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This worksheet is used to file the taxpayer's state tax return as a nonresident or part-year resident of Ohio.
Who Must File An individual who is a part-year resident of Ohio or received Ohio sourced income during the tax year must file an Ohio income tax return unless of the following circumstances are applicable:
- The taxpayer is single, and the federal adjusted gross income is less than or equal to $11,600, and the taxpayer has no Schedule A adjustments.
- The taxpayer is married filing jointly, and the federal adjusted gross income is less than or equal to $13,200, and the taxpayer has no Schedule A adjustments.
- The taxpayer's only source of income is retirement income that is eligible for the retirement income credit, and the credit is the same or larger than the tax before credits.
- The taxpayer's exemption amount is the same as or more than the Ohio adjusted gross income.
Even if the taxpayer is not required to file a return, the taxpayer must file a return to get a refund of the taxes already withheld.
See the Ohio 2010 Income Tax Booklet for more information and details.
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| General Information |
| Residency |
Taxpayer Select the taxpayer's residency status, either "Nonresident" or "Part-year Resident" from the dropdown list.
If "Nonresident" is applicable, select the state in which the taxpayer resides from the second dropdown list.
If "Part-year" is applicable, enter the dates of residency in the State of Ohio.
Spouse Enter the spouse's information as instructed above for the taxpayer.
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Ohio Political Party Fund
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Select "Yes" or "No" for the taxpayer, and spouse if married filing jointly, if he or/and she wants to contribute $1 each to the Ohio Political Party Fund.
The Ohio General Assembly established this fund to support public financing of Ohio political parties. Monies from this fund may only be used for administrative costs associated with party headquarters and party fund-raising drives, organization of voter registration, and get-out-the vote campaigns not related to any particular candidate or election.
Note: This selection will not reduce any refund or increase the amount of tax due.
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| Check Box |
Check this box if the taxpayer does need tax forms mailed to his or her mailing address next year.
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| Taxes and Credits |
Retirement Income Credit
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Check the box only if the taxpayer reported income from Form 1099-R on this return, but does not meet the requirements for the Ohio Retirement Income Credit.
Requirements To qualify for this credit, the taxpayer must meet all of the following requirements:
- The taxpayer must have received retirement benefits, annuities, or distributions that were made from a pension, retirement or profit-sharing plan.
- The taxpayer must have received this income because he or she retired.
- The retirement income must have been included in the taxpayer's Ohio adjusted gross income.
Caution: Social Security benefits, Railroad Retirement benefits, and Military Retirement Income do not qualify the taxpayer for this credit.
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Payments
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| Additional Ohio Income Tax Withheld |
Enter the amount of any Ohio income tax withheld that has not been entered elsewhere on the return.
Do not include any amounts already entered on the W-2 or 1099 worksheets.
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| Amount Paid with Extension |
Enter the amount of tax the taxpayer paid with an extension to file this return, if applicable. |
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Contributions
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| Funds |
Enter the amount of the taxpayer's refund that he or she would like to donate to one or more of the following organizations:
- Military Injury Relief Fund
The Military Injury Relief Fund provides grants to individuals injured while in active service as a member of the United States’ armed forces while serving under Operation Iraqi Freedom or Operation Enduring Freedom.
- Wildlife Species and Conservation of Wildlife
The Division of Wildlife uses these funds to establish habitat and protect open spaces for wildlife. Past donations have helped to restore populations of endangered species including peregrine falcons, bald eagles, and snowshoe hares. The taxpayer's generous donation will continue to help support Ohio’s native wildlife, a natural treasure!
- Nature Preserves and Scenic Rivers
The taxpayer can help create a rich and lasting legacy for all Ohioans. The taxpayer's generous donation supports the protection of Ohio’s endangered species, as well as preserves high-quality natural areas and streams.
Note: A contribution here will reduce the taxpayer's refund.
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Schedule A - Additions to Income
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| Additions |
Federal Interest and Dividends Subject to State Taxation
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Enter interest or dividends on obligations of the United States government that are exempt from federal taxation but are not exempt from state taxation.
