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             Form OR-706-DISC
6           Page 1 of 1, 150-104-005                    Oregon Department of Revenue                    17540001010000                                         6
7           (Rev. 05-26-22, ver. 01)                                                                                                                           7
8            Request for Discharge from Personal Liability                                                                                                     8
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11                                                                   Submit original form—do not submit photocopy.                                             11
              Decedent first name                Decedent last name
12           •                         •Initial  •                                             •Date of death          •Decedent Social Security number (SSN)  12
13                                                                                                                                                             13
             XXXXXXXXXXXX X               XXXXXXXXXXXXXXXXXXXX99/99/9999/                               /              999-99-9999
14          •Decedent last permanent address                                           •City                                      •State •ZIP code             14
15                                                                                                                                                             15
            XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXXXXX XX                                                                 XXXXX-XXXX
                                                 Executor or trustee last name
16           •Executor or trustee name •Initial  •                                             •Title                                                          16
17                                                                                                                                                             17
             XXXXXXXXXXXX X               XXXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
18          •Executor or trustee (if not an individual)                                                            •Executor or trustee phone                  18
19          XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX                                                                    (999)() 999-9999                          19
20          •Executor or trustee current address                                       •City                                      •State •ZIP code             20
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            XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXXXXX XX                                                                 XXXXX-XXXX
                                                                             Person to contact last name
22          •Person to contact* (if other than executor or trustee) •Initial •                                     •Contact phone                              22
23           XXXXXXXXXXXX                                           X  XXXXXXXXXXXXXXXXXXXX                        (999)( ) 999-9999                         23
24          *Include a copy of the Tax Information Authorization and Power of Attorney for Representation form, 150-800-005, with this request.                24
25          Don’t submit this form with your OR-706 filing, instead complete and mail it separately.                                                           25
26                                                                                                                                                             26
27          I certify that I represent the estate named above in a fiduciary capacity as executor, trustee, personal representative, or other fiduciary        27
28          title. (If you haven’t filed Form OR-706, Oregon Estate Transfer Tax Return, include a copy of the decedent’s will, the decedent’s                 28
29          trust, or other document you are relying on to act in a fiduciary capacity.)                                                                       29
30                                                                                                                                                             30
31          As provided in Oregon Revised Statutes (ORS) 118.265 and 118.227, I request a final estate transfer tax determination and discharge of             31
32          personal liability for the Oregon estate transfer tax due on the estate of the above listed decedent. I understand you will notify me of the       32
33          amount of tax due under ORS Chapter 118:                                                                                                           33
34            a.  Within 18 months of this application; or                                                                                                     34
35            b.  If I make this application before the return is filed, by the earliest of:                                                                   35
36                 1. 18 months after the return is filed; or                                                                                                  36
37                 2. The expiration of the period for the assessment of tax under ORS 305.265.                                                                37
38                                                                                                                                                             38
39          You may issue the following:                                                                                                                       39
40          •  Notice of deficiency as provided in ORS 314.410.                                                                                                40
41          •  Notice of assessment as provided in ORS 305.265.                                                                                                41
42          •  Refund of tax paid, or portion of tax paid, under Chapter 118, as provided in ORS 314.415.                                                      42
43                                                                                                                                                             43
44          I understand that after I, the estate executor, make full payment, other than any amount for which the time for payment is extended by             44
45          you, I will be discharged from personal liability for any Oregon estate transfer tax deficiency.                                                   45
46                                                                                                                                                             46
47          The Department of Revenue will issue a Certificate of Discharge letter and mail it to the estate executor after the estate transfer tax            47
48          account is paid in full. I understand this discharge doesn’t discharge me from liability to the extent that assets of the decedent’s estate        48
49          are still in my possession or control. Until such time that the statute of limitations described in ORS 314.410 have expired, I understand         49
50          this discharge doesn’t discharge the heirs and beneficiaries from any estate transfer tax liability, penalties, or interest to the extent that     50
51          assets of the decedent’s estate have been distributed to such heir or beneficiary.                                                                 51
52                                                                                                                                                             52
53          Executor signature, as named above                                                          Date                                                   53
54          X                                                                                                                                                  54
55                                                                                                                                                             55
56                                      Submit this completed discharge request to:                 Oregon Department of Revenue                               56
57                                                                                                  PO Box 14110, Salem OR 97309-0910                          57
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