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3                                                                                                                                                                         3
4                                                                                                                                                                         4
                                                                                                                   Oregon Department of Revenue
5                      2023 Form OR-40                                                                                                                                    5
6                      Oregon Individual Income Tax Return for Full-year Residents                                                                                        6
7                                                                                                                                                                         7
8                      Page 1 of 8  • Use UPPERCASE letters.  • Use blue or black ink.  • Print actual size (100%).  • Don’t submit photocopies or use staples.           8
9           Fiscal year ending date (MM/DD/YYYY)                                       Space for 2-D barcode—do not write in box below                                    9
10                                                           X Extension filed                                                                                            10
11          99/99/9999/       /                                                                                                                                           11
12                                                           X Form OR-24                                                                                                 12
13          X      Amended return.                                                                                                                                        13
14               If amending for an      NOL tax year (YYYY) X Form OR-243                                                                                                14
15               NOL, tax year the                                                                                                                                        15
16               NOL was generated:              9999        X Federal Form 8379                                                                                          16
17                                                                                                                                                                        17
18          X    Calculated with “as if” federal return      X Federal Form 8886                                                                                          18
19                                                                                                                                                                        19
20          X    Short-year tax election                     X Disaster relief                                                                                            20
21                                                                                                                                                                        21
22                                                                                                                                                                        22
23                                                                                                                                                                        23
24          First name                                                         Initial Date of birth (MM/DD/YYYY)                                                         24
25                                                                                                                                                                        25
26          XXXXXXXXXXXXXXXX                                                   X       99/99/9999/          /                                                             26
27          Last name                                                                                                                                                     27
28                                                                                                                                                                        28
29                                                                                                                                                                        29
            XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
30          Social Security number (SSN)                                                                                                                                  30
31                                                                                                                                                                        31
32          999-99-9999                                      X First time using this SSN (see instructions)        X Applied for ITIN             X             Deceased  32
33                                                                                                                                                                        33
34          Spouse first name                                                  Initial Spouse date of birth (MM/DD/YYYY)                                                  34
35                                                                                                                                                                        35
36          XXXXXXXXXXXXXXXX                                                   X       99/99/9999/          /                                                             36
37          Spouse last name                                                                                                                                              37
38                                                                                                                                                                        38
39                                                                                                                                                                        39
            XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
40          Spouse SSN                                                                                                                                                    40
41                                                                                                                                                                        41
42          999-99-9999                                      X First time using this SSN (see instructions)        X Applied for ITIN             X             Deceased  42
43                                                                                                                                                                        43
44          Current mailing address                                                                                                                                       44
45                                                                                                                                                                        45
46                                                                                                                                                                        46
            XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
47          City                                                                       State                       ZIP code                                               47
48                                                                                                                                                                        48
49                                                                                                                                                                        49
            XXXXXXXXXXXXXXXXXXXXXX                                                     XX                          XXXXX-XXXX
50          Country                                                                    Phone                                                                              50
51                                                                                                                                                                        51
52                                                                                                                                                                        52
            XXXXXXXXXXXXXXXXXXXXX                                                      999-999-9999
53                                                                                                                                                                        53
54          Filing Status (check only one box)                                                                                                                            54
55                                                                                                                                                                        55
56          1.   X     Single            2. X    Married filing jointly 3.     X       Married filing separately (enter spouse information above)                         56
57                                                                                                                                                                        57
58          4.   X     Head of household (with qualifying dependent)    5.     X       Qualifying surviving spouse                                                        58
59                                                                                                                                                                        59
60                                                                                                                                                                        60
61                                                                                                                                                                        61
62                                                                                                                                                                        62
                       150-101-040
63                     (Rev. 08-23-23, ver. 01)                                                                      00462301010000                                       63
64                                                                                                                                                                        64
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66                                                                                                                                                                        66

67                                                                                                                                                                                                                                       67
  1  2   68   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   68   84 85
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69                                                                                                                                                                                                                                       69
70                                                                                                                                                                                                                                       70
                                                                                                    Oregon Department of Revenue
71                     2023 Form OR-40                                                                                                                                                                                                   71
