Form IT 1140 Fillable Pass-Through Entity and Trust Withholding Tax Return
(all forms fillable on Windows, Mac, Android tablets, and iPad using Adobe Reader XI)

00 00 00 00 00 00 00 00 2 Payroll 00 00 2/3 5/6 or 6/6 (check applicable 3 Sales 00 00 3a Payments transferred from Ohio forms IT 3b Payments transferred to Ohio form IT 4708 has a beneficial interest in the entity s profits surpluses losses Home Owners Loan Act that are engaging only in activities pass through (via the K 1s it will issue) to its qualifying investors $1 000 9 (: 0) Unchecked (: 0) Unchecked (: 1) Unchecked (: 1) Unchecked (: 2) Unchecked (: 2) Unchecked (: 3) Unchecked (4)(I) directly or indirectly owned by one or more financial (A) (B) (checkbox) Unchecked (checkbox) Unchecked (ii) the investor information as indicated on page 10 of the instructions (Reset Form) Reset 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) (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) (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) 65465456 1 column II of this return 11 1 File this form with the Ohio Department of Taxation by the 15th 1 Property 1 Sum of all distributions to nonresident individuals of income or gain attributable to the trust s 1 Sum of all qualifying investors distributive 1 Tax for each column (from Schedule B line 10 Tax rate (see Note 4 on page 7) 10 10 Total amount owed (sum of 11 columns A and B or from Schedule D line 11 Tax due: Line 9 times line 10 Round tax to 13170106 13170206 13170306 13170406 13170506 2 Attach (i) Ohio Schedules B and C or Schedules D and E and 2013 IT 1140 2013 IT 1140 pg 1 of 6 2013 IT 1140 pg 3 of 6 2013 IT 1140 2013 IT 1140 pg 4 of 6 2013 IT 1140 2013 IT 1140 pg 5 of 6 2013 IT 1140 2210) 2 263A and 482 (see Note 3 on page 7) 4 2a (if the amount is negative type a negative 2a Add lines 1 and 2 2a 2a Add the I R C 168(k) bonus depreciation 2/3 5/6 or 6/6 (check applicable amount) 2a Add the qualifying investors distributiveshares of Internal Revenue Code (I R C ) 2b Other statutory adjustments and miscellaneous federal tax adjustments attributed to nonresi( 2b Subtract qualifying investors distributiveshares of other statutory adjustments and 3 Adjusted qualifying amount: sum of lines 1 and 2a minus line 2b Complete the remainder of 3 exceeds $10 000 (attach Ohio form IT/SD 3 Qualifying investors distributive shares of 3c Net payments (sum of lines 3 and 3a minus 4 For each column subtract line 3c from line 4 on page 4 8 4 Tax rate 4 4 Total weighted apportionment ratio (add lines 1(c) 2 and 3) Enter ratio here and on page 3 line 8 (both columns) 4708ES and IT 4708EXT (attach schedule 5 If the qualifying pass through entity is either 5 If the sum of line 4 columns (I) and (II) is an overpayment enter that sum here OVERPAYMENT 5 5 Tax (carry amount to page 1 line 1 column l of this return) Round tax to the nearest dollar 5 6 Amount of line 5 to be CREDITED to year 2014 CREDIT TO 2014 6 6 If the qualifying pass through entity is an 7 Amount of line 5 to be REFUNDED (line 5 minus line 6) YOUR REFUND 7 7 Qualifying investors adjusted distributive 8 Apportionment ratio from Schedule C line 8 If the sum of line 4 columns (I) and (II) is a balance due or zero enter here the amount you owe 8 9 Interest and penalty due on late paid tax and/or late filed return if any 9 9 Qualifying investors adjusted qualifying a partnership or a limited liability company a) Owned (average cost) Act of 1974 requires us to inform you that providing us with your Social Security number is Add all qualifying investors distributiveshares of expenses and losses incurred inconnection with all direct and indirect transactions Address Address Address Address Address Address (if address change check box) adjusted qualifying amount: Sum of lines 1and 2a minus line 2b 3 amount) Attach a separate schedule show amount: Line 7 times line 8 Complete and (iii) Ohio form IT/SD 2210 and miscellaneous federal tax adjustments attributed to nonresident individuals who are ben( and refunds if any previously claimed for this and Trust Withholding and Trust Withholding and/or by attribution owns at least 40% of the pass through entity authority under 12 U S C 1843(k)(4)(H) or 12 U S C 1843(k) B line 2b 2b b) Rented (annual rental X 8) backed by the right to receive payment from the asset or assets Bank holding companies as defined in the federal Bank Holding be extended Because we require you to provide us with a Social Security number the Federal Privacy belief the return and all enclosures are true correct and complete between the qualifying pass throughentity and its related members includingcertain investors family members (see Note2 on page 7) However do not add expensesor losses incurred in connection with sales c) Total (lines 1a and 1b) Check here if amended return Check here if fi nal return Check only one 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 City State ZIP code City State ZIP code City State ZIP code Code section (R C ) 5725 01 For detailed instructions refer to page 7 in the instructions for this form Columbus OH 43218 1140 Column (I) Withholding Tax Column (II) Entity Tax companies but only if those persons are authorized to conduct Company Act company that also filed Ohio form IT 