1 1 1 2 2 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 Form All layers With grid &2 data 84 85 3 4 82 83 3 3 4 4 Oregon Department of Revenue 5 2023 Form OR-40-P 5 6 Oregon Individual Income Tax Return for Part-year Residents 6 7 7 8 Page 1 of 11 • 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 X Employment exception X Military 22 23 23 24 From (MM/DD/YYYY) To (MM/DD/YYYY) 24 25 25 26 Oregon resident dates: 99/99/9999/ / 99/99/9999/ / 26 27 27 28 First name Initial Date of birth (MM/DD/YYYY) 28 29 29 30 XXXXXXXXXXXXXXXX X 99/99/9999/ / 30 31 Last name 31 32 32 33 33 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 34 Social Security number (SSN) 34 35 35 36 999-99-9999 X First time using this SSN (see instructions) X Applied for ITIN X Deceased 36 37 37 38 Spouse first name Initial Spouse date of birth (MM/DD/YYYY) 38 39 39 40 XXXXXXXXXXXXXXXX X 99/99/9999/ / 40 41 Spouse last name 41 42 42 43 43 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 44 Spouse SSN 44 45 45 46 999-99-9999 X First time using this SSN (see instructions) X Applied for ITIN X Deceased 46 47 47 48 Current mailing address 48 49 49 50 50 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 51 City State ZIP code 51 52 52 53 53 XXXXXXXXXXXXXXXXXXXXXX XX XXXXX-XXXX 54 Country Phone 54 55 55 56 56 XXXXXXXXXXXXXXXXXXXXX 999-999-9999 57 57 58 58 59 59 60 60 61 61 62 62 150-101-055 63 (Rev. 08-23-23, ver. 01) 00612301010000 63 64 64 1 2 65 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 65 84 85 3 4 82 83 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 3 4 82 83 69 69 70 70 Oregon Department of Revenue 71 2023 Form OR-40-P 71 72 72 73 73 74 Page 2 of 11 • 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 Filing Status (check only one box) 80 81 81 82 1. X Single 2. X Married filing jointly 3. X Married filing separately (enter spouse information on page 1) 82 83 83 84 4. X Head of household (with qualifying dependent) 5. X Qualifying surviving spouse 84 85 85 86 86 87 Exemptions 87 88 6a. Credits for yourself .........................................................................................................................................................................................6a. 9 88 89 89 90 Check boxes that apply: X Regular X Severely disabled X Someone else can claim you as a dependent 90 91 91 92 6b. Credits for your spouse .................................................................................................................................................................................6b. 9 92 93 93 94 Check boxes that apply: X Regular X Severely disabled X Someone else can claim you as a dependent 94 95 95 96 Dependents 96 97 List your dependents in order from youngest to oldest. If you have more than three dependents, complete and include Schedule OR-ADD-DEP. 97 98 Dependent 1: First name Initial Dependent 1: Last name 98 99 99 100 100 XXXXXXXXXXXXXXXX X XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 101 Dependent 1: Date of birth (MM/DD/YYYY) Dependent 1: SSN Code * 101 102 Dependent 1: Check if child 102 103 99/99/9999/ / 999-99-9999 XX X has a qualifying disability 103 104 104 105 Dependent 2: First name Initial Dependent 2: Last name 105 106 106 107 107 XXXXXXXXXXXXXXXX X XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 108 Dependent 2: Date of birth (MM/DD/YYYY) Dependent 2: SSN Code * 108 109 Dependent 2: Check if child 109 110 99/99/9999/ / 999-99-9999 XX X has a qualifying disability 110 111 111 112 Dependent 3: First name Initial Dependent 3: Last name 112 113 113 114 114 XXXXXXXXXXXXXXXX X XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 115 Dependent 3: Date of birth (MM/DD/YYYY) Dependent 3: SSN Code * 115 116 Dependent 3: Check if child 116 117 99/99/9999/ / 999-99-9999 XX X has a qualifying disability 117 118 118 119 *Dependent relationship code (see instructions). 119 120 120 121 6c. Total number of dependents ..................................................................................................................................................................6c. 99 121 122 122 123 123 124 6d. Total number of dependent children with a qualifying disability (see instructions) ................................................................................6d. 99 124 125 125 126 126 127 127 128 128 150-101-055 129 (Rev. 08-23-23, ver. 01) 00612301020000 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 3 4 82 83 132 132 |
