Form 40-Ext - Oregon Automatic Extension For Individuals And Payment Voucher - 2004
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1Clear Form
OREGON AUTOMATIC EXTENSION
FORM
2004
40-EXT
FOR INDIVIDUALS
AND PAYMENT VOUCHER
Note to fiscal year taxpayers: File Form 40-EXT by the regular due date of your return.
If you filed a federal extension and you expect to get a
—Check box 7b on your Oregon return. Keep a copy of
refund for Oregon, you do not need to fi le Oregon Form
your extension in your records.
40-EXT. Use Form 40-EXT only if:
An extension does not mean more time to pay. If you do
• You did not fi le a federal extension but you need more time
not pay at least 90 percent of your total tax liability by April
to fi le for Oregon only and you expect an Oregon refund.
15, 2005, a 5 percent late payment penalty, plus interest, may
be added to your tax due. If you do not fi le your return by
—File Oregon Form 40-EXT. Fill out Form 40-V, Oregon
August 15, 2005, you may be assessed an additional 20 per-
Income Tax Payment Voucher, and enter -0- in the pay-
cent penalty, plus interest.
ment amount box. Mail the entire Form 40-EXT to the
department’s extension clerk.
Fill in your Social Security number(s) (SSN) and the fi rst
—Check box 7b on your Oregon return. Keep a copy of
four letters of your last name(s) on the voucher below. If
your extension in your records.
you owe, make your check or money order out to “Oregon
Department of Revenue.” Be sure to write your daytime
• You need more time to fi le for Oregon and you need to
telephone number and “2004 40-EXT” on your check or
make a tax payment to Oregon.
money order. To help us speed processing, use blue or black
—Complete the tax payment worksheet below. Fill out
ink to fi ll out your voucher and check. Do not use red ink.
and detach Form 40-V, Oregon Income Tax Payment
Do not postdate your check. Mail to:
Voucher. Mail the payment voucher and your check
Extension Clerk
or money order by April 15, 2005, to the department’s
Oregon Department of Revenue
extension clerk. If paying by credit card, write “credit
PO Box 14950
card payment” on Form 40-V and mail the voucher to
Salem OR 97309-0980
the department’s extension clerk.
TAX PAYMENT WORKSHEET
Keep your completed worksheet with your tax records. Do not mail with your payment.
1. Estimate of your 2004 Oregon net tax liability ............................................................................................... 1
2. Total 2004 Oregon tax payments (withholding, estimated payments,
and working family child care credit).............................................................................................................. 2
Is line 2 more than line 1? If yes, enter -0- on line 3 and in the
“Enter Payment Amount” box on the voucher below. If no, continue to line 3.
3. Tax to pay with extension. Subtract line 2 from line 1. Enter the difference
here and in the “Enter Payment Amount” box on the voucher below ....................................................... 3
150-101-165 (Rev. 12-04)
Detach Here
Detach Here
FORM
OREGON INCOME TAX PAYMENT VOUCHER
Department of Revenue Use Only
40-V
150-101-172 (Rev. 12-04) Web
•
Payment Type (check only one):
•
•
Tax Year (check only one):
2004 Return
✘
Calendar Year
2004 Extension
Fiscal Year— Begins
2005 Estimated Tax—Quarter:
Clear Form
Ends
Amended Return—Tax Year:
Prior Year Return—Tax Year:
•
•
Enter Payment Amount
Your SSN
First four letters of last name
•
•
Spouse’s SSN
First four letters of last name
$
0 0
.
Your name: last, fi rst, and initial
Spouse's name: last, fi rst, and initial (if joint payment)
(
)
Mailing address
Telephone Number
City
State
Zip Code
First time fi ler
New name or address
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