Form Ltd-V - Ltd Self-Employment Tax Payment Voucher Instructions
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1LTD Self-Employment Tax
FORM
LTD-V
Payment Voucher Instructions
Use this voucher ONLY if enclosing a payment for the following:
• Tax due when you file your original return for any year.
• Tax due by the original return’s due date if you are filing for an extension.
• Tax due with an amended return for any tax year.
• Tax prepayments made before filing your return.
Required for accurate processing:
• Enter your tax year.
• Individual filer: Enter your SSN (Social Security Number) if you are an individual sole proprietor or a member of
a partnership and choose to file your own individual return.
Note: Do not include the BIN (Oregon business identification number) or FEIN (federal employer identification
number) if you are filing as an individual.
• Partnerships: Enter your BIN if you are a partnership and including all your members on one return. If you do
not know your BIN or this is your first year filing, leave blank.
• Partnerships: Enter your FEIN if you are a partnership and including all your members on one return.
Make your check or money order payable to: Oregon Department of Revenue. On your check, write the following:
• Daytime telephone number
• Tax year
• Form LTD
• SSN or FEIN
Mail the voucher with your payment to:
Oregon Department of Revenue
PO Box 14003
Salem OR 97309-2502
Note: This voucher is not an extension to file. Oregon will grant an extension if you already submitted federal Form
7004 to the IRS for your federal return. If you need an extension for Oregon only, complete federal Form 7004 and
write “For Oregon Only” at the top. Make sure to check the extension box on the transit return. Do not send the
extension, keep with your tax records.
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FORM
LTD Self-Employment Tax Payment Voucher
LTD-V
Department of Revenue Use Only
•
•
150-560-172 (Rev. 10-11)
Tax Year
•
Payment Type (check only one):
Return
Extension
Amended
Prepayment
Check if:
First time Oregon filer
Daytime Telephone Number
New name or address
Enter payment amount
Name of filer on tax return
$
0 0
.
•
•
SSN
BIN
FEIN
Business address
City
State ZIP code
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