These instructions were updated on January 8, 2020 to reflect Public Law 116-94, on March 26, 2020 to reflect Director’s Order 20-01, and on April 28, 2020 to reflect Director’s Order 20-02. Publication OR-40-FY 2019 Oregon Income Tax Full-year Resident

Forms and instructions: Form OR-40 Schedule OR-ASC Form OR-40-V Schedule OR-ADD-DEP Schedule OR-529 Schedule OR-DONATE Check out our online services Revenue Online is a secure online portal that provides access to your tax account at any time. You can: • Check the status of your refund. • View and print letters from us. • Make payments or schedule future payments. • Securely communicate with us. • Update your information. • Check balances and view your account history. • File an appeal. Visit www.oregon.gov/dor and click on “Revenue Online” to sign up. • July 15, 2020 is the due date for filing your return and paying your tax due. • File electronically—it’s fast, easy, and secure. See “Electronic filing.” • Find out if you qualify for the earned income credit. See “Tax payments and refundable credits.” • Find out if you qualify for the working family household and dependent care credit. See Schedule OR-WFHDC for details. • Are you a veteran? Find out about veterans’ benefits at www.oregon.gov/odva. • These instructions aren’t a complete statement of laws or Oregon Department of Revenue rules. If you need more information, see Publication OR-17 or contact us. www.oregon.gov/dor 150-101-043 (Rev. 04-28-20)

Contents Electronic filing ................................................................. 3 Subtractions................................................................. 13 New information ............................................................... 3 Deductions ...................................................................14 Federal tax law .................................................................. 4 Oregon tax................................................................... 15 Important reminders........................................................ 4 Credits—nonrefundable ............................................16 General information 16 20 21 22 23 24 25 25 26 ......................................................... 5 Tax payments and refundable credits...................... Do I need to file an Oregon return? .......................... 5 Penalties and interest................................................. Residency....................................................................... 5 Amount due and payment options.......................... What form do I use?..................................................... 6 Refund.......................................................................... Military personnel ....................................................... 6 Direct deposit.............................................................. What if I need more time to file?................................ 6 Before you file ............................................................. Penalties......................................................................... 7 Avoid processing delays............................................ 2020 estimated tax........................................................ 7 Tax return mailing addresses................................... What if I need to change my return after filing?.... 7 Tax tables ......................................................................... General instructions for Form OR-40............................. 9 Tax rate charts ................................................................. 28 29 33 35 49 Check the boxes............................................................ 9 Form OR-40 ...................................................................... Name and address ......................................................10 Form OR-40-V, payment voucher ................................. Filing status..................................................................10 Schedule OR-ASC and instructions .............................. Exemptions...................................................................10 Schedule OR-ADD-DEP................................................... Form OR-40 line instructions ........................................ 13 Schedule OR-529 ............................................................. 51 53 Additions..................................................................... 