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Reimbursement of College Tuition Expenses and Fees Deducted
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Enter any reimbursement received during the tax year of any amount deducted in a previous tax year for college tuition and fees to the extent the amount is not already included in Ohio adjusted gross income.
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Non-Education Expenditures from College Savings Account
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Enter any portion of a distribution reported on Form 1099Q received from a CollegeAdvantage program that was not used for qualified higher education expenses unless the distributions was due to the beneficiary's death, disability or receipt of a scholarship, according to the following guidelines:
- Do not make an entry for any amount of distributions relating to the cost of tuition credits or units purchased before January 1, 2000.
- If the taxpayer is the CollegeAdvantage account owner or beneficiary, and a portion of the distribution reported to the taxpayer on the taxpayer's Form 1099Q relates to original contributions or purchases by the account owner (or beneficiary) not excluded under item 1 above, the nonearnings portion (usually the original contribution or purchase price unless the account has declined in value below these amounts) related to such portion of the distribution must be included to the extent that either the account owner or the beneficiary has taken an Ohio contribution deduction for such contributions or purchases in this or a prior taxable year.
- If any portion of the distribution reported on the Form 1099Q relates to original contributions or purchases to which neither items 1 or 2 above apply, the taxpayer must include the nonearnings portion of such portion of the distribution.
Contribution Carryovers CollegeAdvantage account owners or beneficiaries should reduce any contribution deduction carryovers to future years to the extent the nonearnings distributions in item 2 above exceed contribution deductions taken in this and prior years and is reflected in the taxpayer's contribution deduction carryover to future years returns.
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| Non-Medical Withdrawals from an Ohio Medical Savings Account |
Enter any withdrawals made from an Ohio medical savings account for nonmedical purposes if the amount of the withdrawal was deducted on a previous year's tax return.
Include any lump sum distribution reported on federal Form 4972.
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| Deductions |
Compensation Earned in Ohio by Full-year Residents of Neighboring States and Certain Income Earned by Nonmilitary Residents
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Enter the amount of Ohio compensation earned if the taxpayer meets the requirements for this deduction.
Requirements Because of reciprocity agreements Ohio has with the border states of Indiana, Kentucky, West Virginia, Michigan and Pennsylvania, the taxpayer does not have pay Ohio income tax return if the following two conditions apply:
- The taxpayer was a full-year resident of one of these states, and
- The taxpayer's only source of income within Ohio was from wages, salaries, tips or commissions.
If Ohio income tax was withheld on this income but the taxpayer meets the two conditions set forth above, the taxpayer can file an Ohio income tax return to get a full refund.
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| Military Pay for Ohio Residents, Only if the Pay is Included on Line 1 of the Return, While the Member was Stationed Outside of Ohio |
Enter the amount of military pay the taxpayer and/or spouse earned that was included in federal adjusted gross income and while the military person was stationed outside of the State of Ohio.
Do not include any amounts for civilian wages, interest, dividends or capital gains, retirement or pension benefits, temporary wage continuation plans, or payments for temporary illnesses or injuries.
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Disability and Survivors Benefits
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Enter deductible disability and survivor benefits received by the taxpayer and/or spouse.
Deductible The following amounts are deductible:
- Benefits from an employee’s disability plan paid as the result of a permanent physical or mental disability-Note that the disability must be (or presumed to be) permanent. Disability means a permanent physical or mental impairment which makes the taxpayer unable to work for pay in the jobs for which the taxpayer is qualified by training and experience.
- Survivorship benefits paid from a qualified survivorship plan as the result of the death of a covered employee
The following amounts are not deductible:
- Payments which otherwise qualify as retirement or pension benefits-Upon reaching minimum retirement age, disability benefits under an employee disability plan are considered retirement or pension benefits and are no longer deductible.
- Temporary wage continuation plans
- Payments for temporary illnesses or injuries
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| Contributions to CollegeAdvantage 529 Savings Plan and/or Purchases of Tuition Credits |
Enter up to $2,000 per beneficiary for contributions made to an Ohio Tuition Trust Authority's CollegeAdvantage 529 Savings Plan, only if the amounts do not also qualify as a deduction on the taxpayer's federal return.