72                                                                                                                                                                                                                                       72
73                                                                                                                                                                                                                                       73
74                     Page 2 of 8   • Use UPPERCASE letters.  • Use blue or black ink.  • Print actual size (100%).  • Don’t submit photocopies or use staples.                                                                         74
75           Last name                                                                       SSN                                                                                                                                         75
76                                                                                                                                                                                                                                       76
77                                                                                                                                                                                                                                       77
             XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX                                                999-99-9999
78                                                                                                                                                                                                                                       78
79           Note: Reprint page 1 if you make changes to this page.                                                                                                                                                                      79
80                                                                                                                                                                                                                                       80
81           Exemptions                                                                                                                                                                                                                  81
82             6a.  Credits for yourself .........................................................................................................................................................................................6a. 9  82
83                                                                                                                                                                                                                                       83
84             Check boxes that apply:          X    Regular  X       Severely disabled X    Someone else can claim you as a dependent                                                                                                   84
85                                                                                                                                                                                                                                       85
86             6b.  Credits for your spouse .................................................................................................................................................................................6b.      9  86
87                                                                                                                                                                                                                                       87
88             Check boxes that apply:          X    Regular  X       Severely disabled X    Someone else can claim you as a dependent                                                                                                   88
89                                                                                                                                                                                                                                       89
90           Dependents                                                                                                                                                                                                                  90
91           List your dependents in order from youngest to oldest. If you have more than three dependents, complete Schedule OR-ADD-DEP. Include the                                                                                    91
92           schedule with your return.                                                                                                                                                                                                  92
93                                                                                                                                                                                                                                       93
94           Dependent 1: First name                          Initial Dependent 1: Last name                                                                                                                                             94
95                                                                                                                                                                                                                                       95
96                                                                                                                                                                                                                                       96
             XXXXXXXXXXXXXXXX                                 X       XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
97           Dependent 1: Date of birth (MM/DD/YYYY) Dependent 1: SSN                        Code *                                                                                                                                      97
98                                                                                                      Dependent 1: Check if child                                                                                                      98
99           99/99/9999/           /                 999-99-9999                             XX     X   has a qualifying disability                                                                                                      99
100                                                                                                                                                                                                                                      100
101          Dependent 2: First name                          Initial Dependent 2: Last name                                                                                                                                             101
102                                                                                                                                                                                                                                      102
103                                                                                                                                                                                                                                      103
             XXXXXXXXXXXXXXXX                                 X       XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
104          Dependent 2: Date of birth (MM/DD/YYYY) Dependent 2: SSN                        Code *                                                                                                                                      104
105                                                                                                     Dependent 2: Check if child                                                                                                      105
106          99/99/9999/           /                 999-99-9999                             XX     X   has a qualifying disability                                                                                                      106
107                                                                                                                                                                                                                                      107
108          Dependent 3: First name                          Initial Dependent 3: Last name                                                                                                                                             108
109                                                                                                                                                                                                                                      109
110                                                                                                                                                                                                                                      110
             XXXXXXXXXXXXXXXX                                 X       XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
111          Dependent 3: Date of birth (MM/DD/YYYY) Dependent 3: SSN                        Code *                                                                                                                                      111
112                                                                                                     Dependent 3: Check if child                                                                                                      112
113          99/99/9999/           /                 999-99-9999                             XX     X   has a qualifying disability                                                                                                      113
114                                                                                                                                                                                                                                      114
115          *Dependent relationship code (see instructions).                                                                                                                                                                            115
116                                                                                                                                                                                                                                      116
117            6c.  Total number of dependents ..................................................................................................................................................................6c.                  99 117
118                                                                                                                                                                                                                                      118
119                                                                                                                                                                                                                                      119
120            6d.  Total number of dependent children with a qualifying disability (see instructions) ................................................................................6d.                                            99 120
121                                                                                                                                                                                                                                      121
122                                                                                                                                                                                                                                      122
123            6e.  Total exemptions. Add lines 6a through 6d.................................................................................................................................. Total 6e.                             99 123
124                                                                                                                                                                                                                                      124