13 Schedule OR-DONATE .................................................... Do you have questions or need help? Internet In person www.oregon.gov/dor Offices are located in Salem, Portland, Eugene, Bend, • Download forms, instructions, and publications. Gresham, and Medford. Find hours and directions to • Access additional information not included in these our offices on our website. instructions. Our main office is located at: Revenue Online 955 Center St NE Salem, OR 97301-2555 www.oregon.gov/dor Email or write (click on Revenue Online) • Securely communicate with us. • Check your refund status. • Make or schedule payments. questions.dor@oregon.gov • View your account history. preguntas.dor@oregon.gov • Find out how much you owe. • File an appeal. Oregon Department of Revenue • View letters and your Form 1099-G, if applicable. 955 Center St NE Salem OR 97301-2555 Phone • Include your name and daytime phone number. • Include the last four digits of your SSN or ITIN. (503) 378-4988 or (800) 356-4222 Monday–Friday, 7:30 a.m.– 5 p.m. To request printed forms or publications: Closed Thursdays from 9–11 a.m. Closed holidays. Forms Wait times may vary. Contact us for ADA accommodations or assistance in PO Box Oregon Department of Revenue 14999 other languages. Salem OR 97309-0990 Photo on cover: Two of the Three Sisters mountains overlooking horse cutouts outside of Sisters, Oregon. 150-101-043 (Rev. 04-28-20) 2

Electronic filing E-filing is the fastest way to file your return and receive your refund. The speed and accuracy of computers allow electronic returns to be received and processed faster than paper returns, greatly reducing errors and delays. E-filing uses secure technology to ensure the safety of your personal information when it’s sent to the IRS and the Department of Revenue. Oregon participates in the IRS Federal/State E-file pro­ gram. This program allows you to electronically file both your federal and Oregon returns at the same time. If you’ve already filed your federal return, you can still electronically file your Oregon return. If you haven’t tried e-file yet, why not this year? Join more than 1.8 million other Oregon taxpayers who electronically file their Oregon returns. You can take advantage of e-file in one of two ways: 1. Ask your tax preparer. If your tax preparer is an authorized IRS e-file pro- vider, your preparer can electronically file your fed- eral and Oregon returns. Many Tax-Aide and Tax Counseling for the Elderly (TCE) sites set up by the IRS are authorized IRS e-file providers. 2. Use online tax preparation software. You can file your federal and state returns from your home, work, or library computer using Oregon- approved online tax preparation products. Go to our website at www.oregon.gov/dor/e-filing for a list of tax preparation products to use in preparing your federal and Oregon returns. You may be eligible for free e-file. Several tax preparation software providers offer free online electronic tax filing. For free online tax preparation programs, go to www.oregon.gov/dor/e-filing. New information Due Date Extension. The Oregon tax filing and pay­ ment deadline has been extended to July 15, 2020, if the due date was on or after April 1, 2020 and before July 15, 2020 by Director’s Orders 20-01 and 20-02. Interest and penalties to your Oregon tax filing and payment due dates extended by these orders will begin to accrue on July 16, 2020. Federal tax liability subtraction. The 2019 federal tax subtraction limit is $6,800 ($3,400 for married filing separately). It may be limited further based on your AGI. See the instructions for line 10. First-time home buyer savings account (FTHBSA). As of January 1, 2019, you’re able to save toward the purchase of your first home in a tax-favored account. Contributions to the account and earnings can be claimed as a subtraction on Schedule OR-ASC. For limitations and other information, see “Subtractions” in Publication OR-17. Kicker credit. Oregon’s surplus credit, known as the “kicker,” will be claimed as a credit on your 2019 tax return. See the instructions for line 34. Oregon Form OR-W-4. Because of recent changes to federal Forms W-4 and W-4P, Oregon has a separate withholding statement for state personal income tax withholding. The new federal Form W-4, submitted to employers after January 1, 2020, can’t be used to deter­ mine Oregon withholding. Go to www.oregon.gov/dor to learn more about Oregon income tax withholding and Form OR-W-4. Oregon College and MFS 529 Savings Plans and ABLE account limits. Contribution limits have increased to $4,865 for taxpayers filing joint returns and $2,435 for all others. Contributions had to be made by the end of tax year 2019 to qualify for this subtraction. For more information, see “Subtractions” in Publication OR-17. Tuition and fees deduction. Congress has extended this deduction for tax years 2018 through 2020. See the instructions for Schedule OR-ASC. 150-101-043 (Rev. 04-28-20) 3