Carryovers Qualifying amounts exceeding the $2,000 limitation may be deducted on future years’ returns, subject to the annual $2,000-per-beneficiary limitation, until all unused portions are deducted. However, the taxpayer may not use any contribution deduction carryover to the extent that the carryover has been reduced due to recapture of contribution deductions.
Adjustment for Earnings on Certain Distributions Enter amounts for any distributions of qualified higher education expenses, only if the amounts do not also qualify as a deduction on the taxpayer's federal return either because of the use of federal tax credits instead of the deduction or because of federal earnings limitations.
Adjustment for Distributions at a Loss Enter any loss from box 2, federal Form 1099Q only if this amount has not already been deducted from federal adjusted gross income.
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Ohio National Guard Reimbursements and Benefits
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Enter any of the following amounts that have not already been deducted from federal adjusted gross income or somewhere else on the state return:
- The receipt of any Ohio Adjutant General-authorized Ohio National Guard reimbursement for group life insurance premiums paid, and
- The receipt of any Ohio Adjutant General-authorized payment of death benefits received as a beneficiary of an active duty member of the Ohio National Guard who died while performing active duty.
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Interest Income from OH Public Obligations\OH Purchase Obligations and Gains from Sale of these Obligations
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Enter the amount of any interest income earned from or gains resulting from the sale or disposition of Ohio Public Obligations and Ohio Purchase Obligations if the income was included in the taxpayer's federal adjusted gross income.
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| Qualified Organ Donor Expenses and Amount Contributed to an Individual Development Account |
Enter up to $10,000 each per taxpayer and/or spouse for qualified organ donation expenses, or for the amount of a matching contribution the taxpayer made to another person’s Individual Development Account when the account has been established by a County Department of Human Services.
Qualified Organ Donation Expenses These include expenses incurred for unreimbursed travel and lodging in connection with the taxpayer's or spouse's donation of a human organ to another human being. This deduction can only be taken once in a person's lifetime.
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| Military Retirement Income Included in Federal AGI |
Enter the amount of military retirement income and injury relief fund amounts based on credit for military service received by the taxpayer during the tax year.
Include amounts received by a surviving spouse or former spouse of a military retiree who is receiving payments under the survivor benefit plan.
See the taxpayer's federal civil service retirement benefit handbook for details on which benefits are based on credit for military service. For a replacement booklet, email the Office of Personnel Management at retire@opm.gov.
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| Deduction for Unsubsidized Health and Long-Term Insurance and Excess Medical Expenses |
| Total Amount Paid for Unreimbursed Medical and Dental Expenses and Premiums |
Enter the total of all of the following amounts that have not already been deducted from federal adjusted gross income or somewhere else on the state return:
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Unreimbursed premiums for subsidized and unsubsidized long-term care insurance plans for the taxpayer, spouse, and dependents,
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Unreimbursed premiums for unsubsidized health insurance plans (bolded terms defined below) only for the taxpayer, spouse, and dependents, and
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Excess medical expenses.
Reduce the amount of premiums for an unsubsidized health insurance plan by any amounts deducted as self-employed health insurance on the federal return.
Do not include any amounts excluded from federal adjusted gross income under a cafeteria plan or any flexible spending plan.
Unsubsidized Health Insurance Plan This is a plan for which the current or former employer or spouse’s current or former employer does not pay for any part of the plan’s costs and does not reimburse the taxpayer or spouse for any part of the plan’s costs. Most people who receive wage or salary income from an employer participate in one or more subsidized plans, and therefore are not participating in an unsubsidized health insurance plan.
Medical Expenses This includes qualified unreimbursed costs such as the following: prescription medicine or insulin, hospital costs and nursing care, medical, dental and vision examinations and treatment by a certified health professional, eyeglasses, hearing aids, braces, crutches, and wheelchairs.
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| Amount Paid for Premiums Only |
Enter the total amount entered above for the premiums of long-term care insurance and unsubsidized health insurance plans only. |
| Schedule D - Nonresident/Part-year Resident Income |
| Non Ohio Income |
Enter income received or otherwise incurred during the tax year that is not from Ohio sources only if the user wants to override what has already been automatically calculated.
Nonresidents or Part-year Residents of Ohio are entitled to a credit for income not earned or received in Ohio.
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