125                                                                                                                                                                                                                                      125
126                                                                                                                                                                                                                                      126
127                                                                                                                                                                                                                                      127
128                                                                                                                                                                                                                                      128
                       150-101-040
129                    (Rev. 08-23-23, ver. 01)                                                     00462301020000                                                                                                                       129
130                                                                                                                                                                                                                                      130
  1  2   131   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   131   84 85
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132                                                                                                                                                                                                                                      132

133                                                                                                                                                                                               133
  1  2   134   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   134   84 85
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135                                                                                                                                                                                               135
136                                                                                                                                                                                               136
137                                                                                                                                                                                               137
                                                                                                                                                               Oregon Department of Revenue
138                        2023 Form OR-40                                                                                                                                                        138
139                                                                                                                                                                                               139
140                                                                                                                                                                                               140
141                        Page 3 of 8   • Use UPPERCASE letters.  • Use blue or black ink.  • Print actual size (100%).  • Don’t submit photocopies or use staples.                              141
142          Last name                                                                                                                              SSN                                           142
143                                                                                                                                                                                               143
144                                                                                                                                                                                               144
             XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX                                                                                                       999-99-9999
145                                                                                                                                                                                               145
146          Note: Reprint page 1 if you make changes to this page.                                                                                                                               146
147          Taxable income                                                                                                                                                                       147
148            7.  Federal adjusted gross income from federal Form 1040, 1040-SR, or                                                                                                              148
149                 1040-NR, line 11; or 1040-X, line 1C (see instructions) .............................................. 7.                                  ,            999,999,999.00,   0 0 149
150                                                                                                                                                                                               150
151                                                                                                                                                                                               151
152            8.  Total additions from Schedule OR-ASC, line A5 ........................................................ 8.                                   ,            999,999,999.00,   0 0 152
153                                                                                                                                                                                               153
154                                                                                                                                                                                               154
155            9.  Income after additions. Add lines 7 and 8 .................................................................. 9.                             ,            999,999,999.00,   0 0 155
156                                                                                                                                                                                               156
157          Subtractions                                                                                                                                                                         157
158            10.  2023 federal tax liability (see instructions) ............................................................. 10.                            ,            999,999,999.00,   0 0 158
159                                                                                                                                                                                               159
160                                                                                                                                                                                               160
161            11.  Social Security amount on federal Form 1040 or 1040-SR, line 6b ......................... 11.                                              ,            999,999,999.00,   0 0 161
162                                                                                                                                                                                               162
163                                                                                                                                                                                               163
164            12.  Oregon income tax refund included in federal income ............................................. 12.                                      ,            999,999,999.00,   0 0 164
165                                                                                                                                                                                               165
166                                                                                                                                                                                               166
167            13.  Total subtractions from Schedule OR-ASC, line B7 ................................................. 13.                                     ,            999,999,999.00,   0 0 167
168                                                                                                                                                                                               168
169                                                                                                                                                                                               169
170            14.  Total subtractions. Add lines 10 through 13 ............................................................. 14.                              ,            999,999,999.00,   0 0 170
171                                                                                                                                                                                               171
172                                                                                                                                                                                               172
173            15.  Income after subtractions. Line 9 minus line 14 ....................................................... 15.                                ,            999,999,999.00,   0 0 173
174                                                                                                                                                                                               174
175          Deductions                                                                                                                                                                           175
176            16.  Oregon itemized deductions. Enter your Oregon itemized deductions from                                                                                                        176
177                 Schedule OR-A, line 23. If you are not itemizing your deductions, enter 0 .............. 16.                                               ,            999,999,999.00,   0 0 177
178                                                                                                                                                                                               178
179                                                                                                                                                                                               179
180            17.  Standard deduction. Enter your standard deduction ............................................. 17.                                        ,            999,999,999.00,   0 0 180
181                                                                                                                                                                                               181
182                 You were:            17a.    X     65 or older         17b. X Blind  Your spouse was:                                           17c. X     65 or older  17d. X  Blind         182
183                                                                                                                                                                                               183
184                  Standard            Single          Married filing jointly   Married filing separately                                     Qualifying surviving spouse Head of household     184
185                  deductions          $2,605                  $5,210           $2,605 or $0                                                          $5,210              $4,195                185
186                  See instructions if you are age 65 or older, blind, or if someone can claim you as a dependent.                                                                              186
                     See instructions if you are married filing separately.
