Form Sps - Severance Pay Subtraction Page 2
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Small business sales and employee information
Two years
One year
Year of investment
following investment
following investment
Previous year
(actual or estimated)
(estimated)
(estimated)
Number of
employees
Yearly gross sales
$
$
$
$
(in dollars)
PART C—Severance pay subtraction calculation worksheet
00
1. Enter the amount of severance pay actually invested in a qualifying small business ...................... 1
$500,000 00
2. Enter $500,000 ................................................................................................................................ 2
00
3. Enter the lesser of line 1 or 2 ............................................................................................................ 3
.
___ ___ ___
___%
4. Multiply by Oregon sales factor, if applicable ................................................................................... 4
5. Subtraction amount (line 3 times line 4 or enter line 3 if no sales factor) ......................................... 5
00
Enter the subtraction amount from line 5 on the “other subtractions” line on your Oregon tax return or Schedule OR-ASC.
Use subtraction code 349.
I have read and understand the requirements of this subtraction as outline in this form. The information provided is correct
and accurate according to my best information and belief.
Signed
Taxpayer’s signature
Date
X
Keep a copy of this form for your records. Include this form with your return in the year for which you are claiming the
subtraction. If filing electronically, fax this notice to 503-945-8786, labeled “Attn: Suspense,” or mail it to:
COR-TROL
Attn: Suspense
PO Box 14999
Salem OR 97309-0990
Page 2 of 2
150-101-705 (Rev. 10-10)
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