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5                                                                                                                      Oregon Department of Revenue                        5
                         2022 Form OR-CAT-EXT
6                        Application for Extension of Time to File an Oregon Corporate Activity Tax Return                                                                 6
7                                                                                                                                                                          7
8                        Page 1 of 2 • Use UPPERCASE letters.  • Use blue or black ink.  • Print actual size (100%).  • Don’t submit photocopies or use staples.           8
9                                                                                                                                                                          9
10          Save time and paper by completing this request through Revenue Online, at  www.oregon.gov/dor.                                                                 10
11                                                                                                                                                                         11
12          You must be registered for Oregon Corporate Activity tax (CAT) prior to submitting this form. Complete the tax payment worksheet                               12
13          below to determine if you owe CAT for 2022. An extension of time to file your return isn’t an extension of time to pay your CAT. If                            13
14          you don’t pay all the CAT due by the 15th day of the fourth month following the end of the tax year, you’ll owe interest on the unpaid                         14
15          balance. You may also owe a late payment penalty.                                                                                                              15
16                                                                                                                                                                         16
17          Payments can be made using one of these options:                                                                                                               17
18          •  Electronic payment using Revenue Online.                                                                                                                    18
19          •  By mail. If paying by mail, send each payment with a Form OR-CAT-V voucher.                                                                                 19
20          •  ACH Credit. Submit your application by going to Revenue Online and clicking on Apply for ACH credit.                                                        20
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22                                                                                                                                                                         22
23          Tax payment worksheet                                                                                                                                          23
24                                                                                                                                                                         24
25            1.  CAT for 2022. This is the amount you expect to enter on                                                                                                  25
26              Form OR-CAT, line 16 ............................................................................. 1., , 99,999,999,999.00,                      0 0       26
27                                                                                                                                                                         27
28                                                                                                                                                                         28
29            2.  Total CAT payments for 2022. This is the amount you expect to                                                                                            29
30              enter on Form OR-CAT, line 17 ............................................................... 2.     , , 99,999,999,999.00,                      0 0       30
31                                                                                                                                                                         31
32              — If the amount on line 2 is more than the amount on line 1, you don’t owe CAT.                                                                            32
33              — If the amount on line 1 is more than the amount on line 2, continue to line 3.                                                                           33
34                                                                                                                                                                         34
35                                                                                                                                                                         35
36            3.  CAT to pay with application for an extension. Line 1 minus line 2 ......... 3.                     , , 99,999,999,999.00,                      0 0       36
37                                                                                                                                                                         37
38                                                                                                                                                                         38
39          To request a six-month extension of time to file your 2022 Oregon Corporate Activity tax return, you must submit a completed                                   39
40          application before the 15th day of the fourth month following the end of the tax year. In order to be granted an extension you must                            40
41          certify you have “good cause” for requesting the extension. “Good cause” must have existed at the time the return was due, excluding                           41
42          the extension. “Good cause” is defined in OAR 150-317-1330.                                                                                                    42
43                                                                                                                                                                         43
44          “Good cause” means:                                                                                                                                            44
45          •  Death or serious illness of the taxpayer or a member of the taxpayer’s immediate family.                                                                    45
46          •  Destruction by fire, a natural disaster, or other casualty of the taxpayer’s home, place of business, or records needed to prepare                          46
47            the returns.                                                                                                                                                 47
48          •  Unavoidable and unforeseen absence of the taxpayer from the state that began before the due date of the return; or                                          48
49          •  Information required to complete the return isn’t available or isn’t in the proper form.                                                                    49
50                                                                                                                                                                         50
51          Circumstances that are not accepted by the department as “good cause” include, but are not limited to:                                                         51
52          •  Reliance on a professional to merely prepare a return on time.                                                                                              52
53          •  Reliance on an employee of the taxpayer to prepare a return on time.                                                                                        53
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                         150-106-006
63                       (Rev. 07-22-22, ver. 01)                                                                      20562201010000                                      63
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71                2022 Form OR-CAT-EXT                                                                   Oregon Department of Revenue                             71
72                                                                                                                                                                72
73                                                                                                                                                                73
74                Page 2 of 2         • Use UPPERCASE letters.  • Use blue or black ink.  • Print actual size (100%).  • Don’t submit photocopies or use staples. 74
75           Legal name of designated CAT entity (sole proprietor—complete the next line)                                                                         75
76                                                                                                                                                                76
77                                                                                                                                                                77
             XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
78           First name (if sole proprietorship)                     Initial Last name                                                                            78
79                                                                                                                                                                79
80                                                                                                                                                                80
             XXXXXXXXXXXXXXXX                                        X       XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
81           Federal employer identification number (FEIN)     Social Security number (SSN)                                                                       81
82                                                                                                                                                                82
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             99-9999999                                        999-99-9999
84                                                                                                                                                                84
85           Are you filing on a calendar year or fiscal year? Tax year begin (MM/DD/YYYY)         Tax year end (MM/DD/YYYY)                                      85
86                                                                                                                                                                86
87           X    Calendar year       X          Fiscal year   99/99/9999/                /        99/99/9999/    /                                               87
88                                                                                                                                                                88
89           X    I certify I had “good cause” for requesting an extension for the period ending.                                                                 89
90                                                                                                                                                                90
91                                                                                                                                                                91
92           Under penalty of false swearing, I declare that the information in this application and any enclosures is true, correct, and complete.               92
93                                                                                                                                                                93
94           Signature of taxpayer or officer                                                                                                                     94
95                                                                                                                                                                95
96           X                                                                                                                                                    96
97           Date (MM/DD/YYYY)                                                                                                                                    97
98                                                                                                                                                                98
99           99/99/9999/            /                                                                                                                             99
100          First name of officer                                   Initial Last name of officer                                                                 100
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             XXXXXXXXXXXXXXXX                                        X       XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
103          Title of officer                                                                                                                                     103
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             XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
106                                                                                                                                                               106
107          Signature of preparer other than taxpayer                                                                                                            107
108                                                                                                                                                               108
109          X                                                                                                                                                    109
110          Date (MM/DD/YYYY)                                 Phone                                     License number of preparer                               110
111                                                                                                                                                               111
112          99/99/9999/            /                          999-999-9999                              XXXXXXXXXX                                               112
113          First name of preparer                                  Initial Last name of preparer                                                                113
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             XXXXXXXXXXXXXXXX                                        X       XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
116          Address of preparer                                                                                                                                  116
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             XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
119          City                                                                                  State ZIP code                                                 119
120                                                                                                                                                               120
121          XXXXXXXXXXXXXXXXXXXXXX                                                                XX    XXXXX-XXXX -                                             121
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123          If applying by mail, send your application to: Oregon Department of Revenue, PO Box 14950, Salem OR 97309-0950.                                      123
124          Include a Form OR-CAT-V, payment voucher, if you are making a payment.                                                                               124
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                  150-106-006
129               (Rev. 07-22-22, ver. 01)                                                               20562201020000                                           129
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