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5                                                                                                 Oregon Department of Revenue                                        5
                   Form OR-706-EXT
6                  Application for Extension of Time to File a Return and/or                                                                                          6
7                  Pay Oregon Estate Transfer Tax                                                                                                                     7
8                  Page 1 of 3  • Use UPPERCASE letters.  • Use blue or black ink.  • Print actual size (100%).  • Don’t submit photocopies or use staples.           8
9           Part 1. Decedent information                                                                                                                              9
10          Decedent first name                                  Initial Last name                                                                          , Estate  10
11                                                                                                                                                                    11
12                                                                                                                                                                    12
            XXXXXXXXXXXXXXXX                                     X       XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
13          Decedent Social Security number (DSSN)               Date of birth (MM/DD/YYYY) Date of death (MM/DD/YYYY)                                                13
14                                                                                                                                                                    14
15          999-99-9999                                          99/99/9999/ /              99/99/9999/    /                                                          15
16          Decedent domicile (legal residence) at time of death                                                                                                      16
17          City                                                                            State ZIP code                                                            17
18                                                                                                                                                                    18
19          XXXXXXXXXXXXXXXXXXXXXX                                                          XX    XXXXX-XXXX -                                                        19
20          County                                                                                                                                                    20
21                                                                                                                                                                    21
22                                                                                                                                                                    22
            XXXXXXXXXXXXXXXXXXXXXXXXX
23          Country (if domiciled in a foreign country)                                     Form OR-706 due date (MM/DD/YYYY)                                         23
24                                                                                                                                                                    24
25          XXXXXXXXXXXXXXXXXXXXX                                                           99/99/9999/    /                                                          25
26                                                                                                                                                                    26
27          Part 2. Executor information                                                                                                                              27
28          Executor name                                                                                                                                             28
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            XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
31          SSN                                                  FEIN                       Phone                                                                     31
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            999-99-9999                                          99-9999999                 999-999-9999
34          Title                                                                                                                                                     34
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            XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
37          Mailing address                                                                                                                                           37
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            XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
40          City                                                                            State ZIP code                                                            40
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42          XXXXXXXXXXXXXXXXXXXXXX                                                          XX    XXXXX-XXXX -                                                        42
43          Email                                                                                                                                                     43
44                                                                                                                                                                    44
45                                                                                                                                                                    45
            XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
46                                                                                                                                                                    46
47          Part 3. Application filer information (if not executor)                                                                                                   47
48          Name                                                                                                                                                      48
49                                                                                                                                                                    49
50                                                                                                                                                                    50
            XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
51          Title                                                                                                                                                     51
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            XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
54          Phone                                                                                                                                                     54
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            999-999-9999
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                   150-104-002
63                 (Rev. 06-20-23, ver. 01)                                                       22210001010000                                                      63
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70                                                                                                                                                                                        70
71                 Form OR-706-EXT                                                                                       Oregon Department of Revenue                                     71
72                                                                                                                                                                                        72
73                                                                                                                                                                                        73
74                 Page 2 of 3       • Use UPPERCASE letters.  • Use blue or black ink.  • Print actual size (100%).  • Don’t submit photocopies or use staples.                          74
75           Part 4. Application for extension of time to file Form OR-706                                                                                                                75
76           Select only one option. Requests made in this section do not extend the time to pay.                                                                                         76
77                                                                                                                                                                                        77
78           X     Automatic extension. Check here if you’re applying for a timely automatic 6-month extension of time to file, and the time for filing has not passed.                   78
79                                                                                                                                                                                        79
80           X     Extension for cause / Form OR-706-EXT not filed in time for automatic extension. Check here if you are applying for an extension of time to                            80
81                 file, based on good and sufficient cause, and the time for filing has passed. You must include a statement explaining in detail why an application                     81
82                 for automatic extension was not timely made, why it is impossible or impractical to file the return by the due date, and the specific reasons why                      82
83                 you have good and sufficient cause for not requesting the automatic extension. If granted, the 6-month extension for cause runs from the original                      83
84                 due date of the return. See instructions.                                                                                                                              84
