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5           2022 Form OR-CROP                                                                                           Office use only         5
6           Page 1 of 2, 150-101-240           Oregon Department of Revenue           01582201010000                                            6
7           (Rev. 08-18-22, ver. 01)                                                                                                            7
8           Crop Donation Tax Credit                                                                                                            8
9           Oregon Revised Statutes (ORS) 315.154 and 315.156                                                                                   9
10                                                                                                                                              10
11                                                                                                                                              11
12          Grower name                                       Social Security number (SSN)  Fed. emp. id. no. (FEIN) Phone                      12
13          XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 999-99-9999–                          –     99-9999999–          (999)(    )  999-9999–         13
14          Address                                           City                                         State     ZIP code                   14
15                                                                                                                                              15
            XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXXXXX XX                                             XXXXX-XXXX
16          I am an individual, fiduciary, or corporation making a qualified donation to a gleaning cooperative, food bank, or other charitable 16
17          organization of a crop that I have grown. The organization receiving the donation is engaged in the distribution of food without    17
18          charge and the crop is usable as food for human consumption. The donation is available because (check one):                         18
19                                                                                                                                              19
20           X  I have supplied my contract quota with the wholesale or retail buyer.                                                           20
21                                                                                                                                              21
22           X  I was party to a contingent supply contract. The buyer reduced my crop quota below what I expected to supply.                   22
23                                                                                                                                              23
24           X  I am making a donation of apparently wholesome food intended for human consumption, and I grow this food primarily for sale.    24
25                                                                                                                                              25
26          Determination of wholesale market price                                                                                             26
27          The wholesale market price for each crop being donated is determined by either:                                                     27
28           •  The amount paid to the grower by the last previous cash buyer; or                                                               28
29           •  If there is no previous cash buyer, the market price of the nearest wholesale buyer or the regional u-pick market price.        29
30                                                                                                                                              30
31          Donation and calculation of credit. To be completed by the grower.                                                                  31
32                                                                                                                                              32
33                      A.                      B.                          C.                       D.                       E.                33
34              Description of crop donated    Date donated   Quantity of donation          Wholesale market price         Wholesale value      34
35                                                                                                                                              35
36          1A. XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX                                                       36
37                                                                                                         (multiply column C x column D)       37
38                  1B.99/99/9999/   /      1C.99,999,999,9991D.99,999,999,999.99.                      1E.99,999,999,999.99.                   38
39                                                                                                                                              39
40                                                                                                                                              40
41          2A. XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX                                                       41
42                                                                                                         (multiply column C x column D)       42
43                  2B.99/99/9999/   /      2C.99,999,999,9992D.99,999,999,999.99.                      2E.99,999,999,999.99.                   43
44                                                                                                                                              44
45                                                                                                                                              45
46          3A. XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX                                                       46
47                                                                                                         (multiply column C x column D)       47
48                  3B.99/99/9999/   /      3C.99,999,999,9993D.99,999,999,999.99.                      3E.99,999,999,999.99.                   48
49                                                                                                                                              49
50                                                                                                                                              50
51          4A. XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX                                                       51
52                                                                                                         (multiply column C x column D)       52
53                  4B.99/99/9999/   /      4C.99,999,999,9994D.99,999,999,999.99.                      4E.99,999,999,999.99.                   53
54                                                                                                                                              54
55                                                                                                                                              55
56          5A. XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX                                                       56
57                                                                                                         (multiply column C x column D)       57
58                  5B.99/99/9999/   /      5C.99,999,999,9995D.99,999,999,999.99.                      5E.99,999,999,999.99.                   58
59                                                                                                                                              59
60                                                                                                                                              60
61          6A. XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX                                                       61
62                                                                                                         (multiply column C x column D)       62
63                  6B.99/99/9999/   /      6C.99,999,999,9996D.99,999,999,999.99.                      6E.99,999,999,999.99.                   63
64                                                                                                                                              64
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70                                                                                                                                                                                            70
71           2022 Form OR-CROP                                                                                                                                                                71
72           Page 2 of 2, 150-101-240                 Oregon Department of Revenue           01582201020000                                                                                   72
73           (Rev. 08-18-22, ver. 01)                                                                                                                                                         73
74                                                                                                                                                                                            74
75             7. Total wholesale value (add column E, lines 1–6) ..............................................................................7.                  99,999,999,999.99.        75
76                                                                                                                                                                                            76
77             8. Credit percentage ............................................................................................................................ 8.                  ×  0.15  77
78                                                                                                                                                                                            78
79             9. Credit amount. Multiply line 7 by line 8 and round to the nearest dollar.                                                                                                   79
80              Use code 843 and claim on Schedule OR-ASC, OR-ASC-NP, OR-ASC-FID, or OR-ASC-CORP.                                                                                             80
81              Form OR-40-N and Form OR-40-P filers, multiply your credit by your Oregon percentage ......... 9.                                                   99,999,999,999.00.00      81
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83                                                                                                                                                                                            83
84           Grower signature                                                                                                                                                   Date          84
85           X                                                                                                                                                                  99/99/9999/ / 85
86                                                                                                                                                                                            86
87           Donation verification. To be completed by organization receiving the donation.                                                                                                   87
88           Name of organization receiving donation                                                                                                                      Phone               88
89                                                                                                                                                                                            89
90           Address                                              City                                                                                              State ZIP code            90
91                                                                                                                                                                                            91
92                                                                                                                                                                                            92
93           I verify the crop was, or will be, distributed in Oregon (a) without charge; and (b) to children or homeless, unemployed, elderly, or low-                                       93
94           income individuals; and (c) by a qualified charitable organization as defined by Internal Revenue Code Section 501(c)(3).                                                        94
95                                                                                                                                                                                            95
96           Signature of official receiving donation                                                                                                                                         96
97           X                                                                                                                                                                                97
98           Name of official receiving donation                  Date                                                                                                                        98
99                                                                                                                                                                                            99
100                                                                                                                                                                                           100
101                                   Don’t include this form with your Oregon return. Keep it with your tax records.                                                                         101
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