Form Tm (230) - Self-Employment Tax - 2014
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FORM
2014
TM
Tri-County
Date received
•
Metropolitan Transportation District
•
•
Payment
•
(230)
Self-Employment Tax
1
2
3
•
•
•
If you have previously
Name change
Fiscal year
Fiscal year
/ /
/ /
Mo
Day
Year
Mo
Day
Year
•
•
filed a return, indicate if:
beginning:
ending:
Address change
Last name (if an individual filing)
First name and initial
Social Security number (SSN)
•
•
Partnership name (if a partnership filing)
Federal employer identification number (FEIN)
Business address
Oregon business identification number (BIN)
•
City
State
ZIP code
County
Telephone
•
Did you file Form TM for 2013?
An extension has been filed
•
Yes
This is an amended return
•
No (if No, give reason) ________________________________________________________________________
Utility or telecommunications
Include your payment with this return.
•
1. Self-employment earnings from federal Schedule SE or Partnership Form 1065 .....................
1
%
2. Apportionment percentage ..............................................................................................................2
•
3. Net self-employment earnings. Multiply line 1 by line 2 .............................................................
3
•
4. Less: Exclusion. Not more than $400 per taxpayer ...................................................................
4
•
5. Net earnings subject to transit district tax. Line 3 minus line 4 .................................................
5
•
6. Net tax. Multiply the amount on line 5 by 0.007237 ...................................................................
6
•
7. Prepayments ..............................................................................................................................
7
•
8. TAX TO PAY. Is line 6 more than line 7? If so, line 6 minus line 7 ........................TAX TO PAY
8
9. Penalty and interest for filing or paying late .....................................................................................9
10. Total amount due. Line 8 plus line 9 ...............................................................................................10
•
11. REFUND. Is line 7 more than line 6? If so, line 7 minus line 6 .................................. REFUND
11
Individuals: Attach a copy of your federal Schedule SE. Business activity:
Sales
Services
Other: ____________________
Partnerships: Attach a schedule listing each partner’s name, Social Security number, partnership earnings, and exclusion.
Apportioning? Attach a copy of TSE-AP.
I authorize the Department of Revenue
Under penalty of false swearing, I declare that the information in
Yes
No
this return and any attachments is true, correct, and complete.
to discuss this return with this preparer.
Your signature
Date
Signature of preparer other than taxpayer
/ /
X
X
Telephone
License No.
Make check or money order payable to:
•
Oregon Department of Revenue
Address of preparer
Mail your return to:
TMSE, Oregon Department of Revenue
City
State
ZIP code
PO Box 14003, Salem OR 97309-2502
Do NOT attach your TM self-employment tax return to your Oregon income tax return, or any other form.
Rev. 10-14)
150-555-001 (
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