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Schedule OR-21-MD Instructions 2022
Oregon Pass-through Entity Elective Tax Member Directory
name, SSN, and address in the same manner as an indi-
Purpose of Schedule OR-21-MD vidual. Otherwise, indicate which type of organization the
LLC is treated as for tax purposes.
Pass-through entities (PTEs) electing to pay the PTE elective
tax (PTE-E tax) use Schedule OR-21-MD to provide informa- Identification number. Enter the member’s SSN if the mem-
tion about the members of the PTE. Schedule OR-21-MD ber is an individual, or the member’s FEIN if the member
must be included with Form OR-21 when the return is filed. is a PTE.
The election to be liable for and pay the PTE-E tax can be Current address and phone. Enter the member’s current
made only by entities whose members are: address, including city, state, and ZIP code. Include a day-
time phone where the member or the member’s contact can
• Individuals who are subject to Oregon’s personal income
be reached.
tax laws, or
Column r: Distributive proceeds. Each member’s share of
• Entities that are PTEs owned entirely by such individuals.
distributive proceeds is based on information reported on
By providing the information required by Schedule OR- the entity’s Form OR-65 or Form OR-20-S. (For members who
21-MD, the electing PTE confirms that it qualifies to make are individuals, this information is reported to members
the election. on Schedule OR-K-1, Part III, lines 1 through 11, Oregon
Complete Form OR-21 before completing this schedule. column.)
Column s: Addition for tax deducted at federal level. Taxes
paid by the electing PTE to the State of Oregon that are
Part A: Member information deducted on a federal return filed by the entity must be
Complete all fields for each member. If the electing PTE added to Oregon income. Individual members of the electing
has more than two members, use additional copies of the PTE, or individual members of a PTE that is a member of
schedule to list all members. the electing PTE, report their share of the addition on their
Oregon personal income tax returns, including composite
PTE member legal name and contact name. If the member is returns joined by nonresident individuals.
a PTE, the legal name must be entered even if the PTE does
business under an assumed name. Enter the first name, mid- The total addition amount can be found as a deduction for
dle initial, and last name of a contact person for the member state taxes paid on the applicable federal return, such as
PTE. If the member is an individual, skip these fields. Form 1065 or Form 1120-S. For each member with a posi-
tive share of distributive proceeds in column r, divide the
Ownership percentage. Enter each member’s ownership member’s share by the total distributive proceeds from Form
percentage as of the close of the tax year. If the member OR-21, line 22. Multiply this percentage by the total addition
disposed of all or part of an ownership interest during the amount. Enter the result in column s.
year, enter the member’s ownership percentage before the
disposition. Column t: Credit for PTE-E tax paid. Multiply the total
amount of the PTE-E tax shown on Form OR-21, line 23,
Form OR-OC. Mark this box if the member is a nonresident by the percentage for each member determined using the
individual who elects to be included in a composite filing process described in the instructions for column s. Enter
for this tax year. the result in column t. Do not include penalty, interest on
Individual member name. If the member is an individual, unpaid tax, or interest on an underpayment of estimated tax.
enter their first name, middle initial, and last name. If the
member is a PTE, skip these fields.
Part B: Total distributive proceeds,
Member type. Indicate whether the member is a partnership, Sole proprietorship
addition, and credit
S corporation, or an individual.
• Grantor trust. If the member is a grantor trust (also known Line 3: Total distributive proceeds. Add together all of the
as a revocable trust or living trust), select “Individual” and shares of distributive proceeds from Oregon sources for each
enter the grantor’s name, Social Security number (SSN), member in column r.
and address in the same manner as an individual. Don’t
Line 4: Total addition for tax deducted at federal level. Total
enter the name, federal employer identification number
all of the shares of the Oregon addition for each member in
(FEIN), or address of the grantor trust.
column s. The total should equal the amount of taxes paid to
• Limited liability company (LLC). If the member is a single- the State of Oregon that were deducted on a federal return
member LLC, select “Individual” and enter the member’s filed by the entity.
150-107-112-1 (Rev. 09-13-22) 1 2022 Schedule OR-21-MD Instructions
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