Form Or-41 - Oregon Fiduciary Income Tax Return - 2016
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3Clear Form
2016 Form OR-41
Office use only
Date received
00471601010000
Page 1 of 3, 150-101-041 (Rev. 10-16)
Oregon Department of Revenue
•
Oregon Fiduciary Income Tax Return
Payment
Penalty date
Submit original form—do not submit photocopy.
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Fiscal year
Month
Day
Year
Month
Day
Year
/
/
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/
/
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Amended return
beginning:
Ending:
Federal employer identification number (FEIN)
Name of trust or estate (first name, initial, last name)—print clearly or type
•
of trust or estate
Check if new FEIN
Check if new name
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–
•
•
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Name of fiduciary (first name, initial, last name)
Check if new name
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Title (TTEE or PR)
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Extension to file
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Street address or PO Box
Check if new
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address
Form OR-24 is included
City
State
ZIP code
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A. Check only one box:
B. This is:
C. Check one box:
D. If exempt organization,
/
/
check federal form filed:
An estate—date of death:
–
–
A first return
An Oregon resident.
Decedent’s SSN:
990-T—Specify
A final return
A nonresident.
your due date:
A bankruptcy estate
A funeral trust
A trust
/
/
A part-year trust (use
Other—Specify:
A trust filing as an estate. Include IRS Form 8855.
/
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Schedule OR-SCH-P
Date of death:
–
–
to compute the tax).
Decedent’s SSN:
Include a copy of federal Form 1041, Schedule K-1s, applicable schedules, 1099’s and W-2’s
Beneficiary column
Fiduciary column
1. Revised distributable net income from
.00
•
Form OR-41, Schedule 1, line 29 ..............
1
2. Distribution deduction from federal Form 1041, Schedule B, line 15,
.00
•
plus Form OR-41, Schedule 1, line 31 .......................................
2
a. Tax-exempt income deducted in computing distribution deduction from federal
.00
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Form 1041, Schedule B, line 12 .............
2a
.00
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b. Add lines 2 and 2a ...................................
2b
.00
•
3. Percentage = Line 2b $
= 3
%
.00
Line 1
$
.00
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4. Revised taxable income of fiduciary from Form OR-41, Schedule 1, line 32 ............................
4
5. Fiduciary adjustment from Form OR-41, Schedule 2, line 44
.00
•
•
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Show as an
addition or
subtraction .....
5
.00
a. Beneficiary’s share (line 5 × % on line 3—see instructions) .... 5a
.00
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b. Fiduciary’s share (line 5 minus line 5a) ....................................................................................
5b
6. Income to be reported by beneficiaries (Form 1041, Schedule K-1
.00
•
included—see instructions) (line 2 plus line 5a) ...........................
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Continued on page 2
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