Oregon Department of Revenue
2021 Form OR-STT-1
Oregon Quarterly Statewide Transit Tax Withholding Return
Office use only
Page 1 of 1, 150-206-003
(Rev. 04-09-20 ver. 01)
Date received
Payment received
Submit original form—do not submit photocopy
Place a 0 in the “subject wages” box if the employer is subject to the tax but there was not payroll this quarter.
Signature
PhoneDate
Title
X
Print name signed above
Check the box for the quarter in which the statewide transit tax was withheld:
Quarter 1: January 1, 2021–March 31, 2021. Return and payment are due by April 30, 2021.
Quarter 2: April 1, 2021–June 30, 2021. Return and payment are due by July 31, 2021.
Quarter 3: July 1, 2021–September 30, 2021. Return and payment are due by October 31, 2021.
Quarter 4: October 1, 2021–December 31, 2021. Return and payment are due by January 31, 2022.
Business name
Physical address (required)
County
Daytime phone
Email
ZIP code
ZIP code
State
State
City
City
Business phone
Fax number
Web address
Title
Mailing address
Name
Contact person
Federal employer identication number (FEIN) Business identication number (BIN)
Check if this is an amended return.
Check if address or name have changed.
Please print
1. Subject wages ................................................................................................................................ 1.
2. Total tax withheld ............................................................................................................................ 2.
3. Less: Oregon tax pre-paid this quarter .......................................................................................... 3.
4. Total tax due ................................................................................................................................... 4.
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Mail: Oregon Department of Revenue
PO Box 14800
Salem OR 97309-0920
Declaration
I declare under penalties for false swearing [Oregon Revised Statute 305.990(4)] that I have examined this document and to the best of
my knowledge it is true, correct, and complete.
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