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5           2023 Schedule OR-PTE-FY                                                                                                                Office use only        5
6           Page 1 of 2, 150-101-365                    Oregon Department of Revenue                            18122301010000                                            6
7           (Rev. 08-10-23, ver. 01)                                                                                                                                      7
8           Qualified Business Income Reduced                                                                                                                             8
9           Tax Rate Schedule for Oregon Full-year Residents                                                                                                              9
10                                                                                                                                                                        10
11                                                         Submit original form—do not submit photocopy                                                                   11
12          First name                          Initial    Last name                                                                    Social Security number (SSN)      12
13          XXXXXXXXXXXX                        X          XXXXXXXXXXXXXXXXXXXX                                                         999-99-9999– –                    13
14          Spouse first name (if joint return) Initial    Spouse last name                                                             Spouse SSN                        14
15          XXXXXXXXXXXX                        X          XXXXXXXXXXXXXXXXXXXX                                                         999-99-9999– –                    15
16          To qualify for the reduced tax rate, you must complete both sections and submit this form with your Oregon Form OR-40.                                        16
17                                                                                                                                                                        17
18          Section A—Qualifying business information                                                                                                                     18
19          Complete Section A to determine if you qualify for the reduced tax rate. List each qualifying sole proprietorship (SP), S corporation                         19
20          (SC), or partnership (P) along with the business code number (or NAICS code), Oregon PTE-E tax deducted, number of qualifying                                 20
21          employees, entity type, nonpassive income (or loss), and Section 179 expense attributable to each qualifying business. Only list                              21
22          businesses that qualify. See instructions for more information.                                                                                               22
23                                                                                                                                                                        23
24          1. Qualifying business name                                                                    FEIN           Business code no.  No. of qualifying employees  24

25             XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 99-9999999–                                                            9999999999               999,999,999            25
26             Entity type:                                a. Nonpassive loss                                 b. Section 179 expense         c. Nonpassive income         26
27             XX      (SP, SC, or P only)      99,999,999,999.00.00                                       99,999,999,999.00.00         99,999,999,999.00.00              27
28                                                                                                                                                                        28
29             d. Oregon PTE-E tax deducted                                                                                                                               29
30                                                                                                                                                                        30
               99,999,999,999.00.00
31                                                                                                                                                                        31
32          2. Qualifying business name                                                                    FEIN           Business code no.  No. of qualifying employees  32

33             XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 99-9999999–                                                            9999999999               999,999,999            33
34             Entity type:                                a. Nonpassive loss                                 b. Section 179 expense         c. Nonpassive income         34
35             XX      (SP, SC, or P only)      99,999,999,999.00.00                                       99,999,999,999.00.00         99,999,999,999.00.00              35
36                                                                                                                                                                        36
37             d. Oregon PTE-E tax deducted                                                                                                                               37
38                                                                                                                                                                        38
               99,999,999,999.00.00
39                                                                                                                                                                        39
40          3. Qualifying business name                                                                    FEIN           Business code no.  No. of qualifying employees  40

