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5                                                                                                                      Oregon Department of Revenue                        5
                         2023 Form OR-CAT-EXT
6                        Application for Extension of Time to File an Oregon Corporate Activity Tax Return                                                                 6
7                                                                                                                                                                          7
8                        Page 1 of 2 • Use UPPERCASE letters.  • Use blue or black ink.  • Print actual size (100%).  • Don’t submit photocopies or use staples.           8
9                                                                                                                                                                          9
10          Save time and paper by completing this request through Revenue Online, at  www.oregon.gov/dor.                                                                 10
11                                                                                                                                                                         11
12          To request a six-month extension of time to file your 2023 Oregon Corporate Activity tax return, you must submit a completed                                   12
13          application before the 15th day of the fourth month following the end of the tax year.                                                                         13
14                                                                                                                                                                         14
15          You must be registered for Oregon Corporate Activity tax (CAT) prior to submitting this form. Complete the tax payment worksheet                               15
16          below to determine if you owe CAT for 2023. An extension of time to file your return isn’t an extension of time to pay your CAT. If                            16
17          you don’t pay all the CAT due by the 15th day of the fourth month following the end of the tax year, you’ll owe interest on the unpaid                         17
18          balance. You may also owe a late payment penalty.                                                                                                              18
19          Payments can be made using one of these options:                                                                                                               19
20          •  Electronic payment using Revenue Online.                                                                                                                    20
21          •  By mail. If paying by mail, send each payment with a Form OR-CAT-V voucher.                                                                                 21
22          •  ACH Credit. Submit your application by going to Revenue Online and clicking on Apply for ACH credit.                                                        22
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25                                                                                                                                                                         25
26          Tax payment worksheet                                                                                                                                          26
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28            1.  CAT for 2023. This is the amount you expect to enter on                                                                                                  28
29              Form OR-CAT, line 16 ............................................................................. 1., , 99,999,999,999.00,                      0 0       29
30                                                                                                                                                                         30
31                                                                                                                                                                         31
32            2.  Total CAT payments for 2023. This is the amount you expect to                                                                                            32
33              enter on Form OR-CAT, line 17 ............................................................... 2.     , , 99,999,999,999.00,                      0 0       33
34                                                                                                                                                                         34
35              — If the amount on line 2 is more than the amount on line 1, you don’t owe CAT.                                                                            35
36              — If the amount on line 1 is more than the amount on line 2, continue to line 3.                                                                           36
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38                                                                                                                                                                         38
39            3.  CAT to pay with application for an extension. Line 1 minus line 2 ......... 3.                     , , 99,999,999,999.00,                      0 0       39
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                         150-106-006
63                       (Rev. 06-30-23, ver. 01)                                                                      20562301010000                                      63
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71                2023 Form OR-CAT-EXT                                                                   Oregon Department of Revenue                             71
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73                                                                                                                                                                73
74                Page 2 of 2         • Use UPPERCASE letters.  • Use blue or black ink.  • Print actual size (100%).  • Don’t submit photocopies or use staples. 74
75           Legal name of designated CAT entity (sole proprietor—complete the next line)                                                                         75
76                                                                                                                                                                76
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             XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
78           First name (if sole proprietorship)                     Initial Last name                                                                            78
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             XXXXXXXXXXXXXXXX                                        X       XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
81           Federal employer identification number (FEIN)     Social Security number (SSN)                                                                       81
82                                                                                                                                                                82
83                                                                                                                                                                83
             99-9999999                                        999-99-9999
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85           Are you filing on a calendar year or fiscal year? Tax year begin (MM/DD/YYYY)         Tax year end (MM/DD/YYYY)                                      85
86                                                                                                                                                                86
87           X    Calendar year       X          Fiscal year   99/99/9999/                /        99/99/9999/    /                                               87
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89                                                                                                                                                                89
90           Signature of taxpayer or officer                                                                                                                     90
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92           X                                                                                                                                                    92
93           Date (MM/DD/YYYY)                                                                                                                                    93
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95           99/99/9999/            /                                                                                                                             95
96           First name of officer                                   Initial Last name of officer                                                                 96
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             XXXXXXXXXXXXXXXX                                        X       XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
99           Title of officer                                                                                                                                     99
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             XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
102                                                                                                                                                               102
103          Signature of preparer other than taxpayer                                                                                                            103
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105          X                                                                                                                                                    105
106          Date (MM/DD/YYYY)                                 Phone                                     License number of preparer                               106
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108          99/99/9999/            /                          999-999-9999                              XXXXXXXXXX                                               108
109          First name of preparer                                  Initial Last name of preparer                                                                109
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             XXXXXXXXXXXXXXXX                                        X       XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
112          Address of preparer                                                                                                                                  112
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             XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
115          City                                                                                  State ZIP code                                                 115
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117          XXXXXXXXXXXXXXXXXXXXXX                                                                XX    XXXXX-XXXX -                                             117
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119          If applying by mail, send your application to: Oregon Department of Revenue, PO Box 14950, Salem OR 97309-0950.                                      119
120          Include a Form OR-CAT-V, payment voucher, if you are making a payment.                                                                               120
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                  150-106-006
129               (Rev. 06-30-23, ver. 01)                                                               20562301020000                                           129
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