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(Overpayment)
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13090100
13090200
2 and enter the overpayment
2013 SD 141 Long
4 If line 2 is GREATER than
active school districts
active school districts during
Amended Return
Amount
amount Complete the tax liability and the total payment for each school district
AMOUNT YOU OWE
any previously filed SD 141(s)
Business Gateway:
Check box if amended return
Check box if out of business
City state ZIP
Columbus OH 43218 2388
district income tax due
District No
DO NOT STAPLE OR OTHERWISE ATTACH YOUR CHECK OR CHECK STUB
due mail one check payable to School District Income Tax for the total
Enter the amount of payments
enter the balance of school
Enter the total amount of
Final Return
For the Period Ending
for which you withheld tax
Go paperless! File your
I declare under penalties of perjury that this return including any accompanying
If line 2 is LESS than line 1
If this return is an amended SD 141 (i) you must include on the lines below any
If you do not owe any taxes write 0 in the space on line 3 If you have a balance
knowledge and belief is a true correct and complete return and report
line 1 subract line 1 from line
made for 2013 on
Number and street
of Payment
of school district income tax
Ohio form SD 101 for ALL
Ohio Withholding Account No
Ohio withholding acct no
or no more SD employees
P O Box 182388
Payment due date01/31/2014
previously filed SD 141(s); and (iii) deduct from line 2 total refund(s) received on
Reconciliation of Tax Withheld
return through Ohio
Rev 11/12
schedules and statements has been examined by me and to the best of my
School
School District Employer s Annual
School District Income
school district income tax required
School District Income Tax School District Income Tax
School District Name
SD 141 LongRev 11/12Page 2
Signature
subtract line 2 from line 1 and
tax ohio gov
Tax Withheld
then add any further adjustments; (ii) add to line 2 total payments made on any
Title Date
to be withheld for ALL
TO THIS FORM DO NOT SEND CASH Make check payable to SCHOOL DIS
TRICT INCOME TAX and mail to School District Income Tax P O Box 182388
Underpayment/
underpayment/overpayment(s) that were on any previously filed SD 141(s) and
YOUR REFUND