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 3 4 82 83 135 135 136 136 Oregon Department of Revenue 137 2023 Form OR-40-P 137 138 138 139 139 140 Page 3 of 11 • Use UPPERCASE letters. • Use blue or black ink. • Print actual size (100%). • Don’t submit photocopies or use staples. 140 141 Last name SSN 141 142 142 143 143 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 999-99-9999 144 144 145 Note: Reprint page 1 if you make changes to this page. 145 146 146 147 147 148 6e. Total exemptions. Add lines 6a through 6d.................................................................................................................................. Total 6e. 99 148 149 149 150 Income Federal column (F) Oregon column (S) 150 151 7. Wages, salaries, and other pay for work from federal Form 1040 or 1040-SR, line 1z. Include all Forms W-2. 151 152 152 153 153 154 7F. , 999,999,999.00, 0 0 7S. , 999,999,999.00, 0 0 154 155 155 156 8. Interest income from Form 1040 or 1040-SR, line 2b. 156 157 157 158 158 159 8F. , 999,999,999.00, 0 0 8S. , 999,999,999.00, 0 0 159 160 160 161 9. Dividend income from Form 1040 or 1040-SR, line 3b. 161 162 162 163 163 164 9F. , 999,999,999.00, 0 0 9S. , 999,999,999.00, 0 0 164 165 165 166 10. State and local income tax refunds from federal Schedule 1, line 1. 166 167 167 168 168 169 10F. , 999,999,999.00, 0 0 10S. , 999,999,999.00, 0 0 169 170 170 171 11. Alimony received from federal Schedule 1, line 2a. 171 172 172 173 173 174 11F. , 999,999,999.00, 0 0 11S. , 999,999,999.00, 0 0 174 175 175 176 12. Business income or loss from federal Schedule 1, line 3. 176 177 177 178 178 179 12F. , 999,999,999.00, 0 0 12S. , 999,999,999.00, 0 0 179 180 180 181 13. Capital gain or loss from Form 1040 or 1040-SR, line 7. 181 182 182 183 183 184 13F. , 999,999,999.00, 0 0 13S. , 999,999,999.00, 0 0 184 185 185 186 14. Other gains or losses from federal Schedule 1, line 4. 186 187 187 188 188 189 14F. , 999,999,999.00, 0 0 14S. , 999,999,999.00, 0 0 189 190 190 191 191 192 192 193 193 194 194 150-101-055 195 (Rev. 08-23-23, ver. 01) 00612301030000 195 196 196 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 3 4 82 83 198 198 |
199 199 1 2 200 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 81 200 84 85 3 4 82 83 201 201 202 202 Oregon Department of Revenue 203 2023 Form OR-40-P 203 204 204 205 205 206 Page 4 of 11 • Use UPPERCASE letters. • Use blue or black ink. • Print actual size (100%). • Don’t submit photocopies or use staples. 206 207 Last name SSN 207 208 208 209 209 210 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 999-99-9999 210 211 Note: Reprint page 1 if you make changes to this page. 211 212 Federal column (F) Oregon column (S) 212 213 15. IRA distributions from Form 1040 or 1040-SR, line 4b. 213 214 214 215 215 216 15F. , 999,999,999.00, 0 0 15S. , 999,999,999.00, 0 0 216 217 217 218 16. Pensions and annuities from Form 1040 or 1040-SR, line 5b. 218 219 219 220 220 221 16F. , 999,999,999.00, 0 0 16S. , 999,999,999.00, 0 0 221 222 222 223 17. Schedule E income or loss from federal Schedule 1, line 5. 223 224 224 225 225 226 17F. , 999,999,999.00, 0 0 17S. , 999,999,999.00, 0 0 226 227 227 228 18. Farm income or loss from federal Schedule 1, line 6. 228 229 229 230 230 231 18F. , 999,999,999.00, 0 0 18S. , 999,999,999.00, 0 0 231 232 232 233 19. Social Security benefits from Form 1040 or 1040-SR, line 6b; and unemployment and other income from federal Schedule 1, lines 7 and 9. 