Title:  Ohio IT1040 State 2012 Tax Form

{ -- Initial Template -- Common 0 amounts filled-in as 0's, }
{     Important ???-amounts must be filled-in by most everyone. }

Status      Single      { Single, Married/joint, Married/separate, Head_of_household }

L1	    ??	;	{ Federal Adjusted Gross Income }
Exemptions  ??	;       { Exemptions, self=1/depend=2,3,... }

JointCredit   No	{ Answer YES only if Married Joint Filing, & you and spouse each have AGI >= $500. }

L14		;	{ Manufacturing equipment grant. }

L17		;	{ Unpaid Ohio Use Tax }

L19	    ??	;	{ Ohio Tax Withheld (box 17 on your W-2) }
L20		;	{ Ohio Estimated Tax, IT 40P Payments for 2012, ... }
L21a            ;       { Refundable Business Jobs Credit }
L21b            ;       { Refundable Pass-through Credit }
L21c            ;       { Refundable Histroic Preservation Credit }
L21d            ;       { Refundable Motion Picture Credit }

{ Additions - add to extent not included in fed adjusted gross income (line 1). }
L31	;	{ Non-Ohio state or local gov't interest, dividends. }
L32	;	{ Pass-through Entity addback. }

L33a      ;	{ Fed int+div subject to state tax & misc. fed adj. }
L33b      ;	{ Reimbursed college tuit. fees deducted prev yrs. }
L33c      ;	{ Losses, sale of Ohio Public Obligations. }
L33d      ;	{ Nonmedical withdrawals OH Med. Savings Acct. }
L33e      ;	{ Reimb. exp. prev. deducted, if reimb. not in FAGI .}
L33f      ;	{ Lump sum distribution add-back + misc. fed income tax adjustments }
L33g      ;	{ 5/6 adjustment for IRC section 168(k) and 179 depreciation expense }

{ Deductions - see limitations in instructions. }
L35a	;	{ Fed int + div exempt from state taxation. }
L35b	;	{ Adjustment for Internal Revenue Code sections 168(k) + 179 deprec. expense }
L36	;	{ Employee compensation earned in OH by non-residents. }
L37a	;	{ Military Pay. }
L37b	;	{ Military Retirement Income. }
L38a	;	{ State/municipal income tax overpayments. }
L38b	;	{ Refund or reimbursements shown on IRS form 1040, line 21 }
L38c	;	{ Repayment of income reported in a prior year, ... }
L39	;	{ Disab. & survivor benef. }
L40	;	{ Qualifying soc. sec. + railroad benefits. } 
L41	;	{ Education: Ohio 529 contributions } 
L42	;	{ Ohio National Guard reimbursements }
L43a	;	{ Unreimbursed health insurance ... }
L43b	;	{ Funds deposited into, and earnings of, a medical savings account }
L43c	;	{ Qualified organ donor expenses }
L44	;	{ Wage expense not deducted }
L45     ;	{ Interest from Ohio Public Obligations ... }

L48	;	{ Retirement Income Credit (see instructions for credit table) (Limit $200) }
L49	;	{ Senior Citizen Credit (Limit $50 per return) }
L50	;	{ Lump Sum Distribution Credit (you must be 65 years of age or older to claim this credit) }
L51	;	{ Child and Dependent Care Credit (see instructions and worksheet) }
L52	;	{ Lump Sum Retirement Credit }
L54	;	{ Displaced Worker Credit (see instructions & worksheet) }
L55	;	{ Ohio Political Contributions Credit (Limit $50 single; $100 joint) }
L56	;	{ Ohio Adoption Credit (Limit $1500 per adoption) }

L58	;	{ Portion of line 3 subjected to tax by other states. }
L61	;	{ 2012 income tax paid to other states ... }

L63	;	{ Income not earned or received in Ohio. }
L66	;	{ Nonrefundable Business Credits, Sched-E line 10 }