Federal tax law No extension to pay. Oregon doesn’t allow an exten­ sion of time to pay your tax, even if the IRS allows an extension. Your 2019 Oregon tax is due July 15, 2020. Federal law connection. Oregon has a rolling tie to changes made to the definition of federal taxable income, with the exceptions noted below. For all other purposes, Oregon is tied to federal income tax laws as amended and in effect on December 31, 2018. Oregon exceptions to federal law. Oregon is discon­ nected from the business income deduction allowed by Section 199A of the Internal Revenue Code (IRC). Due to the way Oregon’s returns are designed, no addition is required. Oregon is also disconnected from IRC Sec­ tion 139A, the tax exemption for federal subsidies for employer prescription drug plans. If you have this type of business income, you’ll have an addition on your Oregon return. Important reminders Revenue Online. Revenue Online provides convenient, secure access to tools for managing your Oregon tax account. To set up your Revenue Online account, go to www.oregon.gov/dor and click on “Revenue Online.” Federal return. You must include a copy of your fed­ eral Form 1040 or 1040-SR and Schedules 1 through 3 (if applicable), 1040-X, 1040-NR, or 1040-NR-EZ with your Oregon return. Without this information, we may dis­ allow or adjust items claimed on your Oregon return. Schedule OR-ASC. If you’re claiming an addition, sub­ traction, or credit using a code listed in Publication OR­ CODES, you must include Schedule OR-ASC with your return. Without this information, we may disallow or adjust your claim. Publication OR-17. See Publication OR-17 for more information about filing and personal income tax laws. It is available at www.oregon.gov/dor/forms. 150-101-043 (Rev. 04-28-20) 4

General information Do I need to file an Oregon return? You need to file if your gross income is more than the amount shown below for your filing status. Table 1. Filing thresholds Amounts apply to full-year residents only. Your filing status is: Number of boxes checked on line 17 of return: And your gross income is more than: Dependent Any $1,100* 0 $6,230 Single 1 $7,430 2 $8,630 Married filing jointly 0 $12,460 1 $13,460 2 $14,460 3 $15,460 4 $16,460 0 $6,230 Married filing 1 $7,230 separately 2 $8,230 Head of household 0 $7,775 1 $8,975 2 $10,175 0 $8,665 Qualifying 1 $9,665 widow(er) 2 $10,665 *The larger of $1,100, or your earned income plus $350, up to the standard deduction amount for your filing status. In addition, file a return if: • You’re required to file a federal return. • You had $1 or more of Oregon income tax withheld from your wages and you want to claim a refund. • You want to claim the kicker credit, even if you other­ wise don’t need to file a return. How long will it take to get my refund? Return processing times vary due to many factors, including the complexity of your return. Electronically filed returns are generally received and processed faster. Paper returns must have all required Oregon sched­ ules, proof of tax withheld, and a copy of your federal return included to ensure smooth processing. If you don’t have a federal filing requirement, create a substi­ tute return and check the “calculated using ‘as-if’ fed­ eral return” box on your return. Returns mailed closer to July 15, when we receive the most returns, can take longer to process. Also, returns that require additional review can take more time to process. Typical reasons for additional review include: incomplete documentation, iden­ tity verification needed, claiming the working fam­ ily household and dependent care credit, proof of tax withheld, etc. To check the status of your refund, click on “Where’s my refund?” at www.oregon.gov/dor/personal. What income does Oregon tax? An Oregon resident is taxed on all income, including income from outside the state. A nonresident of Oregon is taxed only on income from Oregon sources. Residency Am I a resident, a nonresident, or a part-year resident? • You're a full-year Oregon resident, even if you live outside Oregon, if all of the following are true: — You think of Oregon as your permanent home. — Oregon is the center of your financial, social, and family life. — Oregon is the place you intend to return. • You're still a full-year resident if: — You temporarily moved out of Oregon or — You moved back to Oregon after a temporary absence. You may also be considered a full-year resident if you spent more than 200 days in Oregon during 2019 or you’re a nonresident alien, as defined by federal law. • You’re a nonresident if your permanent home was outside Oregon all year. • You’re a part-year resident if you moved into or out of Oregon during 2019. You're not considered a part- year resident if: — You temporarily moved out of Oregon, or — You moved back to Oregon after a temporary absence. 150-101-043 (Rev. 04-28-20) 5