233 234 234 235 235 236 19F. , 999,999,999.00, 0 0 19S. , 999,999,999.00, 0 0 236 237 237 238 20. Total income. Add lines 7 through 19. 238 239 239 240 240 241 20F. , 999,999,999.00, 0 0 20S. , 999,999,999.00, 0 0 241 242 242 243 Adjustments 243 244 21. IRA or SEP and SIMPLE contributions, from federal Schedule 1, lines 16 and 20. 244 245 245 246 246 247 21F. , 999,999,999.00, 0 0 21S. , 999,999,999.00, 0 0 247 248 248 249 22. Education deductions from federal Schedule 1, lines 11 and 21. 249 250 250 251 251 252 22F. , 999,999,999.00, 0 0 22S. , 999,999,999.00, 0 0 252 253 253 254 254 255 255 256 256 257 257 258 258 259 259 260 260 150-101-055 261 (Rev. 08-23-23, ver. 01) 00612301040000 261 262 262 1 2 263 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 81 263 84 85 3 4 82 83 264 264 |
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 3 4 82 83 267 267 268 268 Oregon Department of Revenue 269 2023 Form OR-40-P 269 270 270 271 271 272 Page 5 of 11 • 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 Adjustments (continued) Federal column (F) Oregon column (S) 278 279 23. Moving expenses from federal Schedule 1, line 14. 279 280 280 281 281 282 23F. , 999,999,999.00, 0 0 23S. , 999,999,999.00, 0 0 282 283 283 284 24. Deduction for self-employment tax from federal Schedule 1, line 15. 284 285 285 286 286 287 24F. , 999,999,999.00, 0 0 24S. , 999,999,999.00, 0 0 287 288 288 289 25. Self-employed health insurance deduction from federal Schedule 1, line 17. 289 290 290 291 291 292 25F. , 999,999,999.00, 0 0 25S. , 999,999,999.00, 0 0 292 293 293 294 26. Alimony paid from federal Schedule 1, line 19a. 294 295 295 296 296 297 26F. , 999,999,999.00, 0 0 26S. , 999,999,999.00, 0 0 297 298 298 299 27. Total adjustments from Schedule OR-ASC-NP, line A7 for the federal column and line A8 for the Oregon column. 299 300 300 301 301 302 27F. , 999,999,999.00, 0 0 27S. , 999,999,999.00, 0 0 302 303 303 304 28. Total adjustments. Add lines 21 through 27. 304 305 305 306 306 307 28F. , 999,999,999.00, 0 0 28S. , 999,999,999.00, 0 0 307 308 308 309 29. Income after adjustments. Line 20 minus line 28. 309 310 310 311 311 312 29F. , 999,999,999.00, 0 0 29S. , 999,999,999.00, 0 0 312 313 313 314 Additions 314 315 30. Total additions from Schedule OR-ASC-NP, line B7 for the federal column and line B8 for the Oregon column. 315 316 316 317 317 318 30F. , 999,999,999.00, 0 0 30S. , 999,999,999.00, 0 0 318 319 319 320 320 321 321 322 322 323 323 324 324 325 325 326 326 150-101-055 327 (Rev. 08-23-23, ver. 01) 00612301050000 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 3 4 82 83 330 330 |
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 3 4 82 83 333 333 334 334 Oregon Department of Revenue 335 2023 Form OR-40-P 335 336 336 337 337 338 Page 6 of 11 • 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 Additions (continued) Federal column (F) Oregon column (S) 344 345 31. Income after additions. Add lines 29 and 30. 345 346 346 347 347 348 31F. , 999,999,999.00, 0 0 31S. , 999,999,999.00, 0 0 348 349 349 350 Subtractions 350 351 32. Social Security and tier 1 Railroad Retirement Board benefits included on line 19F. 351 352 352 353 353 354 32F. , 999,999,999.00, 0 0 354 355 355 356 33. Total subtractions from Schedule OR-ASC-NP, line C7 for the federal column and line C8 for the Oregon column. 356 357 357 358 358 359 33F. , 999,999,999.00, 0 0 33S. , 999,999,999.00, 0 0 359 360 360 361 34. Income after subtractions. Line 31 minus lines 32 and 33. 361 362 362 363 363 364 34F. , 999,999,999.00, 0 0 34S. , 999,999,999.00, 0 0 364 365 365 366 366 367 35. Oregon percentage (see instructions; not more than 100.0%). ..................................................................................35. 999.9 % 367 368 368 369 369 370 Deductions and modifications 370 371 36. Amount from line 34F ................................................................................................ 