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5 2024 Schedule OR-OC-4 Office use only 5
6 Page 1 of 1, 150-101-149 Oregon Department of Revenue 20722401010000 6
7 (Rev. 09-03-24 ver. 01) 7
8 CPAR Adjustments Report for C Corporation Owners 8
9 9
10 10
11 Submit original form—do not submit photocopy. 11
12 Pass-through entity name Federal employer identification number (FEIN) 12
13 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 99-9999999– 13
14 Owner information (see instructions) 14
15 1. Corporation name FEIN Ownership percentage 15
16 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 99-9999999– 999.9999. % 16
17 Share of federal CPAR adjustments 17
18 18
99,999,999,999.00.00
19 19
20 Share of Oregon-source CPAR adjustments (a) CPAR tax 20
21 21
99,999,999,999.00.00 99,999,999,999.00.00
22 22
23 2. Corporation name FEIN Ownership percentage 23
24 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 99-9999999– 999.9999. % 24
25 Share of federal CPAR adjustments 25
26 26
99,999,999,999.00.00
27 27
28 Share of Oregon-source CPAR adjustments (a) CPAR tax 28
29 29
99,999,999,999.00.00 99,999,999,999.00.00
30 30
31 3. Corporation name FEIN Ownership percentage 31
32 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 99-9999999– 999.9999. % 32
33 Share of federal CPAR adjustments 33
34 34
99,999,999,999.00.00
35 35
36 Share of Oregon-source CPAR adjustments (a) CPAR tax 36
37 37
99,999,999,999.00.00 99,999,999,999.00.00
38 38
39 4. Corporation name FEIN Ownership percentage 39
40 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 99-9999999– 999.9999. % 40
41 Share of federal CPAR adjustments 41
42 42
99,999,999,999.00.00
43 43
44 Share of Oregon-source CPAR adjustments (a) CPAR tax 44
45 45
99,999,999,999.00.00 99,999,999,999.00.00
46 46
47 5. Corporation name FEIN Ownership percentage 47
48 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 99-9999999– 999.9999. % 48
49 Share of federal CPAR adjustments 49
50 50
99,999,999,999.00.00
51 51
52 Share of Oregon-source CPAR adjustments (a) CPAR tax 52
53 53
99,999,999,999.00.00 99,999,999,999.00.00
54 54
55 Total field (a) 55
56 6. Total CPAR tax 56
99,999,999,999.00.00
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60 60
61 Include this schedule with your Form OR-OC . 61
62 Use additional copies of this page for additional C corporations. 62
63 If using more than one page, total all pages on line 6 of the first page. Page ______ 999 of 999_______ 63
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