Special-case Oregon residents. If you’re an Oregon resident and you meet all of the following conditions, you’re considered a nonresident for tax purposes: • You maintained a permanent home outside Oregon for the entire year. • You didn't keep a home in Oregon during any part of the year. • You spent less than 31 days in Oregon during the year. Important. A recreational vehicle (RV) isn’t considered a permanent home outside of Oregon. Oregon residents living abroad. You’re considered a nonresident if you’re a qualified individual for pur­ poses of the federal foreign earned income or housing exclusion for U.S. residents living abroad. What form do I use? Use Form OR-40 if you’re a full-year Oregon resident. Use Form OR-40-P if any ONE of the following is true: • You’re a part-year resident. • You’re filing jointly and one of you is a full-year Ore­ gon resident and the other is a part-year resident. • You’re filing jointly and both of you are part-year Oregon residents. • You qualified as an Oregon resident living abroad for part of the year. Use Form OR-40-N if any ONE of the following is true: • You’re a nonresident. • You’re a special-case Oregon resident. • You’re filing jointly and one, or both, of you is a nonresident. • You meet the military personnel nonresident requirements. • You qualified as an Oregon resident living abroad for the entire year. Forms OR-40-P and OR-40-N are included in Publication OR-40-NP. Download the publication from our website, www.oregon.gov/dor/forms or contact us to order it. Military personnel Nonresidents stationed in Oregon. Oregon doesn’t tax your military pay while you’re stationed in Oregon. File Form OR-40-N if you had other income from Oregon sources or to claim a refund of Oregon tax withheld from your military pay. Military spouses. Federal law does not allow Oregon to tax your wages if you’re in Oregon only to be with your spouse who is stationed in Oregon. If you’re domiciled in Oregon and your spouse is a resident of another state, federal law allows you to choose to be treated for tax purposes as a resident of your spouse’s state. File Form OR-40-N if you had other income from Oregon sources or are claiming a refund of Oregon tax withheld. Residents (or Oregon-domiciled service members) sta­ tioned outside of Oregon. If you meet the requirements for special-case Oregon residents or Oregon residents living abroad, file Form OR-40-N. File Form OR-40 if you don’t meet those requirements. Residents (or Oregon-domiciled service members) sta­ tioned in Oregon. Your pay is subject to tax, although the pay could qualify for certain subtractions. For more information on subtractions available to military per­ sonnel, see Publication OR-17. Military personnel on active service in Oregon are treated as nonresidents for tax purposes if their address in the payroll records of the Defense Finance and Accounting System (DFAS) is outside Oregon, regard­ less of where they are domiciled (ORS 316.027). Filing for a deceased person A personal income tax return must be filed for a per­ son who died if the person would have been required to file. See “Do I need to file?” on the previous page. Check the “Deceased” box next to the person’s name on the return. If you have been appointed personal repre­ sentative or you have filed a small estate affidavit, sign the return as ”personal representative.” A surviving spouse must sign if it’s a joint return. If there’s no per­ sonal representative, only the surviving spouse needs to sign a joint return. Note: Oregon has an estate transfer tax on estates val­ ued at $1 million or more. The tax is paid by the estate using Form OR-706, not by the individuals receiving the inheritance. For more information, see the instruc­ tions for Form OR-706. When should I file my return? The filing deadline for calendar year 2019 is July 15, 2020. If you can’t pay your tax by the due date, it’s important to file your return anyway to avoid a late- filing penalty. Returns for fiscal filers are due by the 15th day of the fourth month after the close of their tax year. However, if this causes the fiscal year filer’s due date to be on or after April 1, 2020 and before July 15, 2020, then the due date is automatically extended to July 15, 2020 and inter­ est will begin to accrue July 16, 2020 for any unpaid tax. What if I need more time to file? If you requested a federal extension to file, Oregon will allow the same extension. Don’t include a copy of your federal extension with your Oregon return; keep it with your records. If you need an extension of time to file only your Oregon return, see Publication OR-40-EXT. 150-101-043 (Rev. 04-28-20) 6