41             XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 99-9999999–                                                            9999999999               999,999,999            41
42             Entity type:                                a. Nonpassive loss                                 b. Section 179 expense         c. Nonpassive income         42
43             XX      (SP, SC, or P only)      99,999,999,999.00.00                                       99,999,999,999.00.00         99,999,999,999.00.00              43
44                                                                                                                                                                        44
45             d. Oregon PTE-E tax deducted                                                                                                                               45
46                                                                                                                                                                        46
               99,999,999,999.00.00
47                                                                                                                                                                        47
48          4. Total for each column                    a. Nonpassive loss total                           b. Section 179 expense total c. Nonpassive income total        48
49             (a), (b), (c), and (d):          99,999,999,999.00.00                                       99,999,999,999.00.00         99,999,999,999.00.00              49
50                                                                                                                                                                        50
51             d. Oregon PTE-E tax deducted                                                                                                                               51
52                                                                                                                                                                        52
               99,999,999,999.00.00
53                                                                                                                                                                        53
54          5.  Add lines 4c and 4d ................................................................ 5.    99,999,999,999.00.00                                           54
55                                                                                                                                                                        55
56          6.  Add lines 4a and 4b ................................................................ 6.    99,999,999,999.00.00                                           56
57                                                                                                                                                                        57
58          7.  Line 5 minus line 6 ................................................................... 7. 99,999,999,999.00.00                                           58
59                                                                                                                                                                        59
60          If line 7 is 0 or less, you can’t use the reduced tax rate. Return to the Form OR-40, line 20, and complete the rest of the form. If line 7                   60
61          is more than 0, enter this amount on line 2b of the Tax worksheet in Section B on page 2.                                                                     61
62                                                                                                                                                                        62
63                                              —You must include this schedule with your Oregon Form OR-40—                                                              63
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71           2023 Schedule OR-PTE-FY                                                                                                                                                                           71
72           Page 2 of 2, 150-101-365                   Oregon Department of Revenue                                   18122301020000                                                                          72
73           (Rev. 08-10-23, ver. 01)                                                                                                                                                                          73
74                                                                                                                                                                                                             74
             Section B—Tax worksheet
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             Complete each applicable line to determine your tax. See the instructions for more information.
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77             1.  Enter Oregon taxable income from Form OR-40, line 19 ................1a.                            99,999,999,999.00.00                                                                    77
78             2.  Enter the total qualifying income from Section A, line 7 ..................................................................................... 2b.                     99,999,999,999.00.00 78
79             3.  Line 1a minus line 2b. Don’t enter less than 0 .................................3a.                 99,999,999,999.00.00                                                                    79
80             4.  Enter the amount on lines 4a and 4b of the depreciation addition                                                                                                                            80
81               from Form OR-40, line 8 that is attributable to the qualifying                                                                                                                                81
82               businesses .......................................................................................4a. 99,999,999,999.00.00 4b.                                           99,999,999,999.00.00 82
83             5.  Line 3a minus line 4a. Don’t enter less than 0 .................................5a.                 99,999,999,999.00.00                                                                    83
84             6.  Line 2b plus line 4b ............................................................................................................................................. 6b. 99,999,999,999.00.00 84
85             7.  Enter the amount on lines 7a and 7b of the depreciation subtraction                                                                                                                         85
86               from Form OR-40, line 13 that is attributable to qualifying                                                                                                                                   86
87               businesses .......................................................................................7a. 99,999,999,999.00.00 7b.                                           99,999,999,999.00.00 87
88             8.  Line 5a plus line 7a ..........................................................................8a.  99,999,999,999.00.00                                                                    88
89             9.  Line 6b minus line 7b. Don’t enter less than 0 ................................................................................................... 9b.                 99,999,999,999.00.00 89
90            10.  Tax for income on line 8a (see instructions)                                                                                                                                                90
91               This is your tax on nonqualifying income ......................................10a.                   99,999,999,999.00.00                                                                    91
92            11.  Tax for income on line 9b using Tax rate chart B in the instructions.                                                                                                                       92
93               This is your tax on qualifying income ............................................................................................................... 11b.               99,999,999,999.00.00 93
94            12.  Line 10a plus line 11b. This is your total tax                                                                                                                                              94
95               with the reduced rate for qualifying income ..................................12a.                    99,999,999,999.00.00                                                                    95
96            13.  Tax for income on line 1a (see instructions)...................................13a.                 99,999,999,999.00.00                                                                    96
97            14.  Enter the lesser of line 12a or line 13a...........................................14a.             99,999,999,999.00.00                                                                    97
98                                                                                                                                                                                                             98
99           If line 12a is less than 13a, enter the amount from line 14a on Form OR-40, line 20, and check box 20c.                                                                                           99
100                                                                                                                                                                                                            100
101          If line 13a is less than 12a, it isn’t more beneficial for you to use the reduced tax rate. Enter the amount from line 14a on Form OR-40,                                                         101
102          line 20, and complete the rest of the return.                                                                                                                                                     102
103                                                                                                                                                                                                            103
104          Note: You can’t amend to revoke or make the election after your original return is filed unless you file an amended return on or before                                                           104
105          the original due date of April 15, 2024, or if filing an extension, October 15, 2024. If you amend after the due date for the return,                                                             105
106          including extensions, you must use the tax on line 12a of the Tax worksheet even if line 13a is less.                                                                                             106
107                                                                                                                                                                                                            107
108                                    —You must include this schedule with your Oregon Form OR-40—                                                                                                            108
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