IFile (1)

Ohio I-File
Tax Year 2016
Income Tax IT-1040 Tax Return

_________________________________________________________________

Filing Information

Primary Social Security Number: XXX-XX-3692

Primary First Name: THEODORA

Primary Last Name: MAKARA

Address: 3226 KENYON RD., COLUMBUS, OH 43221

Primary Resident Status: Resident

Filing Status: Single or Head of Household

Date Filed: 02/11/2017

Confirmation Number: 1704211038

IT 1040 Filing Information

001 Federal Adjusted Gross Income $116,739.00
$0.00
002A Additions to Federal Adjusted Gross Income $0.00

002B Deductions from Federal Adjusted Gross Income $116,739.00
$1,750.00
003 Ohio Adjusted Gross Income
$114,989.00
004 Exemption Deduction $0.00

005 Ohio Taxable Income $114,989.00
$3,677.00
006 Taxable Business Income $0.00
$3,677.00
007 Ohio Taxable Income Less Taxable Business Income $0.00
$3,677.00
008A Tax Liability on Ohio Taxable Income Less Taxable Business Income $0.00
$0.00
008B Business Income Tax Liability $3,677.00
$4,481.00
008C Ohio Income Tax Before Credits $0.00
$0.00
009 Ohio Nonrefundable Tax Credits $0.00
$0.00
010 Tax Liability After Nonrefundable Credits/Grants $0.00
$0.00
011 Interest Penalty on Underpayment of Estimated Tax $4,481.00
$0.00
012 Ohio Use Tax Amount $4,481.00
$0.00
013 Total Ohio Tax

014 Ohio Tax Withheld

015A Ohio IT 1040ES Estimated Payments

015B Ohio IT 40P Extension Payments

015C Amount of Last Year's Credit Carryover

015D Total Ohio Installment Payments

016 Total Refundable Credits

017 Amount Previously Paid with Original/Amended Return (Amended Only)

018 Total Payments

019 Overpayment Previously Rcvd on Original/Amended Return (Amended Only)

020 Total Payments Minus Previous Overpayments

021 Tax Before Interest

Ohio Department of TaxationPage:1

022 Interest and Penalty $0.00
023 Amount You Owe $0.00
024 Amount Overpaid $804.00
025 Amount to be Credited to Next Year's Income Tax Liability $0.00
026A Wildlife Donation $0.00
026B Military Donation $0.00
026C Ohio History Fund Donation $0.00
026D State Nature Preserves $0.00
026E Breast/Cervical Cancer Donation $0.00
026F Wishes for Sick Children Donation $0.00
026G Total Donation Amount $0.00
027 Refund Amount $804.00

001 Schedule A Additions $0.00
002 Non-Ohio Interest and Dividends $0.00
003 Pass-through Entity and Financial Institutions Tax Paid and Adjustment $0.00
004 Reimbursement of College Tuition Expense and Non-Education Expenditure $0.00
005 Losses from Ohio Public Obligations $0.00
006 Withdrawals from Ohio Medical Savings Account $0.00
007 Reimbursements Previously Deducted $0.00
008 Adjustment for IRC Sections 168(K) and 179 Depreciation Expense $0.00
009 Federal Interest and Dividends $0.00
010 Miscellaneous Federal Income Tax Additions $0.00
Total Schedule A Additions
011 $0.00
012 Schedule A Deductions $0.00
013 Business Income Deduction $0.00
014 Compensation Earned in Ohio by Full-Year Residents of Neighbor States $0.00
015 State and Local Overpayment $0.00
016 Social Security Benefits / Railroad Benefits $0.00
017 Interest from Ohio Public Obligations and Public Service Payments $0.00
018 Individual Development Account Contributions $0.00
019 Contributions to STABLE Account: Ohio's ABLE Plan $0.00
020 Federal Interest and Dividends $0.00
021 Adjustment for IRC sections 168(K) and 179 Depreciation Expense $0.00
022 Reimbursements from Federal Itemized Deductions $0.00
023 Repayment of Income $0.00
024 Wage and Salary Expense $0.00
025 Miscellaneous Federal Income Tax Deductions $0.00
026 Military Pay for Ohio Residents $0.00
027 Income Earned by Military Nonresidents and Civilian Nonresident Spouse $0.00
028 Uniformed Services Retirement Income $0.00
029 Military Injury Relief Fund Amounts Included in Fed Adj Gross Income $0.00
030 National Guard Reimbursements and Benefits $0.00
031 Contributions to College Savings Accounts $0.00
Pell/Ohio College Opportunity Taxable Grant Amounts
Disability and Survivorship Benefits

