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-R-V 5 6 Repayment of Oregon Natural Resource Credit 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 taxable event (MM/DD/YYYY) 9 10 10 11 99/99/9999/ / 11 12 12 13 Property owner first name Initial 13 14 14 15 15 XXXXXXXXXXXXXXXX X 16 Property owner last name 16 17 17 18 18 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 19 Property owner Social Security number (SSN) 19 20 20 21 21 999-99-9999 22 Property owner name (if not an individual) 22 23 23 24 24 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 25 Property owner federal employer identification number (FEIN) 25 26 26 27 27 99-9999999 28 Property owner current mailing address 28 29 29 30 30 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 31 City State ZIP code 31 32 32 33 33 XXXXXXXXXXXXXXXXXXXXXX XX XXXXX-XXXX 34 Property owner phone 34 35 35 36 36 999-999-9999 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 X Prepayment 50 51 Revenue. Write “Form OR-706-R-V,” the property owner name, the property owner 51 SSN or FEIN, the date of the taxable event, and a daytime phone on your payment. 52 Don’t mail cash. Mail the voucher and payment to: X Amended return 52 53 53 54 Oregon Department of Revenue 54 55 PO Box 14950 55 Salem OR 97309-0950 56 56 57 Enter payment amount 57 58 58 59 150-104-173 59 (Rev. 05-10-23, ver. 03) 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 |