36. , 999,999,999.00, 0 0 371 372 372 373 37. Oregon itemized deductions. Enter your Oregon itemized deductions from 373 374 Schedule OR-A, line 23. If you are not itemizing your deductions, enter 0 .............. 37. , 999,999,999.00, 0 0 374 375 375 376 376 377 38. Standard deduction. Enter your standard deduction ............................................. 38. , 999,999,999.00, 0 0 377 378 378 379 You were: 38a. X 65 or older 38b. X Blind Your spouse was: 38c. X 65 or older 38d. X Blind 379 380 380 381 Standard Single Married filing jointly Married filing separately Qualifying surviving spouse Head of household 381 382 deductions $2,605 $5,210 $2,605 or $0 $5,210 $4,195 382 383 See instructions if you are age 65 or older, blind, or if someone can claim you as a dependent. 383 See instructions if you are married filing separately. 384 384 385 39. Enter the larger of line 37 or 38 ................................................................................. 39. , 999,999,999.00, 0 0 385 386 386 387 387 388 40. 2023 federal tax liability (see instructions) .............................................................. 40. , 999,999,999.00, 0 0 388 389 389 390 390 391 391 392 392 150-101-055 393 (Rev. 08-23-23, ver. 01) 00612301060000 393 394 394 1 2 395 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 81 395 84 85 3 4 82 83 396 396 |
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 3 4 82 83 399 399 400 400 Oregon Department of Revenue 401 2023 Form OR-40-P 401 402 402 403 403 404 Page 7 of 11 • Use UPPERCASE letters. • Use blue or black ink. • Print actual size (100%). • Don’t submit photocopies or use staples. 404 405 Last name SSN 405 406 406 407 407 408 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 999-99-9999 408 409 Note: Reprint page 1 if you make changes to this page. 409 410 410 411 Deductions and modifications (continued) 411 412 41. Total modifications from Schedule OR-ASC-NP, line D7 .......................................... 41. , 999,999,999.00, 0 0 412 413 413 414 414 415 42. Add lines 39, 40, and 41 ........................................................................................... 42. , 999,999,999.00, 0 0 415 416 416 417 417 418 43. Taxable income. Line 36 minus line 42. If line 42 is more than line 36, enter 0 ........ 43. , 999,999,999.00, 0 0 418 419 419 420 Oregon tax 420 421 44. Tax. Check the appropriate box if you’re using an alternative method to 421 422 calculate your tax (see instructions) ......................................................................... 44. , 999,999,999.00, 0 0 422 423 423 424 44a. X Schedule OR-FIA-40-P 44b. X Worksheet FCG 44c. X Schedule OR-PTE-PY 424 425 425 426 45. Oregon income tax. Line 44 multiplied by the Oregon percentage 426 427 from line 35 (see instructions) .................................................................................. 45. , 999,999,999.00, 0 0 427 428 428 429 429 430 46. Interest on certain installment sales ......................................................................... 46. , 999,999,999.00, 0 0 430 431 431 432 432 433 47. Total tax recaptures from Schedule OR-ASC-NP, line E5 ......................................... 47. , 999,999,999.00, 0 0 433 434 434 435 435 436 48. Total additions to tax. Line 46 plus line 47 ................................................................ 48. , 999,999,999.00, 0 0 436 437 437 438 438 439 49. Total tax before credits. Add lines 45 and 48 ........................................................... 49. , 999,999,999.00, 0 0 439 440 440 441 441 442 Standard and carryforward credits 442 443 50. Exemption credit (see instructions) .......................................................................... 50. , 999,999,999.00, 0 0 443 444 444 445 445 446 51. Total standard credits from Schedule OR-ASC-NP, line F16 ................................... 51. , 999,999,999.00, 0 0 446 447 447 448 448 449 52. Total standard credits. Add lines 50 and 51 ............................................................ 52. , 999,999,999.00, 0 0 449 450 450 451 451 452 53. Tax minus standard credits. Line 49 minus line 52. If line 52 is more than 452 453 line 49, enter 0 ......................................................................................................... 53. , 999,999,999.00, 0 0 453 454 454 455 455 456 456 457 457 458 458 150-101-055 459 (Rev. 08-23-23, ver. 01) 00612301070000 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 3 4 82 83 462 462 |
