Ohio Ohio Universal Payment Coupon (OUPC)

Ohio Universal Payment Coupon (OUPC)
Form OUPC
Ohio Universal Payment Coupon (IT)
Include the coupon below with your Ohio individual income tax payment.

Important
•	 Make payment payable to: Ohio Treasurer of State
•	 Include the tax year, “IT 1040”, and the last four digits of your SSN on the “Memo”
line of your payment.
•	 Do not send cash.
•	 Do not use this coupon to make a payment for a school district income tax return.

Electronic Payment Options
You can make your payment electronically even if you file by paper. To pay by electronic
check, credit card, or debit card, visit tax.ohio.gov/pay OR scan with your phone.

Federal Privacy Act Notice
Because we require you to provide us with a Social Security number, the Federal Privacy Act of 1974 requires us to inform you that providing
us with your Social Security number is mandatory. Ohio Revised Code sections 5703.05, 5703.057 and 5747.08 authorize us to request this
information. We need your Social Security number in order to administer this tax.



Cut on the dotted lines. Use only black ink.

Ohio Universal Payment Coupon (OUPC)
440

Individual Income Tax
ID Type		

01

Coupon Type
M.I.	

54

Using UPPERCASE letters,
print the first three letters of
the taxpayer’s last name.

Last name



First name	

Tax Year

Address
City, State, ZIP code

Note: Pay online at tax.ohio.gov/pay
Make payment payable to: Ohio Treasurer of State
Mail to: Ohio Department of Taxation,
P.O. Box 182131, Columbus, OH 43218-2131

Taxpayer’s SSN

Amount of
Payment

222

$

,

,

00