
1. Enter the total amount of school district income tax required to be withheld for ALL
active school districts during the year .................................................................
2. Enter previous payments including any balance due paid with Ohio form SD 141;
deduct any refund received from Ohio form SD 141 .............................................
3. If line 2 is LESS than line 1, subtract line 2 from line 1 and enter the balance of
school district income tax due ........................................ AMOUNT YOU OWE
4. If line 2 is GREATER than line 1, subtract line 1 from line 2 and enter the overpay-
ment of school district income tax .......................................... YOUR REFUND
Federal Employer Identification NumberOhio Withholding Account Number
Name
Number and street
City State ZIP code
Mail to:
School District Income Tax
P.O. BOX 182388
Columbus, Ohio 43218-2388
SD 141X – Amended School District Employer’s Annual Reconciliation of Tax Withheld
Go paperless! File your
return through
Ohio Business Gateway:
www.obg.ohio.gov
1.
2.
3.
4.
NOTE: If you do not owe any taxes, write 0.00 in the space on line 3. If you have a balance due, make your check
payable to: School District Income Tax. Complete the reverse side for each school district you withheld for,
the tax liability for each district, and the total payment for each district.
I declare under penalties of perjury that to the best of my knowledge and belief this is a true, correct and complete return.
Signature of responsible person Title Telephone number
Address, number and street City State ZIP code
Social Security number of responsible person Date
SD 141X
Rev. 11/07
Tax Year
Final return: Check the
box if out of business or
no more SD employ-
ees. Explain on back.
hio
Department of
Taxation