Form 40x - Oregon Amended Individual Income Tax Return
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1
2FORM
OREGON AMENDED
40X
For Office Use Only
INDIVIDUAL INCOME
Original Return Number
Date Received
TAX RETURN
Code
Tax
P&I
Payment Amount
Check if amending to change from
FOR TAX YEAR ___________
married filing separate to filing joint.
Last name
Social Security number (SSN)
Your Age
First name and initial
—
—
Spouse’s last name, if different and joint return
Spouse’s first name and initial, if joint return
Spouse’s SSN if joint return
Spouse’s Age
—
—
Current Mailing address
City
State
ZIP
Telephone number
(
)
A.
B.
C. Correct amount
As originally
Net change
INCOME AND DEDUCTIONS
reported or as
(increase or
adjusted (see
decrease –
(Please read instructions)
explain on back)
specific instr.)
1. Income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1
2
2. Additions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3
3. Federal tax liability (Form 40S only) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4
4. Subtractions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5
5. Deductions (standard deduction or itemized deductions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6. Oregon taxable income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6
TAX AND CREDITS
7
7. TAX . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8
8. Interest on certain installment sales . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9
9. TOTAL OREGON TAX (add lines 7 and 8) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
10
10. Exemption credit (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
11. Other income tax credits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
11
12
12. Total credits (add lines 10 and 11) (it can’t be more than amount on line 9) . . . . . . . . . . . . . .
13. Net income tax (line 9 minus line 12) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
13
PAYMENTS
14. State surplus “Kicker”refund - if applicable (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . .
14
15
15. Oregon income tax withheld . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
16
16. Estimated tax payment(s) for the tax year and payments made with extension requests . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
17
17. Amount paid with original return and any later payment(s) for the tax year (include TAX paid only - see instructions) . . . . . . . . . .
18
18. Total payments (add lines 14 through 17) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(
)
19. Less income tax refunds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
19
20. Net payments (line 18 minus line 19) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
20
REFUND OR BALANCE DUE
21
21. Refund. If line 20 is more than line 13C, you overpaid. Line 20 minus line 13C . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
22. Amount of line 21 you want applied to your 199__ estimated tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
22
23
23. NET REFUND. Line 21 minus line 22. Enter the amount of line 21 you want refunded to you . . . . . . . . . . . . . . . . . . . . . . . . . . . .
24
24. Additional tax-to-pay. If line 13C is more than line 20, you have tax-to-pay. Line 13C minus line 20 . . . . . . . . . . . . . . . . . . . . . . .
25
25. Interest on additional tax-to-pay . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
26
26. AMOUNT-YOU-OWE. Add lines 24 and 25. Pay in full with this return . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Attach a copy of your federal Form 1040X if you also amended your federal return.
See instructions for additional items to attach.
Mail refund returns and no tax due returns to:
Mail tax-to-pay returns to:
Refund, PO Box 14700, Salem OR 97309-0930
Oregon Department of Revenue, PO Box 14555, Salem, OR 97309-0940
Refunds may take 3 – 4 months to process.
Be sure to complete back and sign
150-101-046 (Rev. 9-98)
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