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2021 Form OR-40
Page 5 of 8
150-101-040
(Rev. 08-23-21, ver. 01)
• Use UPPERCASE letters. • Use blue or black ink. • Print actual size (100%). • Don’t submit photocopies or use staples.
Oregon Department of Revenue
Social Security number (SSN)
Last name
Payments and refundable credits
32. Oregon income tax withheld. Include a copy of your Forms W-2 and 1099 ........ 32.
33. Amount applied from your prior year’s tax refund .................................................... 33.
34. Estimated tax payments for 2021. Include all payments you made before
filing this return (see instructions). Do not include the amount on line 33 ................ 34.
35. Earned income credit (see instructions) .................................................................... 35.
36. 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 53 .......................................................... 36.
37. Total refundable credits from Schedule OR-ASC, Section F ................................... 37.
38. Total payments and refundable credits. Add lines 32 through 37 ............................ 38.
Tax to pay or refund
39. Overpayment of tax. If line 31 is less than line 38, you overpaid.
Line 38 minus line 31 ................................................................................................ 39.
40. Net tax. If line 31 is more than line 38, you have tax to pay.
Line 31 minus line 38 ................................................................................................ 40.
41. Penalty and interest for filing or paying late (see instructions) ................................. 41.
42. Interest on underpayment of estimated tax. Include Form OR-10 ......................... 42.
Exception number from Form OR-10, line 1 42a. Check box if you annualized: 42b.
43. Total penalty and interest due. Add lines 41 and 42 ................................................ 43.
Note: Reprint page 1 if you make changes to this page.
Oregon Individual Income Tax Return for Full-year Residents