Use the following scenarios when submitting Form OR-21-V.
Test Scenarios Scenario 1 Scenario 2* Scenario 3 Scenario 4**
Legal Name James Construction Lee's Tackle Shop 4-U Sky Writers Bob & Rob's Diner
Contact Name Robert James Gary Williams Mary M. Lewiston Robert Stanford
Tax Year Begins Date/Ends Date 01/01/2022 – 12/31/2022 04/14/2022 – 04/13/2023 01/01/2022 – 12/31/2022 01/01/2023 – 12/31/2023
FEIN Applied For 98-6543120 97-1203948 99-2030401
Filer Address 654 Park St 1234 Oak St. 1099 SE Clay St. 20222 Airport Road
City Ashland Roseburg Dallas Pendleton
State OR OR OR OR
Zip 97520 97471 97338 97801
Contact Phone 541-482-1111 541-492-1113 503-623-7888 541-276-0030
Original Return X X
Amended Return X
Estimated Payment X
Payment Amount 600.00 1,500.00 1,200.00 1,000.00
*This scenario is for vendors who support fiscal year filers. If you do not support fiscal filers, please submit the scenario as a calendar year 2022. **This scenario is for vendors who support estimated payments, if you do not support estimated payments submit this test as an original return payment.

Approval Process for Vouchers
You will receive notification that your documents have been received. The department will review your submission and e-mail the results in approximately 5-7 business days. NOTE: We will accept first submission approval requests from November 1, 2022 through March 1, 2023 after the voucher becomes final. We will not accept any first submissions after March 1st 2023, unless prior arrangements are made.

Scannable vouchers must be approved by the department prior to providing the forms to your customers.
Do not submit faxed or scanned copies of vouchers as part of your submission. Below are the guidelines for the approval process.

When submitting your scannable forms for approval, please do the following:
Include your company name / software product, NACTP vendor ID number, contact person with phone number, email address, and indicate which forms are being submitted for approval.
Submit one (1) sample of each test scenario provided on page 1. If your software does not support any of the test scenarios, please indicate any limitations in a cover letter or in the main body of your submission email even if previously stated in prior submission.
Use the criteria listed on page 3 when preparing vouchers for approval.
Submit your vouchers for approval by email as PDF attachments. If you need to send a zipped file, the extension must be renamed before sending. The simplest way is to change the extension from “.ZIP” to “.ZP”
If unable to send an electronic submission, send hardcopies via currier or USPS.

Send electronic submission: Send submission by currier or USPS:
forms.a.vendor@dor.oregon.gov Oregon Department of Revenue
Processing Center Operations Unit
955 Center Street NE
Salem OR 97301-2555

Criteria for approval
Must include QR code
Must include target marks
Form number, revision date, and version number must be correct
Information in the scanline including the check digit must be correct
Layout of the voucher must be correct and match the “With grid & data” layer
Test scenario data on page one must be used to complete the test vouchers

If you have questions about the voucher specifications or test scenarios,

Email: forms.a.vendor@dor.oregon.gov
or
Call: Mark Noble at 971-701-1125
Rob Caster at 971-701-0664

2022 Test Scenarios for Form OR-21-V

2

Form 20-V 2007 Draft Specifications


Document checksum: 3660753919

Document converted by WebSite-Watcher.
(Plugin #1/1.38/3.1.0/1.0)