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 3 4 82 83 465 465 466 466 Oregon Department of Revenue 467 2023 Form OR-40-P 467 468 468 469 469 470 Page 8 of 11 • 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 Standard and carryforward credits (continued) 476 477 54. Total carryforward credits used this year (Schedule OR-ASC-NP, line G9). Line 54 477 478 can’t be more than line 53 (Schedule OR-ASC and OR-ASC-NP Instructions)........ 54. , 999,999,999.00, 0 0 478 479 479 480 480 481 55. Tax after standard and carryforward credits. Line 53 minus line 54 ......................... 55. , 999,999,999.00, 0 0 481 482 482 483 483 484 Payments and refundable credits 484 485 56. Oregon income tax withheld. Include a copy of your Forms W-2 and 1099 ........ 56. , 999,999,999.00, 0 0 485 486 486 487 487 488 57. Amount applied from your prior year’s tax refund ................................................... 57. , 999,999,999.00, 0 0 488 489 489 490 58. Estimated tax payments for 2023. Include all estimated payments you made by 490 491 April 15, 2024, including any extension payment or tax withheld from real estate 491 492 transactions. Do not include the amount you already reported on line 57 .............. 58. , 999,999,999.00, 0 0 492 493 493 494 494 495 59. Tax payments from a pass-through entity ............................................................... 59. , 999,999,999.00, 0 0 495 496 496 497 497 498 60. Earned income credit (see instructions) ................................................................... 60. , 999,999,999.00, 0 0 498 499 499 500 500 501 61. Oregon Kids Credit (see instructions) ....................................................................... 61. , 999,999,999.00, 0 0 501 502 502 503 62. Kicker (Oregon surplus credit). Enter your kicker credit amount (see instructions). 503 504 To donate your kicker to the State School Fund, enter 0 and see line 78 ........ 62. , , 0 0 504 999,999,999.00 505 505 506 506 507 63. Total refundable credits from Schedule OR-ASC-NP, line H7.................................. 63. , 999,999,999.00, 0 0 507 508 508 509 509 510 64. Total payments and refundable credits. Add lines 56 through 63 ........................... 64. , 999,999,999.00, 0 0 510 511 511 512 Tax to pay or refund 512 513 65. Overpayment of tax. If line 55 is less than line 64, you overpaid. 513 514 Line 64 minus line 55 ............................................................................................... 65. , 999,999,999.00, 0 0 514 515 515 516 66. Net tax. If line 55 is more than line 64, you have tax to pay. 516 517 Line 55 minus line 64 ............................................................................................... 66. , 999,999,999.00, 0 0 517 518 518 519 519 520 67. Penalty and interest for filing or paying late (see instructions) ................................ 67. , 999,999,999.00, 0 0 520 521 521 522 522 523 523 524 524 150-101-055 525 (Rev. 08-23-23, ver. 01) 00612301080000 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 3 4 82 83 528 528 |