187                                                                                                                                                                                               187
188            18.   Enter the larger of line 16 or 17 ................................................................................. 18.                   ,            999,999,999.00,   0 0 188
189                                                                                                                                                                                               189
190            19.  Oregon taxable income. Line 15 minus line 18. If line 18 is more than                                                                                                         190
191                 line 15, enter 0 .......................................................................................................... 19.            ,            999,999,999.00,   0 0 191
192                                                                                                                                                                                               192
193                                                                                                                                                                                               193
194                                                                                                                                                                                               194
195                                                                                                                                                                                               195
                           150-101-040
196                        (Rev. 08-23-23, ver. 01)                                                                                                            00462301030000                     196
  1  2   197   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   197   84 85
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198                                                                                                                                                                                               198

199                                                                                                                                                                                     199
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201                                                                                                                                                                                     201
202                                                                                                                                                                                     202
203                                                                                                                                                                                     203
                                                                                                                                                        Oregon Department of Revenue
204                        2023 Form OR-40                                                                                                                                              204
205                                                                                                                                                                                     205
206                                                                                                                                                                                     206
207                        Page 4 of 8  • Use UPPERCASE letters.  • Use blue or black ink.  • Print actual size (100%).  • Don’t submit photocopies or use staples.                     207
208          Last name                                                                                                                              SSN                                 208
209                                                                                                                                                                                     209
210                                                                                                                                                                                     210
211          XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX                                                                                                       999-99-9999                         211
212          Note: Reprint page 1 if you make changes to this page.                                                                                                                     212
213                                                                                                                                                                                     213
214          Oregon tax                                                                                                                                                                 214
215            20.  Tax (see instructions) ................................................................................................ 20.         ,          999,999,999.00,  0 0 215
216                                                                                                                                                                                     216
217              Check the appropriate box if you’re using an alternative method to calculate your tax:                                                                                 217
218                                                                                                                                                                                     218
219              20a.      X    Schedule OR-FIA-40         20b.   X  Worksheet FCG        20c.  X                                               Schedule OR-PTE-FY                      219
220                                                                                                                                                                                     220
221                                                                                                                                                                                     221
222            21.  Interest on certain installment sales ......................................................................... 21.                 ,          999,999,999.00,  0 0 222
223                                                                                                                                                                                     223
224                                                                                                                                                                                     224
225            22.   Total tax recaptures from Schedule OR-ASC, line C5 .............................................. 22.                              ,          999,999,999.00,  0 0 225
226                                                                                                                                                                                     226
227                                                                                                                                                                                     227
228            23.   Total additions to tax. Line 21 plus line 22 ................................................................ 23.                  ,          999,999,999.00,  0 0 228
229                                                                                                                                                                                     229
230                                                                                                                                                                                     230
231            24.  Total tax before credits. Add lines 20 and 23 ........................................................... 24.                       ,          999,999,999.00,  0 0 231
232                                                                                                                                                                                     232
233          Standard and carryforward credits                                                                                                                                          233
234            25.  Exemption credit. If the amount on line 7 is $100,000 or less, multiply your total                                                                                  234
235                 exemptions on line 6e by $236. Otherwise, see instructions ................................... 25.                                  ,          999,999,999.00,  0 0 235
236                                                                                                                                                                                     236
237                                                                                                                                                                                     237
238            26.  Political contribution credit.  See limits in instructions ........................................... 26.                          ,          999,999,999.00,  0 0 238
239                                                                                                                                                                                     239
240                                                                                                                                                                                     240
241            27.  Total standard credits from Schedule OR-ASC, line D16 ......................................... 27.                                 ,          999,999,999.00,  0 0 241
242                                                                                                                                                                                     242
243                                                                                                                                                                                     243
244            28.  Total standard credits. Add lines 25 through 27 ....................................................... 28.                         ,          999,999,999.00,  0 0 244
245                                                                                                                                                                                     245
246            29.  Tax minus standard credits. Line 24 minus line 28. If line 28 is more than                                                                                          246
247                 line 24, enter 0 .......................................................................................................... 29.     ,          999,999,999.00,  0 0 247
248                                                                                                                                                                                     248
249            30.  Total carryforward credits used this year from Schedule OR-ASC, line E9.                                                                                            249
250                 Line 30 can’t be more than line 29 (see Schedule OR-ASC instructions) ................ 30.                                          ,          999,999,999.00,  0 0 250
251                                                                                                                                                                                     251
252                                                                                                                                                                                     252
253          31.   Tax after standard and carryforward credits. Line 29 minus line 30 ........................... 31.                                   ,          999,999,999.00,  0 0 253
