Form 40-V - Oregon Income Tax Payment Voucher

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Where to mail
Oregon Income Tax Payment Voucher, Form 40-V
If you filed your return:
Mail to:
On paper
PO Box 14555
Salem OR 97309-0940
With a 2-D barcode or
PO Box 14720
Salem OR 97309-0463
Don’t use Form 40-V if you are using an electronic payment option.
Use the voucher only if you are paying by check or money order.
Complete the form below using your computer.
After you have printed it, cut along the dotted line and
mail to the Department of Revenue at the addresses shown above.
If, when typing, you see a solid box instead of letters or numbers,
adjust the view size to 100 percent. If the letters or numbers still are not visible,
press the tab key.
Clear Form
Detach Here
Detach Here
Department of Revenue Use Only
150-101-172 (Rev. 12-14)
Fiscal Year Ending
Payment Type (check only one):
2014 Return
Check if:
First time Oregon filer
Amended—Tax Year:
Prior Tax Year:
Daytime telephone number:
Enter Payment Amount
Last name
First name and initial
0 0
Spouse’s/RDP’s last name if joint payment
Spouse’s/RDP’s first name and initial
Spouse’s/RDP’s SSN if joint payment
Current mailing address
ZIP code


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Parent category: Financial