COMBINED REPORT FORM FOR INDIVIDUALS
FORM
MULTNOMAH COUNTY BUSINESS INCOME TAX
CITY OF PORTLAND BUSINESS LICENSE
SP-2007
01/01/07
12/31/07
Taxable Year ____/____/____ to ____/____/____
th
th
DUE DATE:15
day of the 4
month following the taxable year end
Reset Form
(April 15 for calendar year filers)
Name/Mailing Address:
Account #:
Amended Return?
Ceased Portland/Multnomah Business?
(attach explanation)
Social Security #_______________________ and FEIN # _______________________
b
Please
if address change:
Federal Business Code ______________
Please notify Bureau if your business location changes
SOLE PROPRIETORSHIP
, 1 MEMBER LLC
, JT. VENT./TENANTS-IN-COMMON
(Check all that apply)
Multnomah County Tax
City of Portland License
$0
1. Net Income or (Loss) from Federal Schedule C (attach Schedule C) _____________________
____________________
$0
$0
$0
2. Multnomah County Business Income Tax Add Back
_____________________
____________________
$0
$0
3. Net Income or (Loss) from Federal Schedule E, D (attach Schedule)_____________________
____________________
$0
$0
4. Total ½ SE tax and Oregon modifications
_____________________
____________________
$0
5. Adjusted Net Income (total lines 1, 2, 3 and 4)
_____________________
____________________
$0
1
6. Compensation Allowance Deduction (Owners___--see instructions)(_____________________)
$0
(____________________)
$0
$0
$0
7. Subject Net Income (line 5 minus line 6)
_____________________
____________________
Multnomah County Business Income Tax
Average Sum of Multnomah Employees in 2007
$1
100.0000%
8. County Gross Income =
____________________________ =______________.______
$1
Total Gross Income
$0
9. County Apportioned Net Income (line 7 x line 8)
____________________
$0
10. Net Operating Loss Deduction (max 75% of line 9)
(___________________)
Must be entered as negative sum
$0
11. Income Subject to Tax (line 9 minus line 10)
____________________
$0
12. Tax (line 11 x tax rate of 1.45%)
____________________
$0
Must be entered as negative sum
13. Prepayments
(___________________)
$0
14. Penalty
____________________
$0
15. Interest
____________________
$0
16. Balance Due or (Overpayment)
_____________________
$0
$0
$0
17. Refund _______________ Credit _________________ Transfer to Portland ______________
City of Portland Business License Fee
Average Sum of Portland Employees in 2007
$1
100.0000%
18. Portland Gross Income = ____________________________ =______________.______
If you are not liable for a Portland Business License
please push "Not Liable" button:
Total Gross Income
$1
Not Liable
$0
19. Portland Apportioned Net Income (line 7 x line 18)
____________________
20. Net Operating Loss Deduction (max 75% of line 19)
Must be entered as negative sum
(___________________)
$0
$0
21. Income Subject to Fee (line 19 minus line 20)
____________________
22. Fee (line 21 x rate of 2.2%) MINIMUM $100
____________________
$100
a. Application Year Adjustment Fee (see instructions)
____________________
$0
b. Temporary Rate Increase (line 21 x .07% or .0007)
____________________
$0
23. Prepayments
(___________________)
$0
Must be entered as negative sum
24. Penalty
____________________
$0
25. Interest
____________________
$0
26. Balance Due or (Overpayment)
______________________
$100
$0
$0
$0
27. Refund _______________ Credit ________________ Transfer to Multnomah _____________
Donation to “Work for Art” Program
$0
_____________________
28. Combined Amount Due with Report (total lines 16 and 26) Check # ____________
_____________________
$100
Make check payable to City of Portland, 111 SW Columbia St., Suite #600, Portland, OR 97201-5840.
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 _______________________________________________________ Filer’s Daytime Telephone (
)___________________
Signature of Preparer _______________________________________________________ Date _________________________________________
Preparer’s Name/Address ___________________________________________________ Telephone (
) _______________________________
REVENUE BUREAU (503) 823-5157
FAX (503) 823-5192
TDD (503) 823-6868
Rev. 12/21/07