254                                                                                                                                                                                     254
255                                                                                                                                                                                     255
256                                                                                                                                                                                     256
257                                                                                                                                                                                     257
258                                                                                                                                                                                     258
259                                                                                                                                                                                     259
260                                                                                                                                                                                     260
261                                                                                                                                                                                     261
                           150-101-040
262                        (Rev. 08-23-23, ver. 01)                                                                                                     00462301040000                  262
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264                                                                                                                                                                                     264

265                                                                                                                                                                                     265
  1  2   266   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   266   84 85
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267                                                                                                                                                                                     267
268                                                                                                                                                                                     268
                                                                                                                                                        Oregon Department of Revenue
269                       2023 Form OR-40                                                                                                                                               269
270                                                                                                                                                                                     270
271                                                                                                                                                                                     271
272                       Page 5 of 8      • Use UPPERCASE letters.  • Use blue or black ink.  • Print actual size (100%).  • Don’t submit photocopies or use staples.                  272
273          Last name                                                                                                                         SSN                                      273
274                                                                                                                                                                                     274
275                                                                                                                                                                                     275
276          XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX                                                                                                  999-99-9999                              276
277          Note: Reprint page 1 if you make changes to this page.                                                                                                                     277
278                                                                                                                                                                                     278
279          Payments and refundable credits                                                                                                                                            279
280            32.  Oregon income tax withheld.     Include a copy of your Forms W-2 and 1099 ........  32.                                             ,  999,999,999.00,          0 0 280
281                                                                                                                                                                                     281
282                                                                                                                                                                                     282
283            33.  Amount applied from your prior year’s tax refund .................................................... 33.                           ,  999,999,999.00,          0 0 283
284                                                                                                                                                                                     284
285            34.  Estimated tax payments for 2023. Include all estimated payments you made                                                                                            285
286                 by April 15, 2024, including any extension payment (see instructions).                                                                                              286
287                 Do not include the amount on line 33 ....................................................................... 34.                    ,  999,999,999.00,          0 0 287
288                                                                                                                                                                                     288
289                                                                                                                                                                                     289
290            35.  Tax payments from a pass-through entity ................................................................ 35.                        ,  999,999,999.00,          0 0 290
291                                                                                                                                                                                     291
292                                                                                                                                                                                     292
293            36.  Earned income credit (see instructions) .................................................................... 36.                    ,  999,999,999.00,          0 0 293
294                                                                                                                                                                                     294
295                                                                                                                                                                                     295
296            37.   Oregon Kids Credit (see instructions) ....................................................................... 37.                  ,  999,999,999.00,          0 0 296
297                                                                                                                                                                                     297
298            38.  Kicker (Oregon surplus credit). Enter your kicker credit amount                                                                                                     298
299                 (see instructions). If you elect to donate your kicker to the                                                                                                       299
300                 State School Fund, enter 0 and see line 55 .......................................................... 38.                           ,  999,999,999.00,          0 0 300
301                                                                                                                                                                                     301
302                                                                                                                                                                                     302
303            39.  Total refundable credits from Schedule OR-ASC, line F7 ........................................ 39.                                 ,  999,999,999.00,          0 0 303
304                                                                                                                                                                                     304
305                                                                                                                                                                                     305
306            40.  Total payments and refundable credits. Add lines 32 through 39 ............................ 40.                                     ,  999,999,999.00,          0 0 306
307                                                                                                                                                                                     307
308          Tax to pay or refund                                                                                                                                                       308
309            41.  Overpayment of tax. If line 31 is less than line 40, you overpaid.                                                                                                  309
310                 Line 40 minus line 31 ................................................................................................ 41.          ,  999,999,999.00,          0 0 310
311                                                                                                                                                                                     311
312            42.  Net tax. If line 31 is more than line 40, you have tax to pay.                                                                                                      312
313                 Line 31 minus line 40 ................................................................................................ 42.          ,  999,999,999.00,          0 0 313
314                                                                                                                                                                                     314
315                                                                                                                                                                                     315
316            43.  Penalty and interest for filing or paying late (see instructions) ................................. 43.                             ,  999,999,999.00,          0 0 316
317                                                                                                                                                                                     317
318                                                                                                                                                                                     318
319            44.  Interest on underpayment of estimated tax.      Include Form OR-10 ......................... 44.                                    ,  999,999,999.00,          0 0 319
320                                                                                                                                                                                     320
321                                                                                                                                                                                     321
