Clear Form
For Office Use Only
UNDERPAYMENT OF
FORM
Date Received
2006
10
OREGON ESTIMATED TAX
File with your 2006 Oregon individual income tax re turn
Name
Social Security Number
–
–
EXCEPTION TO PAYING INTEREST
1. I am claiming an exception to the imposition of estimated payment interest because I qualified
for relief under ORS 316.573 or 316.587. See instructions and write in the exception number
Exception No._______
you are claiming here and on Form 40, box 51a; Form 40N, box 69a; or Form 40P, box 68a ......................... 1
PART A—Figure your required annual payment
.00
2. 2006 net income tax from Form 40, line 41; Form 40N, line 59; or Form 40P, line 58 ...................................... 2
3. 2006 refundable tax credit amounts you claimed on Form 40, lines 44–46; Form 40N, lines 62–64;
.00
or Form 40P, lines 61–63 ..........................................................................................................................................3
.00
4. Line 2 minus line 3 ............................................................................................................................................. 4
.00
5. Mul ti ply line 4 by 90% (0.90) ............................................................................................5
.00
6. 2006 Oregon income tax withheld from income ................................................................................................ 6
.00
7. Line 4 minus line 6. If less than $1,000, stop here! You do not owe underpayment interest .......................... 7
.00
8. Enter your 2005 tax after credits, including the working family child care credit (see instructions) .................. 8
.00
9. Required annual payment. Enter the smaller of line 5 or line 8 ....................................................................... 9
Note: If line 6 is equal to or more than line 9, stop here! You do not owe underpayment interest. Attach this form to your return.
A
B
C
D
PART B—Fig ure your required periodic payment
10. Payment period due date ............................................................ 10
April 17, 2006
June 15, 2006
Sept. 15, 2006
Jan. 16, 2007
11. Divide the amount on line 9 by four and enter the amount
in each column, or if you use the Annualized Income
Worksheet on the back of this form, enter the amounts
from line 31 here (see instructions) ............................................. 11
PART C — Figure your interest (
See instructions on page 2)
No. of
Monthly
No. of
Daily
Interest
Date
Event
Amount
Running Balance
Months
Rate
Days
Rate
Due
4/17/06
Req. Pymt.
.
.
12.
13. 4/17/06
Withholding
.
.
0.005833
0.000192
.
14.
Payment
.
.
0.005833
0.000192
.
15.
Payment
.
.
0.005833
0.000192
.
16.
Payment
.
.
0.005833
0.000192
.
17. 6/15/06
Req. Pymt.
.
.
18. 6/15/06
Withholding
.
.
0.005833
0.000192
.
19.
Payment
.
.
0.005833
0.000192
.
20.
Payment
.
.
0.005833
0.000192
.
21.
Payment
.
.
0.005833
0.000192
.
22. 9/15/06
Req. Pymt.
.
.
23. 9/15/06
Withholding
.
.
0.005833
0.000192
.
24.
Payment
.
.
0.005833
0.000192
.
25.
Payment
.
.
0.005833
0.000192
.
26.
Payment
.
.
0.005833
0.000192
.
27. 1/16/07
Rate Chg.
.
28. 1/16/07
Req. Pymt.
.
.
29. 1/16/07
Withholding
.
.
0.0075
0.000247
.
30.
Payment
.
.
0.0075
0.000247
.
31.
Payment
.
.
0.0075
0.000247
.
32.
Payment
.
.
0.0075
0.000247
.
33. 4/16/07
— Do not calculate interest after April 16, 2007 —
34. Total interest due. Add the amounts in the interest column. Round to the nearest
.00
whole dollar and enter here and on Form 40, line 51; Form 40N, line 69; or Form 40P, line 68 ..................... 34
150-101-028 (Rev. 12-06) Web