Enlarge image | 1 1 1 2 2 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 Form All layers With grid &2 data 84 85 3 4 82 83 3 3 4 4 Oregon Department of Revenue 5 Form OR-706-V 5 6 Oregon Estate Transfer Tax Payment Voucher 6 7 7 8 Page 1 of 1 • Use UPPERCASE letters. • Use blue or black ink. • Print actual size (100%). • Don’t submit photocopies or use staples. 8 9 Date of death (MM/DD/YYYY) 9 10 10 11 99/99/9999/ / 11 12 12 13 Decedent first name Initial 13 14 14 15 15 XXXXXXXXXXXXXXXX X 16 Decedent last name 16 17 17 18 18 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 19 Decedent Social Security number (DSSN) 19 20 20 21 21 999-99-9999 22 22 23 Executor name 23 24 24 25 25 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 26 Executor mailing address 26 27 27 28 28 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 29 City State ZIP code 29 30 30 31 31 XXXXXXXXXXXXXXXXXXXXXX XX XXXXX-XXXX 32 Executor phone 32 33 33 34 34 999-999-9999 35 35 36 36 37 37 38 38 39 39 40 40 41 41 42 42 43 43 44 44 45 45 46 Payment type (check one) 46 47 47 48 X Original return 48 49 Use this voucher only if you’re sending a payment separate from a return. Make 49 50 your check, money order, or cashier’s check payable to the Oregon Department of Prepayment 50 51 Revenue. Write “Form OR-706-V,” the Decedent name, the DSSN, the date of death, X 51 and a daytime phone for the executor on your payment. Don’t mail cash. Mail the 52 voucher and payment to: X Amended return 52 53 53 54 Oregon Department of Revenue 54 PO Box 14950 55 Salem OR 97309-0950 55 56 56 57 Enter payment amount 57 58 58 59 150-104-172 59 (Rev. 05-10-23, ver. 05) 60 9999 99 $ , 99,999,999.00, 0 0 60 61 61 62 62 63 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 63 64 64 1 2 65 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 65 84 85 3 4 82 83 66 66 |