322              Exception number from Form OR-10, line 1           44a.    9         Check box if you annualized:                                 44b. X                               322
323                                                                                                                                                                                     323
324                                                                                                                                                                                     324
325                                                                                                                                                                                     325
326                                                                                                                                                                                     326
                          150-101-040
327                       (Rev. 08-23-23, ver. 01)                                                                                                      00462301050000                  327
328                                                                                                                                                                                     328
  1  2   329   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   329   84 85
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330                                                                                                                                                                                     330

331                                                                                                                                                                                   331
  1  2   332   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   332   84 85
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333                                                                                                                                                                                   333
334                                                                                                                                                                                   334
                                                                                                                                                      Oregon Department of Revenue
335                       2023 Form OR-40                                                                                                                                             335
336                                                                                                                                                                                   336
337                                                                                                                                                                                   337
338                       Page 6 of 8    • Use UPPERCASE letters.  • Use blue or black ink.  • Print actual size (100%).  • Don’t submit photocopies or use staples.                  338
339          Last name                                                                                                                            SSN                                 339
340                                                                                                                                                                                   340
341                                                                                                                                                                                   341
342          XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX                                                                                                     999-99-9999                         342
343          Note: Reprint page 1 if you make changes to this page.                                                                                                                   343
344                                                                                                                                                                                   344
345           Tax to pay or refund (continued)                                                                                                                                        345
346            45.  Total penalty and interest due. Add lines 43 and 44 ................................................ 45.                          ,       999,999,999.00,     0 0 346
347                                                                                                                                                                                   347
348           46.   Net tax including penalty and interest.                                                                                                                           348
349                 Line 42 plus line 45 ..................................................This is the amount you owe. 46.                            ,       999,999,999.00,     0 0 349
350                                                                                                                                                                                   350
351            47.  Overpayment less penalty and interest.                                                                                                                            351
352                 Line 41 minus line 45 ...............................................................This is your refund. 47.                     ,       999,999,999.00,     0 0 352
353                                                                                                                                                                                   353
354            48.  Estimated tax. Fill in the portion of line 47 you want applied to your open                                                                                       354
355                 estimated tax account .............................................................................................. 48.          ,       999,999,999.00,     0 0 355
356                                                                                                                                                                                   356
357                                                                                                                                                                                   357
358            49.  Charitable checkoff donations from Schedule OR-DONATE, line 30 ....................... 49.                                        ,       999,999,999.00,     0 0 358
359                                                                                                                                                                                   359
360                                                                                                                                                                                   360
361            50.  Political party $3 checkoff ........................................................................................ 50.          ,       999,999,999.00,     0 0 361
362                                                                                                                                                                                   362
363                                                                                                                                                                                   363
364                 Party code:          50a.  You             999                           50b.  Spouse             999                                                             364
365                                                                                                                                                                                   365
366            51.  Oregon 529 college savings plan deposits from Schedule OR-529, line 5 .............. 51.                                          ,       999,999,999.00,     0 0 366
367                                                                                                                                                                                   367
368            52.  Total. Add lines 48 through 51. Line 52 can’t be more than your                                                                                                   368
369                 refund on line 47 ....................................................................................................... 52.     ,       999,999,999.00,     0 0 369
370                                                                                                                                                                                   370
371                                                                                                                                                                                   371
372            53.  Net refund.Line 47 minus line 52 ....................................This is your net refund. 53.                                 ,       999,999,999.00,     0 0 372
373                                                                                                                                                                                   373
374          Direct deposit                                                                                                                                                           374
375            54.  For direct deposit of your refund, see instructions. Check the box if the final deposit destination is outside the United States:                X                375
376                                                                                                                                                                                   376
377                 Type of account:                                                                                                                                                  377
378                                                    Account information:                                                                                                           378
379                 X     Checking or                  Routing number                                                 Account number                                                  379
380                                                                                                                                                                                   380
381                 X     Savings                                     999999999                                       XXXXXXXXXXXXXXXXX                                               381
382                                                                                                                                                                                   382
383                                                                                                                                                                                   383
384          Kicker donation                                                                                                                                                          384
385            55.  If you elect to donate your kicker to the State School Fund, check this box. .........  55a.                                  X                                   385
386                                                                                                                                                                                   386
387              Complete the kicker worksheet in the instructions and enter the                                                                                                      387
388                 amount here. ............................................................This election is irrevocable. 55b.                       ,       999,999,999.00,     0 0 388
389                                                                                                                                                                                   389
