Fillable 2019 Form OR-40 Oregon Individual Income Tax Return (Oregon)

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2019 Form OR-40 Oregon Individual Income Tax Return (Oregon)

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The 2019 Form OR-40 Oregon Individual Income Tax Return (Oregon) form is 4 pages long and contains:

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Oregon Department of Revenue
2019 Form OR-40
Oregon Individual Income Tax Return for Full-year Residents
Page 1 of 4, 150-101-040
(Rev. 09-19-19 ver. 01)
Last name
Spouse’s last name
First name Initial
Spouse’s rst name Initial
Social Security no. (SSN)
Spouse’s SSN
Deceased
Deceased
Applied
for ITIN
Applied
for ITIN
Check if child
with
qualifying
disability
Dependent’s date
of birth (mm/dd/yyyy)Dependent’s SSNCode*First name Last name
Dependents. List your dependents in order from youngest to oldest.
If more than four, check this box
and include Schedule OR-ADD-DEP
with your return.
6c. Total number of dependents. ........................................................................................................................................................................... 6c.
6d. Total number of dependent children with a qualifying disability (see instructions). ......................................................................................... 6d.
6e. Total exemptions. Add 6a through 6d. ................................................................................................................................................... Total. 6e.
Amended return. If amending for an NOL,
tax year the NOL was generated:
Calculated using “as if” federal return.
Short-year tax election. Federal disaster relief.
Extension filed. Federal Form 8886.
Form OR-24.
*Dependent relationship code (see instructions).
Submit original form—do not submit photocopy
Space for 2-D barcode—do not write in box below
Fiscal year ending:
00461901010000
First time using
this SSN (see
instructions)
First time using
this SSN (see
instructions)
Filing status (check only one box)
1. Single.
2. Married filing jointly.
3. Married filing separately (enter spouse’s information above).
4. Head of household (with qualifying dependent).
5. Qualifying widow(er) with dependent child.
Phone
Current mailing address
Country
Exemptions
Total
6a. Credits for yourself: Regular Severely disabled .... 6a.
Check box if someone else can claim you as a dependent.
6b. Credits for spouse: Regular Severely disabled .... 6b.
Check box if someone else can claim your spouse as a dependent.
Date of birth (mm/dd/yyyy)
Spouse’s date of birth
City State ZIP code
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2019 Form OR-40
Oregon Department of RevenuePage 2 of 4, 150-101-040
(Rev. 09-19-19 ver. 01)
Taxable income
7. Federal adjusted gross income from federal Form 1040 or 1040-SR, line 8b; 1040-NR, line 35;
1040-NR-EZ, line 10; or 1040-X, line 1C (see instructions). ..................................................................................... 7.
8. Total additions from Schedule OR-ASC, section 1. ................................................................................................. 8.
9. Income after additions. Add lines 7 and 8. ............................................................................................................... 9.
Subtractions
10. 2019 federal tax liability. See instructions for the correct amount: $0-$6,800. ................................................... 10.
11. Social Security included on federal Form 1040 or 1040-SR, line 5b.. ..................................................................... 11.
12. Oregon income tax refund included in federal income. ........................................................................................... 12.
13. Total subtractions from Schedule OR-ASC, section 2. ............................................................................................ 13.
14. Total subtractions. Add lines 10 through 13. ........................................................................................................... 14.
15. Income after subtractions. Line 9 minus line 14. ...................................................................................................... 15.
Deductions
16. Oregon itemized deductions. Enter your Oregon itemized deductions from Schedule OR-A, line 23. If you
are not itemizing your deductions, enter -0-. ........................................................................................................... 16.
17. Standard deduction. Enter your standard deduction (see instructions). ................................................................ 17.
You were: 17a. 65 or older 17b. Blind Your spouse was: 17c. 65 or older 17d. Blind
18. Enter the larger of line 16 or 17. ............................................................................................................................... 18.
19. Oregon taxable income. Line 15 minus line 18. If line 18 is more than line 15, enter -0-. ....................................... 19.
Oregon tax
20. Tax. Check the appropriate box if you’re using an alternative method to calculate your tax (see instructions). ..... 20.
20a. Schedule OR-FIA-40 20b. Worksheet OR-FCG 20c. Schedule OR-PTE-FY
21. Interest on certain installment sales. ........................................................................................................................ 21.
22. Total tax before credits. Add lines 20 and 21. ......................................................................................................... 22.
Standard and carryforward credits
23. Exemption credit. If the amount on line 7 is $100,000 or less, multiply your total exemptions on
line 6e by $206. Otherwise, see instructions. ........................................................................................................... 23.
24. Political contribution credit. See limits in instructions. .......................................................................................... 24.
25. Total standard credits from Schedule OR-ASC, section 3....................................................................................... 25.
26. Total standard credits. Add lines 23 through 25. ...................................................................................................... 26.
27. Tax minus standard credits. Line 22 minus line 26. If line 26 is more than line 22, enter -0-. .................................. 27.
28. Total carryforward credits claimed this year from Schedule OR-ASC, section 4. Line 28 can’t be more
than line 27 (see Schedule OR-ASC instructions). ................................................................................................... 28.
