Ohio Ohio Nonresident Statement (Formerly Form IT DA)

Ohio Nonresident Statement (Formerly Form IT DA)
Form IT NRS
Do not staple or paper clip.

2025 Ohio IT 10

Zero Liability / No Refund
Individual Income Tax Return

Use only black ink and UPPERCASE letters.

25120102

Important: You can only file an IT 1040 or an IT 10. If you are liable for school district income tax, you must file the Ohio IT 1040.
Primary taxpayer's SSN (required)

Check if
deceased

Check if
deceased

Spouse’s SSN (if filing jointly)

First name

M.I.

Spouse's first name (only if married filing jointly)

M.I. Last name

Check if federal
extension filed

School district #

Last name

Address line 1 (number and street) or P.O. Box

Address line 2 (apartment number, suite number, etc.)

ZIP code

City

State

Foreign country (if the mailing address is outside the U.S.)

Foreign postal code

Residency Status – Check only one for primary
Part-year
resident*
Check only one for spouse (if filing jointly)
Resident

Resident

Part-year
resident*

Ohio county (first four letters)

Filing Status –	Check one (as reported on federal income tax return)

*Indicate state

Nonresident*

Single, head of household or qualifying surviving spouse
*Indicate state

Married filing jointly

Nonresident*

Spouse’s SSN

Married filing separately

Reason(s) For Filing (Required): By filing this return, the primary taxpayer and spouse (if filing jointly) declare that their correctly calculated tax liability
(Ohio IT 1040, line 8c) is $0.00 for one or more of the following reasons (check all that apply):
	
	

There is no tax liability on my Ohio taxable nonbusiness income 	
(Ohio IT 1040, line 7) and taxable business income (Ohio IT 1040, line 6).

	
	

I was a nonresident military servicemember for the entire tax year 	
and my only source of income earned in Ohio is from the military.

	
	

I was a nonresident of Ohio for the entire tax year and did not have
Ohio-sourced income (e.g. the above address is for mailing purposes only).

	
	

I was a civilian spouse of a nonresident servicemember stationed in 	
Ohio.

Ohio Nonresident Statement – See instructions for required criteria
By checking this box and signing this return I, the primary taxpayer listed above, declare under penalties of perjury that I meet all of the required criteria for
the tax year listed above, and thus, am irrebuttably presumed to not be domiciled in Ohio for the tax year.
By checking this box and signing this return I, the spouse listed above, declare under penalties of perjury that I meet all of the required criteria for the tax
year listed above, and thus, am irrebuttably presumed to not be domiciled in Ohio for the tax year.
I understand that I cannot request a refund of any amount on this return.

Sign Here (required):

I declare under penalties of perjury that this return or claim (including any accompanying schedules and statements) has been examined by me
and to the best of my knowledge and belief is a true, correct, and complete return and report.

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Primary signature		
Phone number
		
Spouse’s signature 			
Date

Preparer's printed name	

Phone number

Authorize your preparer to
discuss this return

Non-paid preparer

PTIN:

P

Do not write in this area; for department use only.

Mail to:
Ohio Department of Taxation
P.O. Box 2057
Columbus, OH 43270-2057

MM-DD-YY
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