390                                                                                                                                                                                   390
391                                                                                                                                                                                   391
392                                                                                                                                                                                   392
                          150-101-040
393                       (Rev. 08-23-23, ver. 01)                                                                                                    00462301060000                  393
394                                                                                                                                                                                   394
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396                                                                                                                                                                                   396

397                                                                                                                                                                       397
  1  2   398   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   398   84 85
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399                                                                                                                                                                       399
400                                                                                                                                                                       400
                                                                                                                 Oregon Department of Revenue
401                     2023 Form OR-40                                                                                                                                   401
402                                                                                                                                                                       402
403                                                                                                                                                                       403
404                     Page 7 of 8 • Use UPPERCASE letters.  • Use blue or black ink.  • Print actual size (100%).  • Don’t submit photocopies or use staples.           404
405          Last name                                                                                SSN                                                                 405
406                                                                                                                                                                       406
407                                                                                                                                                                       407
             XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX                                                         999-99-9999
408                                                                                                                                                                       408
409          Note: Reprint page 1 if you make changes to this page.                                                                                                       409
410          Sign here.  Under penalty of false swearing, I declare that the information in this return and any attachments is true, correct and complete.                410
411                                                                                                                                                                       411
412            Your signature                                                                                                                                             412
413                                                                                                                                                                       413
414          X                                                                                                                                                            414
415          Date (MM/DD/YYYY)                                                                                                                                            415
416                                                                                                                                                                       416
417          99/99/9999/         /                                                                                                                                        417
418            Spouse signature                                                                                                                                           418
419                                                                                                                                                                       419
420          X                                                                                                                                                            420
421          Date (MM/DD/YYYY)                                                                                                                                            421
422                                                                                                                                                                       422
423          99/99/9999/         /                                                                                                                                        423
424            Signature of preparer other than taxpayer                                                                                                                  424
425                                                                                                                                                                       425
426          X                                                                                                                                                            426
427          Date (MM/DD/YYYY)                           Preparer phone                                          Preparer license number                                  427
428                                                                                                                                                                       428
429          99/99/9999/         /                       999-999-9999                                            XXXXXXXXXX                                               429
430          Preparer first name                            Initial     Preparer last name                                                                                430
431                                                                                                                                                                       431
432                                                                                                                                                                       432
             XXXXXXXXXXXXXXXX                               X           XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
433          Preparer address                                                                                                                                             433
434                                                                                                                                                                       434
435                                                                                                                                                                       435
             XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
436          City                                                                                          State ZIP code                                                 436
437                                                                                                                                                                       437
438                                                                                                                                                                       438
             XXXXXXXXXXXXXXXXXXXXXX                                                                        XX    XXXXX-XXXX
439          Signing this return does not grant your preparer the right to represent you or make decisions on your behalf. For more information, see the instructions for 439
440          the Tax Information Authorization and Power of Attorney for Representation form on our website.                                                              440
441                                                                                                                                                                       441
442          Important: Include a copy of your federal Form 1040, 1040-SR, 1040-X, or 1040-NR. We may adjust your return without it.                                      442
443                                                                                                                                                                       443
444          Pay the amount due (shown on line 45)                                                                                                                        444
445          • Online: www.oregon.gov/dor.                                                                                                                                445
446          • By mail: Payable to the Oregon Department of Revenue.Write “2023 Oregon Form OR-40” and the last four digits of your SSN or ITIN on your                   446
447            check or money order. If you include a payment with your return, don’t include Form OR-40-V payment voucher.                                               447
448                                                                                                                                                                       448
449          Mail your return                                                                                                                                             449
450          • Non-2-D barcode. If the large 2-D barcode box on the first page of this form is blank:                                                                     450
451            —  Mail tax-due returns to: Oregon Department of Revenue, PO Box 14555, Salem OR 97309-0940.                                                               451
452            —  Mail refund and no-tax-due returns to: Oregon Department of Revenue, PO Box 14700, Salem OR 97309-0930.                                                 452
453          • 2-D barcode. If the large 2-D barcode box on the first page of this form is filled in:                                                                     453
454            —  Mail tax-due returns to: Oregon Department of Revenue, PO Box 14720, Salem OR 97309-0463.                                                               454
455            —  Mail refund and no-tax-due returns to: Oregon Department of Revenue, PO Box 14710, Salem OR 97309-0460.                                                 455
456                                                                                                                                                                       456
457                                                                                                                                                                       457
458                                                                                                                                                                       458
                        150-101-040
459                     (Rev. 08-23-23, ver. 01)                                                                 00462301070000                                           459