An extension doesn’t mean more time to pay. To avoid interest charges, you must pay all of the tax you expect to owe by July 15, 2020. If you can’t pay all of the tax you expect to owe, pay what you can. You’ll owe interest on any unpaid tax starting July 16, 2020 until the date of your payment. You may also be charged a penalty for failing to pay your tax on time. See “Penal­ ties” and the instructions for line 39. To make an extension payment, see “Payment options” after the instructions for line 42 or Publication OR­ 40-EXT. Check the “Extension payment” box on the voucher if you’re mailing your payment or paying in person. Select the “Estimated payment” option if mak­ ing your payment through Revenue Online. Don’t forget to check the “Extension filed” box on your return when you file. Penalties If you don’t pay all of your tax by July 15, 2020, you may be charged a 5 percent penalty on the unpaid amount, even if you requested an extension to file your return. Oregon doesn’t allow an extension of time to pay tax, even if the IRS does. You’ll be charged a 20 percent penalty for failing to file your return if you file it more than three months after the due date, including extensions. If both penalties apply, the total penalty will be 25 percent of the unpaid tax. Note: If you fail to file returns for three consecutive years by the due date for the third year’s return, includ­ ing extensions, you’ll be charged a penalty of 100 per­ cent of each year’s unpaid tax. For more information about these and other penalties, see the instructions for line 39 and “Interest and Penal­ ties” in Publication OR-17. 2020 estimated tax Estimated tax is the amount of tax (after credits and Oregon tax withheld) you expect will be shown on your return when you file. Oregon estimated tax laws are not the same as fed­ eral estimated tax laws. For more information on how to calculate your estimated payments for Oregon, see Publication OR-ESTIMATE. Vouchers for estimated payments are available at www.oregon.gov/dor/forms. Do I need to make estimated payments? In most cases, if you expect your return to show that you will owe $1,000 or more in tax after credits and withholding you must make estimated payments. You may need to make estimated payments if: • You're self-employed and don’t have Oregon tax withheld from your income. • You have Oregon Lottery single ticket winnings of less than $1,500. • Oregon tax isn’t withheld from other types of income (such as pensions, interest, or dividends) and you expect to owe tax of $1,000 or more. • You’re a wage earner but after withholding you still expect to owe tax of $1,000 or more on your 2020 return. You may want to increase the amount your employer withholds from your Oregon wages. For withholding information, go to www.oregon.gov/dor/personal. See Publication OR-ESTIMATE for more information, including: • Detailed instructions for calculating installment payments. • Tax rate charts for 2020. • Installment periods and due dates. • Helpful worksheets and examples. • Payment instructions and voucher. Download Publication OR-ESTIMATE from our web­ site or contact us to order it. Interest on underpayment of estimated tax You may owe interest for underpaying your estimated tax if: • The tax on your return after credits and withholding is $1,000 or more; or • You underpaid one or more of your required esti­ mated tax installments. See the instructions for line 40 and Publication OR-10 for more information. What if I’m self-employed? If you’re self-employed and do business in Mult­ nomah, Clackamas, or Washington counties, you may need to file Form OR-TM. If you’re self- employed and do business in Lane County, you may need to file Form OR-LTD. Go to our website to download the forms, contact us to order either form, or file electronically through Revenue Online at www.oregon.gov/dor. What if I need to change my Oregon return after filing? It depends on what you need to change. Follow these instructions for amending (changing) your return if: 150-101-043 (Rev. 04-28-20) 7