1140 this pass through entity compensation paid to or for family member employees if the passthrough credited to 2013 (see Note 1 on page 7) 3 day of the fourth month following the last day of the entity s taxable Definition of owned for this purpose: a person owns another Definition of securitization for this purpose: Transferring one or dent individuals who are beneficiaries of trusts (see page 6 of the instructions for Schedule distributive shares of compensation that the do not apply See page 6 of the instructions 6 Do not submit this page with your IT 1140 return Do not use staples Do not use staples tape or glue Place any supportingdocuments including K 1 s after the last page of this return Do you authorize your preparer to contact us regarding this return? Yes E mail address efi ciaries of trusts (see page 6 of the instructions for Schedule B line 2a) Attach a separate entities compute the tax at the rate of 8 5% See R C 5733 41 entity if the person: entity made to any qualifying investor directly entity or person directly or indirectly related to the taxpayer if entity or trust has invested in a partnership or limited liability entity owner who is a member of family directly indirectly entity s or this trust s proportionate share of tax paid by that investee entity should pay no tax with respect to these corporations Entity Type: Federal employer I D number (FEIN) federal income tax adjustments Federal Privacy Act Notice Financial holding companies as defined in the federal Bank First name/entity M I Last name First name/entity M I Last name First name/entity M I Last name Fiscal filers: Use the rate in effect on the last day of the taxable year For Department Use Only for qualifying investors that are estates trusts and pass through For taxable year beginning on for the taxable year beginning in 2013 is 0%; therefore the passthrough For those qualifying corporate investors that are listed below and Furthermore this pass through entity or trust cannot claim such holding companies bank holding companies savings and loan holding companies insurance companies or persons directly Holding Company Act holding company under 12 U S C 1843(k) I have read this return Under penalties of perjury I declare that to the best of my knowledge and if any (see page 6 of the instructions) if any (see page 6 of the instructions) 2b if required; see instructions) and other payments If you use multiple rates for column B attach a schedule reflecting If your refund is $1 00 or less no refund will be issued If you owe $1 00 or less no payment is necessary Important Notes: in R C 5733 042(A)(6) but is modified by R C 5733 40(P) For ing calculations 2a institutions financial holding companies bank holding companies Instructions for this form are on our Web site at tax ohio gov Interest penalty on underpayment of tax if the investors distributive shares of guaranteed IT 1140 IT 1140 IT 1140 IT 1140 Rev 10/13 K 1s and a listing of pass through credits of participating investors See Special Notes beginning on page 4 of the instructions which are available on less than 0 7 Limited liability corporation line 3b) not less than zero 3c lines 8 and 9) Make check payable to Ohio Treasurer of State include located in Ohio 1 M I Last nameFirst name/entity M I Last nameFirst name/entity 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 made to any qualifying investor directly or indirectly Mail to: mandatory Ohio Revised Code sections 5703 05 5703 057 and 5747 08 authorize us to miscellaneous federal income tax adjustments MM / 1302 more assets to one or more persons and then issuing securities Name of pass through entity Nonresident Individuals Nonresident Individuals Than Nonresident Individuals Note 1: Instructions for page 1 Schedule A line 3 If this passthrough Note 2: Instructions for page 2 line 4 Related member is defined Note 3: Instructions for page 2 line 4 Include on this line all Note 4: Instructions for page 3 line 10 column (B) For those Note 5: Amount of tax credits that will pass through from the qualifying 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 Number of investors Apportionment ratio page 3 line 8 of all ownership interests of inventory to the extent that the cost ofthe inventory and the loss incurred werecalculated in accordance with I R C sections Ohio Dept of Taxation Ohio form IT 1140P and place FEIN on check TOTAL AMOUNT OWED 10 Ohio IT 1140ES and IT 1140EXT payments on last year s return Provide investor information for all (resident and nonresident) investors in the pass through entity or trust List investors by highest on page 1 line 1 column I of this return; or distributions (partnerships trusts or other business interests) or indirectly owned by such businesses or indirectly owning at least 20% of or investee limited liability company paid on behalf of this or qualifying benefi ciary or savings and loan holding companies but only if those or similar transactions for fi nancial institutions financial or to its qualifying beneficiaries the pass through entity s or trust s or trust is not entitled to any payment or credit for this pass through our Web site at tax ohio gov If the amount below is negative type a negative sign ( ) before the figure ownership of or disposition