Form 150-101-062 - Oregon Amended Schedule For Amending Individual Income Tax Returns - Oregon Department Of Revenue

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Oregon Amended Schedule
for Amending Individual Income Tax Returns
Tax Year
Reminder: If you object to an adjustment we made to your return, do not respond by filing an amended return.
Check if amending to change from married/RDP filing separate to married/RDP filing joint.
1a
Check if amending due to a net operating loss (NOL).
Last name
First name and initial
Social Security number (SSN)
Spouse’s/RDP’s last name, if different and joint return
Spouse’s/RDP’s first name and initial, if joint return
Spouse’s/RDP’s SSN if joint return
Please read instructions
Round to the nearest dollar
.00
101 Net income tax as amended .............................................................................................................................................
101
.00
102 Oregon income tax withheld as amended .....................................................................................
102
103 Refundable tax credits as amended (see instructions on page 2)
.00
Earned income credit as amended (tax years 2006 and later only) ...........
103a
.00
Working family child care credit as amended ............................................
103b
Mobile home park closure credit (tax year 2007 or later) or involuntary
.00
move of a mobile home credit (tax year 2006 only) as amended .........
103c
.00
Total refundable tax credits as amended (add lines 103a, 103b, and 103c) .................................
103
.00
104 Estimated tax payments .................................................................................................................
104
.00
105 Amount of net income tax paid with original return and later (do not include penalty or interest) ...
105
.00
106 Total payments (add lines 102–105) ..................................................................................................................................
106
.00
107 Income tax refunds received from original return and later (do not include interest or kicker; see instructions) ...........
107
.00
108 Net payments (line 106 minus line 107) .............................................................................................................................
108
.00
109 Overpayment. If line 108 is more than line 101, you over paid. Line 108 minus line 101 ..............................................
109
.00
110 Amount on line 109 you want applied to your estimated tax. For tax year:
1b
..................................
110
.00
111 Refund. Line 109 minus line 110 .......................................................................................................................................
111
.00
112 Additional tax to pay. If line 101 is more than line 108, you have tax to pay. Line 101 minus line 108 ........................
112
.00
113 Interest on additional tax to pay (see instructions on pages 3–4) ......................................................................................
113
.00
114 Amount you owe. Add lines 112 and 113. Pay in full with this return .................................................................................
114
Explanation of adjustments made—Include line number(s) and show the computations in detail. Additional space is available on the back
if needed. Attach schedules, if applicable. If you are amending for an NOL, attach a copy of your NOL
computation and a copy of the tax return for the year the NOL occurred.
Amended returns may take six months or longer to process.
—Attach this schedule to your Oregon amended return—
150-101-062 (Rev. 12-12)
Amended, page 1 of 2

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