460                                                                                                                                                                       460
  1  2   461   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   461   84 85
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462                                                                                                                                                                       462

463                                                                                                                                                               463
  1  2   464   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   464   84 85
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465                                                                                                                                                               465
466                                                                                                                                                               466
                                                                                    Oregon Department of Revenue
467                    2023 Form OR-40                                                                                                                            467
468                                                                                                                                                               468
469                                                                                                                                                               469
470                    Page 8 of 8 • Use UPPERCASE letters.  • Use blue or black ink.  • Print actual size (100%).  • Don’t submit photocopies or use staples.    470
471          Last name                                                          SSN                                                                               471
472                                                                                                                                                               472
473                                                                                                                                                               473
             XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX                                   999-99-9999
474                                                                                                                                                               474
475          Note: Reprint page 1 if you make changes to this page.                                                                                               475
476          Amended statement. Complete this section only if you’re amending your 2023 return or filing with a new SSN.                                          476
477                                                                                                                                                               477
478          If filing an amended return, use this space to explain what you’re changing. Include the return line numbers and the reason for each change. If your 478
479          filing status has changed, explain why. Include all supporting forms and schedules when you file your amended return, even if you haven’t changed    479
480          anything on them.                                                                                                                                    480
481                                                                                                                                                               481
482          If filing with a new SSN, enter your former identification number.                                                                                   482
483                                                                                                                                                               483
484                                                                                                                                                               484
             XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
485                                                                                                                                                               485
             XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
486                                                                                                                                                               486
             XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
487                                                                                                                                                               487
             XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
488                                                                                                                                                               488
             XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
489                                                                                                                                                               489
             XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
490                                                                                                                                                               490
             XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
491                                                                                                                                                               491
             XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
492                                                                                                                                                               492
             XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
493                                                                                                                                                               493
             XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
494                                                                                                                                                               494
             XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
495                                                                                                                                                               495
             XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
496                                                                                                                                                               496
             XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
497                                                                                                                                                               497
             XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
498                                                                                                                                                               498
             XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
499                                                                                                                                                               499
             XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
500                                                                                                                                                               500
             XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
501                                                                                                                                                               501
             XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
502                                                                                                                                                               502
503                                                                                                                                                               503
504                                                                                                                                                               504
505                                                                                                                                                               505
506                                                                                                                                                               506
507                                                                                                                                                               507
508                                                                                                                                                               508
509                                                                                                                                                               509
510                                                                                                                                                               510
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512                                                                                                                                                               512
513                                                                                                                                                               513
514                                                                                                                                                               514
515                                                                                                                                                               515
516                                                                                                                                                               516
517                                                                                                                                                               517
518                                                                                                                                                               518
519                                                                                                                                                               519
520                                                                                                                                                               520
521                                                                                                                                                               521
522                                                                                                                                                               522
523                                                                                                                                                               523
524                                                                                                                                                               524
                       150-101-040
525                    (Rev. 08-23-23, ver. 01)                                     00462301080000                                                                525
526                                                                                                                                                               526
  1  2   527   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   527   84 85
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528                                                                                                                                                               528