deduction multiply your personal and 5 Ohio taxable income (line 3 minus line 4; enter 0 if line 3 is less than line 4) 5 6 Tax on line 5 (see tax tables on pages 35 41 of the instructions) 6 7 If line 5 is $10 000 or less enter a credit of $88; otherwise enter 0 or leave blank 7 8 Ohio tax less line 7 credit (line 6 minus line 7; enter 0 if line 6 is less than line 7) 8 9 Income based exemption credit (see instructions on page 17) 9 a Military injury relief b Natural areas and 1099 R if tax was withheld Place any other supporting belief the return and all enclosures are true correct and complete c Ohio Historical Society d Wildlife species check box check boxYour first name M I Last name check payable to Ohio Treasurer of State and include Ohio form IT 40P (see our Web site at Columbus OH 43218 2294 Columbus OH 43218 2850 County (first four letters)ZIP codeHome address (if different from mailing address) do NOT show city or state dependent exemptions Do not use staples Do not use staples tape or glue Place your W 2(s) check Do you authorize your preparer to contact us regarding this return? Yes No Do you want $1 to go to this fund? documents or statements after the last page of your return E mail address Enclose your federal income Enter school district # for Filing Status Check one (as reported on federal income tax return) For Department Use Only Foreign country (provide this information if the mailing address is outside the U S ) Foreign postal code Go paperless It s FREE! here (If line 23 is more than line 21 you have an amount due Subtract I have read this return Under penalties of perjury I declare that to the best of my knowledge and If joint return does your spouse want $1 to go to this fund? If line 18 is MORE THAN line 17 go to line 19 If line 18 is LESS THAN line 17 skip to line 22 If you entered an amount on line 21 skip to line 25 If you entered an amount on line 22 go to line 24 If your refund is $1 00 or less no refund will be issued If you owe $1 00 or less no payment is necessary in 5 7 business days by direct deposit! INCOME AND TAX INFORMATION If amount is negative type a negative sign ( ) before the figure Individual Income Tax IT 1040EZ IT 40P after the last page of your return Include forms W 2G line 21 from line 23 and enter this amount on line 24 ) YOUR REFUND 25 Mailing address (for faster processing use a street address) Married filing jointly Married filing separately Most electronic filers receive their refunds NO Payment Enclosed Mail to: Note: Checking Yes will not increase your tax or decrease your refund Ohio Department of Taxation Ohio Political Party Fund Yes No Ohio Residents or 1040EZ line 4) 1 P O Box 182294 P O Box 182850 Payment Enclosed Mail to: pg 2 of 2 2013 IT 1040EZ2013 IT 1040EZ Place W 2(s) W 2G(s) and 1099 R(s) on top of this return AMOUNT WITHHELD 18 Preparer s printed name (see page 10 of the instructions) Phone number REFUND OR AMOUNT YOU OWE Return for Full Year return is 0 or negative Rev 11/13 SIGN HERE (required) Single head of household or qualifying widow(er) Spouse s first name (only if married filing jointly) M I Last name Spouse s signature (see page 10 of the instructions) Phone number (optional) tax ohio gov) AMOUNT DUE PLUS INTEREST AND PENALTY 24 tax return if line 1 on page 1 of this Taxable year beginning in Taxable year beginning in Rev 11/13 Taxpayer Social Security no (required) this return (see pages 43 48) times $1 700 and enter the result here 4 Use only black ink Use UPPERCASE letters Visit tax ohio gov to try Ohio I File Your signature Date (MM/DD/YYYY) ZIP codeStateCity Ohio county (first four letters)