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032 Total Health Care and Insurance Deduction $0.00
033 Funds in Medical Savings Accounts $0.00
034 Qualified Organ Donor Expenses $0.00
035 Total Schedule A Deductions $0.00

035A Schedule A Deductions - Health Care Expenses Worksheet $0.00
035B Unreimbursed Health Care Exp & Unreimbursed Long-term Care Ins Premium $0.00
035C Unreimbursed Long-term Care & Health Insurance Premiums $0.00
035D Line 1 - Line 2 (not less than zero) $8,755.00
035E 7.5% of Federal Adjusted Gross Income Amount $0.00
035F Line 3 minus Line 4 (not less than zero) $0.00
035G Amount for health insurance coverage for certain dependent relatives $0.00
Total Health Care and Insurance Deduction
035H $0.00
035I Schedule A Deductions - Medical Savings Account Worksheet $0.00
035J Medical Savings Account Primary Contributions $0.00
035K Medical Savings Account Spouse Contributions $0.00
035L Medical Savings Account Earnings $0.00
035M Medical Savings Account Subtotal $0.00
035N Medical Savings Account Withdrawals $0.00
Funds in Medical Savings Accounts
001 Withdrawals from Ohio Medical Savings Account $0.00
002 $0.00
003 Ohio IT-BUS Business Income Schedule $0.00
004 Federal Schedule B - Interest and Ordinary Dividends $0.00
005 Federal Schedule C - Profit or Loss from Business (Sole Proprietor) $0.00
006 Federal Schedule D - Capital Gains and Losses $0.00
007 Federal Schedule E - Supplemental Income and Loss $0.00
008 Guaranteed Payments, Compensation, Wages from Pass-Through Entity $0.00
009 Federal Schedule F - Profit or Loss from Farming $0.00
010 Other Income/Gain on Schedule K1 and Misc. Fed. Income Tax Adjustments $250,000.00
011 Total of Business Income $0.00
012 All Business Income $0.00
013 Business Deduction Maximum Amount $0.00
014 Business Deduction Amount $0.00
Business Income Less Business Income Deduction
001 Taxable Business Income $3,677.00
002 Business Income Tax Liability $0.00
003 $0.00
004 Schedule of Credits - Nonrefundable Credits $0.00
005 Tax Liability Before the Schedule of Credits $0.00
006 Retirement Income Credit $0.00
007 Lump Sum Retirement Credit (not available on I-file) $0.00
008 Senior Citizen Credit $0.00
009 Lump Sum Distribution Credit (not available on I-file) $0.00
Child and Dependent Care Credit
Credit if Ohio taxable income is $10,000 or less
Displaced Worker Training Credit
Campaign Contribution Credit

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010 Exemption Credit $0.00
011 Nonrefundable Credits Subtotal $0.00
012 Tax Less Credits $3,677.00