29. Ta x after standard and carryforward credits. Line 27 minus line 28. ........................................................................ 29.
Name SSN
00461901020000
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2019 Form OR-40
Oregon Department of RevenuePage 3 of 4, 150-101-040
(Rev. 09-19-19 ver. 01)
Payments and refundable credits
30. Oregon income tax withheld. Include a copy of your Forms W-2 and 1099. ....................................................... 30.
31. Amount applied from your prior year’s tax refund. .................................................................................................. 31.
32. Estimated tax payments for 2019. Include all payments you made prior to the filing date of this return.
Do not include the amount you already reported on line 31. ................................................................................... 32.
33. Earned income credit (see instructions). .................................................................................................................. 33.
34. Kicker (Oregon surplus credit). Enter your kicker credit amount (see instructions).
If you elect to donate your kicker to the State School Fund, enter -0- and see line 51.
................................. 34.
35. Total refundable credits from Schedule OR-ASC, section 5. ................................................................................... 35.
36. Total payments and refundable credits. Add lines 30 through 35. .......................................................................... 36.
Tax to pay or refund
37. Overpayment of tax. If line 29 is less than line 36, you overpaid. Line 36 minus line 29. ...................................... 37.
38. Net tax. If line 29 is more than line 36, you have tax to pay. Line 29 minus line 36. .............................................. 38.
39. Penalty and interest for filing or paying late (see instructions). ................................................................................ 39.
40. Interest on underpayment of estimated tax. Include Form OR-10. ........................................................................ 40.
Exception number from Form OR-10, line 1: 40a. Check box if you annualized: 40b.
41. Total penalty and interest due. Add lines 39 and 40. ............................................................................................... 41.
42. Net tax including penalty and interest. Line 38 plus line 41. ............................... This is the amount you owe. 42.
43. Overpayment less penalty and interest. Line 37 minus line 41. ......................................... This is your refund. 43.
44. Estimated tax. Fill in the portion of line 43 you want applied to your open estimated tax account......................... 44.
45. Charitable checkoff donations from Schedule OR-DONATE, line 30. ...................................................................... 45.
46. Political party $3 checkoff. Party code: 46a. You. 46b. Spouse. ................................... 46.
47. Oregon 529 college savings plan deposits from Schedule OR-529 (see instructions). ........................................... 47.
48. Total. Add lines 44 through 47. Total can’t be more than your refund on line 43. .................................................... 48.
49. Net refund. Line 43 minus line 48. .................................................................................... This is your net refund. 49.
Name SSN
00461901030000
Direct deposit
50. For direct deposit of your refund, see instructions. Check the box if the final deposit destination is outside the United States:
Type of account: Checking or Savings
Routing number:
Account number:
Kicker donation
51. Kicker donation. If you elect to donate your kicker to the State School Fund, check this box: 51a.
Complete the kicker worksheet, located in the instructions, and enter the amount here.
This election is irrevocable .................................................................................................................................. 51b.
Note: Reprint page 1 if you make changes to this page.
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Your signature
Spouse’s signature (if filing jointly, both must sign)
Signature of preparer other than taxpayer
Preparer address City State ZIP code
Date
Date
Preparer phone
X
X
X
Sign here. Under penalty of false swearing, I declare that the information in this return is true, correct, and complete.
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
the Tax Information Authorization and Power of Attorney for Representation form on our website.
Important: Include a copy of your federal Form 1040, 1040-SR, 1040-X, 1040-NR, or 1040-NR-EZ. Without this information, we may adjust your
return.
Make your payment (if you have an amount due on line 42)
• Online payments: Visit our website at www.oregon.gov/dor.
• Mailing your payment: Make your check or money order payable to the Oregon Department of Revenue. Write “2019 Oregon Form OR-40”
and the last four digits of your SSN or ITIN on your check or money order. Include your payment with this return. Don’t use the Form OR-40-V
payment voucher unless you’re sending us a separate payment.
Send in your return
• Non-2-D barcode. If the 2-D barcode area on the front of this return is blank:
— Mail tax-due returns to: Oregon Department of Revenue, PO Box 14555, Salem OR 97309-0940.
— Mail refund and no-tax-due returns to: Oregon Department of Revenue, PO Box 14700, Salem OR 97309-0930.
• 2-D barcode. If the 2-D barcode area on the front of this return is filled in:
— Mail tax-due returns to: Oregon Department of Revenue, PO Box 14720, Salem OR 97309-0463.
— Mail refund and no-tax-due returns to: Oregon Department of Revenue, PO Box 14710, Salem OR 97309-0460.
2019 Form OR-40
Oregon Department of RevenuePage 4 of 4, 150-101-040
(Rev. 09-19-19 ver. 01)
Name SSN
00461901040000
Amended statement. Complete this section only if you’re amending your 2019 return or filing with a new SSN.
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
filing status has changed, explain why. Include all supporting forms and schedules when you file your amended return, even if you haven’t changed
anything on them.
If filing with a new SSN, enter your former identification number.
Preparer license number, if professionally prepared
Note: Reprint page 1 if you make changes to this page.
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2019 Form OR-40 Oregon Individual Income Tax Return (Oregon)

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Completed 28 February 2021

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