• You discover that your income, deductions, or other item(s) were wrong. • You used a form that didn’t match your residency status. • Your filing status wasn’t correct. • The IRS or another state adjusted or audited your return and it affects your Oregon tax. • You have a net operating loss (NOL) carryback. • Changes in federal or state income tax laws affect a return you’ve already filed. Don’t amend your Oregon return if: • We made changes to your return and you object to those changes. You must follow the appeal process in the notice we sent you. • You’re filing a protective claim for a refund. Use Form OR-PCR. There’s a time limit for filing an amended return. See the instructions for lines 43 through 47, and for more infor­ mation, see “Amended returns” in Publication OR-17. How do I amend my 2019 return? General instructions • Complete the return as it should’ve been filed, includ­ ing adjustments we made. • Check the “Amended return” box on the first page. • In the “Amended statement” space, provide the return line number and reason for each change. • Use the Amended worksheet, below, to figure your amended tax due or refund. • If you’re amending your federal return or a return you filed with another state, include a copy of those amended returns with your amended Oregon return. If you’re only amending your Oregon return, include a copy of your original federal return. Don’t include a copy of your original Oregon return. Residency. Use the form that matches your residency status for the year you’re amending, even if your origi­ nal return was filed on a different form. Adjustment made by the IRS or another state. Include a copy of the corrected federal or other state return or audit report. NOL carryback. Enter the loss year in the NOL-year box on the first page of the return. If you’re carrying back an NOL from more than one year, file a separate amended return for each NOL year. In the “Amended statement” space, tell us the section number of the Internal Rev­ enue Code that allows you to carry back the NOL(s) to the 2019 tax year. See “Net operating losses for Oregon” in Publication OR-17 for more information. What if I need to change a return I filed for an earlier year? Refer to the instructions for the tax year you need to amend. Visit our website or contact us if you need the form and instructions for a different year. How long will it take to process my amended return? It may take six months or longer to process your amended return. Amended worksheet Use this worksheet to figure your amended refund or tax to pay. Keep the completed worksheet with your records. Note: If we adjusted any of the amounts on your original 2019 return, use the adjusted amounts. 1. Amended tax after standard and 1. carryforward credits (amended Form OR-40, line 29). 2. Amended total payments and refundable credits (amended Form OR-40, line 36). 2. 3. Line 1 minus line 2. If less than 3. -0-, use a minus sign. 4. Refund you already had for 2019 (original Form OR-40, line 43; Form OR-40-N, line 69; or Form OR-40-P, line 68). If you didn’t have a refund, enter -0-. 4. 5. Amended tax to pay or refund. Line 3 plus line 4. If less than -0-, you have a refund; go to line 6. If more than -0-, you owe tax; skip to line 8. 5. 6. Refund applications that weren’t on your original return (amended Form OR-40, lines 44 through 47), up to the refund amount on line 5. Don’t use a minus sign. Example: If line 5 is –$500, you may apply up to $500 on your amended Form OR-40, lines 44 through 47. 6. 7. Net amended refund. Line 5 plus line 6. This can’t be more than -0-. 7. 8. Penalty and interest on amended tax to pay (amended Form OR-40, line 41). 8. 9. Total amount to pay with your amended return. Line 5 plus line 8. 9. 150-101-043 (Rev. 04-28-20) 8

General instructions for Form OR-40 Step 1: Complete your federal return Complete your federal return first. Do this even if you aren’t required to file a federal return. You must use the information from your federal return to complete your Oregon return. You must include a copy (front and back) of your federal Form 1040 or 1040-SR with Schedules 1 through 3 (if applicable), 1040-NR, or 1040-NR-EZ with your Oregon return. If you're amending your Oregon return and your federal return, include a copy of Form 1040-X and an amended Form 1040 or 1040-SR with Schedules 1 through 3 (if applicable). If you don’t provide a copy of your federal return, we may adjust or deny your Oregon subtractions, deductions, and credits. Include federal Schedules 1 through 3 (if applicable); don’t include any other fed­ eral schedules unless otherwise instructed. We may ask you for copies of other schedules or additional information later. Oregon same-sex registered domestic partners (RDPs): To correctly determine your Oregon tax liabil­ ity, you must complete a federal income tax return as if you were filing as married filing jointly or married filing separately. Check the “Calculated using ‘as if’ federal return” box on your Oregon return. For more information on how to file as an RDP, go to www.oregon.gov/dor and search for “RDP.” Step 2: Select the appropriate Oregon form To decide which form to use, see “What form do I use?” in the “General information” section. Step 3: Fill out the Oregon return Use blue or black ink only for easier reading and faster processing. The equipment used to