012A Schedule of Credits - Retirement Income Credit Worksheet $116,739.00
012B Ohio Adjusted Gross Income $0.00
012C Retirement Income Amount $0.00
Retirement Income Credit
012D $116,739.00
012E Schedule of Credits - Child and Dependent Care Credit Worksheet $0.00
012F Ohio Adjusted Gross Income 0.0%
012G Federal Child and Dependent Care Credit $0.00
Eligible Percentage based on Ohio Adjusted Gross
012H Child and Dependent Care Credit $0.00
012I $0.00
012J Schedule of Credits - Displaced Worker Training Credit Worksheet $0.00
012K Amount of Displaced Worker Training Expenses for Primary $0.00
012L Half of Displaced Worker Training Expenses $0.00
012M Lesser of $500 or half of Displaced Worker Training Expenses $0.00
012N Amount of Displaced Worker Training Credit Claimed Last Year $0.00
012O Amount of Displaced Worker Training Credit for Primary SSN $0.00
012P Amount of Displaced Worker Training Expenses for Spouse $0.00
012Q Half of Displaced Worker Training Expenses $0.00
012R Lesser of $500 or half of Displaced Worker Training Expenses $0.00
Amount of Displaced Worker Training Credit Claimed Last Year - Spouse
013 Amount of Displaced Worker Training Credit for Spouse SSN $0.00
014 Displaced Worker Training Credit $0.00
015 $0.00
016 Schedule of Credits - Additional Nonrefundable Credits $0.00
017 Joint Filing Credit $0.00
018 Earned Income Credit $0.00
019 Ohio Adoption Credit Amount $0.00
020 Job Retention Credit, Nonrefundable Portion $0.00
021 Credit for Eligible New Employees in an Enterprise Zone $0.00
022 Credit for Purchases of Grape Production Property $0.00
023 Credit for Investing in an Ohio Small Business $0.00
024 Technology Investment Credit Carryforward $0.00
025 Enterprise Zone Day Care and Training Credits $3,677.00
Research and Development Credit
025A Ohio Historic Preservation Credit, Nonrefundable Carryforward Portion $0.00
025B Total Additional Credits $0.00
025C Tax Less Additional Credits $0.00
025D $0.00
025E Schedule of Credits - Ohio Earned Income Credit Worksheet $0.00
Federal Earned Income Tax Credit
026 Ohio EIC - Calculated Limit $0.00
Ohio EIC - OH Tax Less Credits
Half of Ohio Tax Less Total Credits to Calculate Ohio EIC
Lesser of Ohio EIC Limit and Half of Ohio Tax Less Credits for EIC

Ohio Nonresident Credit
Portion of Ohio adjusted gross income not earned in Ohio

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027 Ohio Adjusted Gross Income $116,739.00
028 Nonresident Credit $0.00

Ohio Resident Credit $0.00
029 Portion of Ohio adjusted gross income subjected to tax by Other States $116,739.00
030 Ohio Adjusted Gross Income
031 Resident Credit Before Limit $0.00
032 2016 Income Tax Less Other State Tax Payments $0.00
033 Ohio Resident Tax Credit Amount $0.00

Schedule of Credits - Refundable Credits Total $0.00
034 Total Nonrefundable Credits
$0.00
Refundable Credits $0.00
035 Historical Building Rehabilitation Credit $0.00
036 Business Jobs Credit $0.00
037 Pass-through Entity Credit $0.00
038 Motion Picture Investment Credit $0.00
039 Financial Institutions Tax (FIT) Credit $0.00
040 Venture Capital Credit
041 Total of Refundable Credits $0.00
$0.00
Billing Interest and Penalty Amounts on Late-Filed Return $0.00
001 Billing Interest
002 Billing Filing Penalty
003 Balance Due

Wage and Income Statement Summary

SSN FEIN Gross Wages Federal Withholding Ohio Withholding Ohio Withholding Acct

272523692 316400416 $48894.00 $8612.00 $1481.00 51164061
272523692 310795647 $3000.00 518737093
$67820.00 $12163.00
PTE Withholding PTE Percent of
K1 Summary Amount Ownership

SSN FEIN PTE Business Name

Other Income Summary

SSN Income Amount Income Source

Refund Summary

Deposit Type Details Amount

Direct Dep: Reg Checking Routing #041000124 Account #4209806361 $804.00

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