529 529 1 2 530 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 81 530 84 85 3 4 82 83 531 531 532 532 Oregon Department of Revenue 533 2023 Form OR-40-P 533 534 534 535 535 536 Page 9 of 11 • Use UPPERCASE letters. • Use blue or black ink. • Print actual size (100%). • Don’t submit photocopies or use staples. 536 537 Last name SSN 537 538 538 539 539 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 999-99-9999 540 540 541 Note: Reprint page 1 if you make changes to this page. 541 542 Tax to pay or refund (continued) 542 543 68. Interest on underpayment of estimated tax. Include Form OR-10 ........................ 68. , 999,999,999.00, 0 0 543 544 544 545 545 546 Exception number from Form OR-10, line 1: 68a. 9 Check box if you annualized: 68b. X 546 547 547 548 548 549 69. Total penalty and interest due. Add lines 67 and 68 ................................................ 69. , 999,999,999.00, 0 0 549 550 550 551 70. Net tax including penalty and interest. 551 552 Line 66 plus line 69. .................................................This is the amount you owe.70. , 999,999,999.00, 0 0 552 553 553 554 71. Overpayment less penalty and interest. 554 555 Line 65 minus line 69. ..............................................................This is your refund.71. , 999,999,999.00, 0 0 555 556 556 557 72. Estimated tax. Fill in the portion of line 71 you want applied to your open 557 558 estimated tax account ............................................................................................. 72. , 999,999,999.00, 0 0 558 559 559 560 560 561 73. Charitable checkoff donations from Schedule OR-DONATE, line 30 ....................... 73. , 999,999,999.00, 0 0 561 562 562 563 563 564 74. Oregon 529 college savings plan deposits from Schedule OR-529, line 5 .............. 74. , 999,999,999.00, 0 0 564 565 565 566 75. Total. Add lines 72 through 74. The total can’t be more than your refund 566 567 on line 71................................................................................................................... 75. , 999,999,999.00, 0 0 567 568 568 569 569 570 76. Net refund. Line 71 minus line 75 ....................................This is your net refund.76. , 999,999,999.00, 0 0 570 571 571 572 572 573 Direct deposit 573 574 77. For direct deposit of your refund, see instructions. Check the box if the final deposit destination is outside the United States: X 574 575 575 576 Type of account: 576 577 Account information: 577 578 X Checking or Routing number Account number 578 579 579 580 X Savings 999999999 XXXXXXXXXXXXXXXXX 580 581 581 582 Kicker donation 582 583 78. If you elect to donate your kicker to the State School Fund, check this box. ......... 78a. X 583 584 584 585 Complete the kicker worksheet in the instructions and enter the 585 586 amount here. ............................................................This election is irrevocable.78b. , 999,999,999.00, 0 0 586 587 587 588 588 589 589 590 590 150-101-055 591 (Rev. 08-23-23, ver. 01) 00612301090000 591 592 592 1 2 593 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 81 593 84 85 3 4 82 83 594 594 |
595 595 1 2 596 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 81 596 84 85 3 4 82 83 597 597 598 598 Oregon Department of Revenue 599 2023 Form OR-40-P 599 600 600 601 601 602 Page 10 of 11 • Use UPPERCASE letters. • Use blue or black ink. • Print actual size (100%). • Don’t submit photocopies or use staples. 602 603 Last name SSN 603 604 604 605 605 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 999-99-9999 606 606 607 Note: Reprint page 1 if you make changes to this page. 607 608 Sign here. Under penalty of false swearing, I declare that the information in this return and any attachments is true, correct, and complete. 608 609 Your signature 609 610 610 611 X 611 612 Date (MM/DD/YYYY) 612 613 613 614 99/99/9999/ / 614 615 Spouse signature 615 616 616 617 X 617 618 Date (MM/DD/YYYY) 618 619 619 620 99/99/9999/ / 620 621 Signature of preparer other than taxpayer 621 622 622 623 X 623 624 Date (MM/DD/YYYY) Preparer phone Preparer license number 624 625 625 626 99/99/9999/ / 999-999-9999 XXXXXXXXXX 626 627 Preparer first name Initial Preparer last name 627 628 628 629 629 XXXXXXXXXXXXXXXX X XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 630 Preparer address 630 631 631 632 632 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 633 City State ZIP code 633 634 634 635 635 XXXXXXXXXXXXXXXXXXXXXX XX XXXXX-XXXX 636 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 636 637 the Tax Information Authorization and Power of Attorney for Representation form on our website. 