of either tangible personal property located in Ohio or real property owning at least 20% of the qualifying owns at least 50% of the entity s membership interests (LLCs); owns at least 50% of the entity s voting stock (corporations); P O Box 181140 Partnership partnership or investee limited liability company Pass Through Entity Pass Through Entity Pass through entity officer or agent (please print) pass through entity or qualifying trust to each qualifying investor pass through entity or trust pass through entity Reciprocity agreements Pass Through Entityand Trust WithholdingTax Return Pass Through Entityand Trust WithholdingTax Return payment as an estimated payment for this pass through entity s or payments that the qualifying pass through Percent of ownershipSocial Security no Amount of PTE tax credit Percent of ownershipSocial Security no Amount of PTE tax credit Percent of ownershipSocial Security no Amount of PTE tax credit percentage Use an additional sheet if necessary See Note 5 on page 7 for the amount of pass through entity tax credits permissible under 12 United States Code (U S C ) 1843(k) persons are engaged in activities permissible for a financial Persons directly or indirectly owned by one or more insurance Persons other than persons held pursuant to merchant banking Persons that solely facilitate or service one or more securitizations pg 2 of 6 2013 IT 1140 pg 6 of 6 2013 IT 1140 2013 IT 1140 place the column B amount on page 1 line places) decimal places) Preparer s name (please print) Telephone number previously made for this taxable year 3a proportionate share of such tax payment that the investee partnership Provide investor information for all (resident and nonresident) investors in the pass through entity or trust List investors by highest to lowest ownership purposes of the line 4 adjustment a related member is any business qualifying corporate investors that are not listed below the tax rate Qualifying Investors Other Qualifying Investors Who Are Qualifying Investors Who Are Qualifying Investors Other qualifying pass through entity S corporation Ratio (carry to six decimal Weight Weighted Ratio (carry to six Ratio (carry to Weight Weighted Ratio (carry to real property located in Ohio If the amount below is negative type a negative sign ( ) before the figure request this information We need your Social Security number in order to administer this tax Rev 10/13 Rev 10/13 Rev 10/13 2013 13170606 S corporation S corporation add all qualifying investors Savings and loan holding companies as defined in the federal SCHEDULE A RECONCILIATION TAX AND PAYMENTS SCHEDULE A RECONCILIATION TAX AND PAYMENTS cont Schedule B line 1 total of columns A and B SCHEDULE B QUALIFYING PASS THROUGH ENTITIES TAX DUE SCHEDULE B QUALIFYING PASS THROUGH ENTITIES TAX DUE cont SCHEDULE C QUALIFYING PASS THROUGH ENTITIES APPORTIONMENT WORKSHEET SCHEDULE C QUALIFYING PASS THROUGH ENTITIES APPORTIONMENT WORKSHEET cont SCHEDULE D TRUSTS TAX DUE SCHEDULE E INVESTOR INFORMATION SCHEDULE E INVESTOR INFORMATION cont schedule showing calculations 2a section 168(k) bonus depreciation and thequalifying I R C 179 depreciation and miscellaneous See R C 5733 40(A)(3) Do not show on line 6 any amount you shares of income gain expenses and losses 1 shares Sum of lines 3 4 5 and 6 but not show on line 4 sign ( ) before the figure 4 SIGN HERE (required) Signature of pass through entity officer or agent six decimal places) six decimal places) six decimal places) so transferred Social Security no FEIN Percent of ownership Amount of PTE tax credit Social Security no FEIN Percent of ownership Amount of PTE tax credit State ZIP code sum of columns A and B on line 9 exceeds sum of columns A and B on line 9 on page Tax Return taxable year 3b text) Than Nonresident Individuals the business of insurance in this state 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 the computation of tax for each type of investor the direct and indirect ownership interests equals or exceeds 40% the entity or trust made and/or 2012 overpayment the nearest dollar Place the column A amount the qualifying pass through entity 5 the remainder of this worksheet only if the the worksheet only if line 3 exceeds $1 000 3 time to file this return The due date for payment of tax cannot Title of officer or agent (please print) Telephone number 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 Total Everywhere Within Ohio treated as a partnership add all qualifying Trust trust s taxable year However the pass through entity or trust can Use only black ink Tax Return Use this schedule to calculate the adjusted qualifying amounts and tax due for all qualifying investors in qualifying pass through entities Attach federal Use this schedule to calculate the adjusted qualifying amounts and withholding tax due for nonresident individuals who are beneficiaries of trusts that Use this schedule to calculate the apportionment ratio for a qualifying pass through entity that is not a financial institution as defined in Ohio Revised Use UPPERCASE letters Weighted Ratio (carry to Within Ohio Total Everywhere Within Ohio Total Everywhere X 085 x 20 == x 60 == year See general instructions for automatic extensions of ZIP code StateCity ZIP code StateCity