First name
Spouse’s first name
Social Security number (SSN)
Spouse’s SSN
Last name
Spouse’s last name
Oregon Department of Revenue
19481902010000
2019 Schedule OR-A
Oregon Itemized Deductions
Submit original form—do not submit photocopy
Office use only
Page 1 of 1, 150-101-007
(Rev. 12-24-19 ver. 02)
Medical and dental expenses
Caution! Don’t include expenses reimbursed or paid by others.
1. Medical and dental expenses (see instructions). ....................................................... 1.
2. Federal adjusted gross income (AGI). Enter the amount
from Form OR-40, line 7 or Form OR-40-N or OR-40-P,
line 29F .......................................................................... 2.
3. AGI threshold. Multiply line 2 by 7.5% (0.075) ........................................................... 3.
4. Medical and dental expense deduction. Subtract line 3
from line 1. If line 3 is more than line 1, enter -0- ..................................................................................................... 4.
Taxes you paid
5. State and local income taxes. Don’t include Oregon
income tax! .................................................................. 5.
6. Real estate taxes (see instructions) ............................... 6.
7. Personal property taxes ................................................ 7.
8. Reserved ....................................................................... 8.
9. Total income and property taxes. Add lines 5 through 8.
Don’t enter more than $10,000 ($5,000 if married filing separately) .................... 9.
10. Other taxes. List type and amount:
10.
11. Taxes paid deduction. Add lines 9 and 10 ............................................................................................................. 11.
Interest you paid
12.
Mortgage interest and points reported to you on federal Form 1098
................................ 12.
13. Mortgage interest not reported to you on federal Form 1098 .................................... 13.
14. Points not reported to you on federal Form 1098 ..................................................... 14.
15. Mortgage insurance premiums (see instructions) ...................................................... 15.
16. Investment interest (see instructions) ......................................................................... 16.
17. Interest paid deduction. Add lines 12 through 16 .................................................................................................. 17.
Gifts to charity
18. Gifts by cash or check (see instructions) ................................................................... 18.
19. Gifts other than by cash or check (see instructions) .................................................. 19.
20. Carryover from prior year ........................................................................................... 20.
21. Total gifts to charity. Add lines 18 through 20 .......................................................................................................... 21.
Other miscellaneous deductions
22. List type and amount. Important! Don’t include employee business expenses, tax preparation fees,
or other deductions subject to the 2 percent of AGI limitation (see instructions).
22.
Oregon itemized deductions
23. Add lines 4, 11, 17, 21, and 22 ................................................................................................................................. 23.
Enter the amount from line 23 on Form OR-40, line 16; Form OR-40-N or OR-40-P, line 37.
Read instructions carefully before completing this schedule.
—You must include this schedule with your Oregon income tax return—
. 00
Initial
Initial
–
–
–
–
. 00
. 00
. 00
. 00
. 00
. 00
. 00
. 00
. 00
. 00
. 00
. 00
. 00
. 00
. 00
. 00
. 00
. 00
. 00
. 00
. 00
. 00
Congress extended several tax provisions by passing Public Law 116-94.
As a result, this form was updated on December 24, 2019.
