Form E-2003 - Combined Report Form For Estates & Trusts
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1COMBINED REPORT FORM FOR ESTATES & TRUSTS
MULTNOMAH COUNTY BUSINESS INCOME TAX
Form
PORTLAND CITY BUSINESS LICENSE
Taxable Year ____/____/____ to ____/____/____
E-2003
th
th
DUE DATE: 15
day of the 4
month following the taxable year end
Name/Address:
Account #:
Please
if address change:
Mailing
Location
FEIN # _________________________
Business Code ___________ (see instructions)
ESTATE AND TRUST
1. Net Income or (Loss) before distribution
_________________________
2. Multnomah County Business Income Tax add back
_________________________
3. Total lines 1 and 2
_________________________
4. Other income and deductions
_________________________
5. Subject Net Income (total lines 3 and 4)
_________________________
Multnomah County Business Income Tax
8. County Gross Income = _____________________________=______.______
Total Gross Income
9. County Apportioned Net Income (line 5 x line 8)
____________________
10. Net Operating Loss Deduction (max 75% of line 9)
(___________________)
11. Income subject to tax (line 9 minus line 10)
____________________
12. Tax (line 11 x tax rate of 1.45%)
____________________
13. Prepayments
(___________________)
14. Penalty
____________________
15. Interest
____________________
16. Balance Due or (Overpayment)
_____________________
17. Refund _______________ Apply to Portland Underpayment __________
City of Portland Business License Fee
Portland Gross Income =
=______.______
18.
Total Gross Income
Portland Apportioned Net Income (line 5 x line 18)
___________________
19.
Net Operating Loss Deduction (max 75% of line 19)
(__________________)
20.
Income subject to fee (line 19 minus line 20)
___________________
21.
Fee (line 21 x rate of 2.2%) MINIMUM $100
___________________
22.
a. Application Year Adjustment Fee (see instructions)
___________________
b. Temporary rate increase (line 21 X .4%--no minimum)
___________________
Prepayments
(__________________)
23.
Penalty
___________________
24.
Interest
___________________
25.
Balance Due or (Overpayment)
_____________________
26.
Refund _______________
Apply to Multnomah Underpayment __________
27.
28. Combined amount due with report (total lines 16 and 26)
_____________________
Make check payable to City of Portland, 111 SW Columbia St, Suite 600, Portland, OR 97201-5814*.
The undersigned declares that the information given on this report is true. The undersigned is authorized to act as a representative of the filer.
Signature of Filer ___________________________________________________________ Email Address _________________________________
Signature of Preparer _______________________________________________________________ Date __________________________________
Preparer’s Name/Address __________________________________________________________ Telephone (
) _______________________
Bureau of Licenses (503)823-5157
FAX (503)823-5192
TDD (503)823-6868
Rev 11/03
*Address effective 1/15/2004
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