Form Sp-99 - Combined Report Form
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1COMBINED REPORT FORM
SP-99
PORTLAND CITY BUSINESS LICENSE
MULTNOMAH COUNTY BUSINESS INCOME TAX
Taxable Year ____/____/____ to ____/____/____
Name/Address:
Account #:
Please b if address change: U Mailing U Location
FEIN #
_________________________
SOLE PROPRIETORSHIP ¨, 1 MEMBER LLC ¨ (Check one)
1. Net Income or (Loss) from Federal Schedule C
_________________________
2. Multnomah County Business Income Tax add back
_________________________
3. Business Incomes from Schedule E, D, etc. (see instructions)
_________________________
4. Total ½ SE tax and Oregon modifications
(________________________)
5. Adjusted Net Income (total lines 1,2,3 and 4)
_________________________
6. Compensation allowance deduction (see instructions)
(________________________)
7. Subject Net Income (line 5 minus line 6)
_________________________
Multnomah County Business Income Tax
8. County Gross Receipts =
=______.______
Total Gross Receipts
9. County Apportioned Net Income (line 7 x line 8)
____________________
10. Net Operating Loss Deduction (max 75% of line 9)
(___________________)
11. Income subject to tax (line 9 minus line 10)
____________________
12. Tax (line 11 x tax rate of 1.45%)
____________________
13. Prepayments
(___________________)
14. Penalty
____________________
15. Interest
____________________
16. Balance Due or (Overpayment)
_____________________
17. Refund _______________
or Credit ________________
City of Portland Business License Fee
18. Portland Gross Receipts =
=______.______
Total Gross Receipts
19. Portland Apportioned Net Income (line 7 x line 18)
___________________
20. Net Operating Loss Deduction (max 75% of line 19)
(__________________)
21. Income subject to fee (line 19 minus line 20)
___________________
22. Fee (line 21 x rate of 2.2%) MINIMUM $100
___________________
a. Application Year Adjustment Fee (see instructions)
___________________
23. Prepayments
(__________________)
24. Penalty
___________________
25. Interest
___________________
26. Balance Due or (Overpayment)
_____________________
Refund _______________
or Credit ________________
27.
28. Combined amount due with report (total lines 16 and 26)
_____________________
th
Make check payable to City of Portland, 1900 SW 4
Ave., Suite #3500, Portland, OR 97201-5350.
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 _______________________________________________________________Telephone (
) _______________________________
Date __________________________ Address ____________________________________________________________________________________________
Signature of Paid Preparer _______________________________________________________Telephone (
) _______________________________
Rev. 11/99
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