85                                                                                                                                                                                        85
86           X     Additional extension. Check here if you’re an executor out of the country applying for an extension of time beyond the 6-month automatic extension                     86
87                 to file. You must include a statement explaining in detail why it was impossible or impractical to file the return by the due date. See instructions.                  87
88                                                                                                                             Enter extension date requested (MM/DD/YYYY)                88
89                                                                                                                                                                                        89
90                                                                                                                             99/99/9999/    /                                           90
91                                                                                                                                                                                        91
92           Part 5. Application for extension of time to pay                                                                                                                             92
93           You must include a written statement explaining in detail why you’re unable to pay the tax due by the original return due date. Your request will be denied if a written     93
94           statement isn’t included. We will review your written statement to determine if it meets the requirements for reasonable cause as explained in OAR 150-118-0150.             94
95                                                                                                                                                                                        95
96           Select only one option. Requests made in this section do not extend the time to file.                                                                                        96
97                                                                                                                                                                                        97
98           X     1 year or less. Check here if you’re applying for up to a 1-year extension of time to pay for the above-named decedent. This request doesn’t extend                    98
99                 the time to file Form OR-706.                                                                                                                                          99
100                                                                                                                                                                                       100
101          X     More than 1 year up to 14 years. Check here if you’re applying for more than 1 year, and up to 14 years, extension of time to pay for the above-                       101
102                named decedent. This request doesn’t extend the time to file Form OR-706.                                                                                              102
103                                                                                                                                                                                       103
104                We will contact you to discuss the length of the extension of time to pay and the process for securing acceptable collateral. See instructions.                        104
105                                                                                                                                                                                       105
106          Part 6. Payment to accompany extension request                                                                                                                               106
107                                                                                                                                                                                       107
108            1.  Amount of Oregon Estate Transfer Tax estimated to be due ...................1.                      , ,     99,999,999,999.00,                                     0 0 108
109                                                                                                                                                                                       109
110                                                                                                                                                                                       110
111            2.  Amount of cash shortage .........................................................................2. , ,     99,999,999,999.00,                                     0 0 111
112                                                                                                                                                                                       112
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114            3.  Balance due (subtract line 2 from line 1) (see instructions) .....................3.                , ,     99,999,999,999.00,                                     0 0 114
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                   150-104-002
129                (Rev. 06-20-23, ver. 01)                                                                                    22210001020000                                             129
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70                                                                                                                                                                              70
71                    Form OR-706-EXT                                                                                                   Oregon Department of Revenue            71
72                                                                                                                                                                              72
73                                                                                                                                                                              73
74                    Page 3 of 3        • Use UPPERCASE letters.  • Use blue or black ink.  • Print actual size (100%).  • Don’t submit photocopies or use staples.            74
75           Part 7. Signature and verification                                                                                                                                 75
76           If filed by executor—Under penalties of false swearing, I declare that I’m an executor of the estate of the above-named decedent and that to the best of my knowl- 76
77           edge and belief, the statements made herein and included are true and correct.                                                                                     77
78           Executor signature                                                                                                                                                 78
79                                                                                                                                                                              79
80           X                                                                                                                                                                  80
81           Date (MM/DD/YYYY)                                                                                                                                                  81
82                                                                                                                                                                              82
83           99/99/9999/        /                                                                                                                                               83
84                                                                                                                                                                              84
85           Application filer, if filed by someone other than the executor—Under penalties of false swearing, I declare that to the best of my knowledge and belief,           85
86           the statements made herein and included are true and correct, that I’m authorized by an executor to file this application.                                         86
87           Application filer signature                                                                                                                                        87
88                                                                                                                                                                              88
89           X                                                                                                                                                                  89
90           Date (MM/DD/YYYY)                                                                                                                                                  90
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92           99/99/9999/        /                                                                                                                                               92
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121          Mail to: Oregon Department of Revenue                                                                                                                              121
122          Extension with payment: PO Box 14555, Salem OR 97309-0940                                                                                                          122
123          Extension without payment: PO Box 14110, Salem OR 97309-0910                                                                                                       123
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                      150-104-002
129                   (Rev. 06-20-23, ver. 01)                                                                                          22210001030000                          129
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