637 638 638 639 Important: Include a copy of your federal Form 1040, 1040-SR, 1040-X, or 1040-NR. We may adjust your return without it. 639 640 640 641 Pay the amount due (shown on line 69) 641 642 • Online: www.oregon.gov/dor. 642 643 • By mail: Payable to the Oregon Department of Revenue.Write “2023 Oregon Form OR-40-P” and the last four digits of your SSN or ITIN on your 643 644 check or money order. If you include a payment with your return, don’t include Form OR-40-V payment voucher. 644 645 645 646 Mail your return 646 647 • Non-2-D barcode. If the large 2-D barcode box on the first page of this form is blank: 647 648 — Mail tax-due returns to: Oregon Department of Revenue, PO Box 14555, Salem OR 97309-0940. 648 649 — Mail refund and no-tax-due returns to: Oregon Department of Revenue, PO Box 14700, Salem OR 97309-0930. 649 650 • 2-D barcode. If the large 2-D barcode box on the first page of this form is filled in: 650 651 — Mail tax-due returns to: Oregon Department of Revenue, PO Box 14720, Salem OR 97309-0463. 651 652 — Mail refund and no-tax-due returns to: Oregon Department of Revenue, PO Box 14710, Salem OR 97309-0460. 652 653 653 654 654 655 655 656 656 150-101-055 657 (Rev. 08-23-23, ver. 01) 00612301100000 657 658 658 1 2 659 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 81 659 84 85 3 4 82 83 660 660 |
661 661 1 2 662 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 81 662 84 85 3 4 82 83 663 663 664 664 Oregon Department of Revenue 665 2023 Form OR-40-P 665 666 666 667 667 668 Page 11 of 11 • Use UPPERCASE letters. • Use blue or black ink. • Print actual size (100%). • Don’t submit photocopies or use staples. 668 669 Last name SSN 669 670 670 671 671 672 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 999-99-9999 672 673 Note: Reprint page 1 if you make changes to this page. 673 674 Amended statement. Complete this section only if you’re amending your 2023 return or filing with a new SSN. 674 675 675 676 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 676 677 filing status has changed, explain why. Include all supporting forms and schedules when you file your amended return, even if you haven’t changed 677 678 anything on them. 678 679 679 680 If filing with a new SSN, enter your former identification number. 680 681 681 682 682 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 683 683 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 684 684 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 685 685 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 686 686 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 687 687 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 688 688 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 689 689 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 690 690 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 691 691 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 692 692 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 693 693 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 694 694 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 695 695 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 696 696 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 697 697 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 698 698 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 699 699 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 700 700 701 701 702 702 703 703 704 704 705 705 706 706 707 707 708 708 709 709 710 710 711 711 712 712 713 713 714 714 715 715 716 716 717 717 718 718 719 719 720 720 721 721 722 722 150-101-055 723 (Rev. 08-23-23, ver. 01) 00612301110000 723 724 724 1 2 725 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 81 725 84 85 3 4 82 83 726 726 |