scan documents and checks can’t read gel ink or certain colors, and using them will delay the processing of your return. Fiscal-year filers Write the ending date of your fiscal year in the “Fiscal year ending” box on the return. Check the boxes Amended return If you’re amending your 2019 return, check this box. See “What if I need to change my return after filing?” in the “General information” section for instructions. Calculated using “as if” federal return Check this box if: • You’re filing as an Oregon RDP. • Your filing status is married filing separately for Ore­ gon only because you and your spouse don’t have the same residency status. • You didn’t file a federal return. Short-year tax election If you’re filing a short-year return due to a bankruptcy, check this box and write the ending date in the “Fiscal year ending” box. Extension filed Check this box if you requested an extension to file your return. See “What if I need more time to file?” in the “General information” section and Publication OR-40-EXT for more information. Form OR-24—Like-kind property exchange or conversions Check this box if you’re deferring gain on like-kind prop­ erty that was exchanged or converted. You will report the gain to Oregon when it’s reported on your federal return (federal Form 8824). You must include Form OR-24 with your Oregon return or provide it electronically through your Revenue Online account at www.oregon.gov/dor. Federal disaster relief If you were affected by a presidentially-declared natu­ ral disaster in 2019, check this box. Federal Form 8886 Check this box if you filed federal Form 8886, Reportable Transaction Disclosure Statement. 150-101-043 (Rev. 04-28-20) 9

Name and address Type or clearly print names, Social Security numbers (SSN), and dates of birth for you and your spouse. Enter your spouse’s information even if you’re filing as married filing separately. If you’re filing for some­ one who died in 2019 or 2020, check the “Deceased” box next to their name. Enter your current mailing address. This is where we’ll send any refund or correspondence, if needed. Enter your current daytime phone number. Date of birth. Enter the month, day, and year that you and your spouse were born. For example, “11/01/1978.” SSN. You must provide your SSN per Section 405, Title 42, of the United States Code. We will only use it to establish your identity for tax purposes. Follow these instructions if you’ve filed previous tax returns using an individual taxpayer identification number (ITIN) and this is your first year filing using your new SSN: • Check the “First time using this SSN” box. • Write your previous identification number on the first line of the “Amended statement” space on page 4 of your return. ITIN. If the IRS assigned you an ITIN because you don’t qualify for an SSN, enter your ITIN wherever an SSN is requested. Refunds will not be issued without a valid SSN or ITIN. If you don’t have an ITIN, you must request one from the IRS. To get an ITIN application (federal Form W-7), go to www.irs.gov or call (800) 829-1040. If you’ve applied for an ITIN but you haven’t received it yet: • Check the “Applied for ITIN” box. • File your return by July 15, 2020. • Don’t include Form W-7 with your return. Keep it with your records. • Once the IRS issues your ITIN, mail a copy of your ITIN letter to us at PO Box 14999, Salem OR 97309-0990. Filing status Check the box next to your filing status. 1 – 5 Generally, you must use the same fil­ ing status for your Oregon and federal returns. Choose only one filing status. Exception for Oregon RDPs. As an Oregon RDP, you’re not eligible to use the single filing status on your Ore­ gon return. For Oregon, you’re generally required to use married filing jointly or married filing separately. For more information, go to our website, see “Filing an Oregon return” in Publication OR-17, or contact us. Exceptions for married persons who filed a joint fed­ eral return when each person had a different residency status. Use this table to determine which return form to use if you file a joint return or separate returns for Oregon. Table 2. Spouses with different residency status Spouses’ residency status: If you file a joint return, use: If you file separate returns: Part-year and nonresident OR-40-N Each spouse uses the form that matches their individual residency status Nonresident and full-year resident OR-40-N Part-year and full- year resident OR-40-P How to file separate returns for Oregon If you’re filing a joint federal return but separate Oregon returns, enter your spouse’s name, SSN, and date of birth on your return. Report your own share of federal AGI and deductions. Also, report your share of any Oregon additions or subtractions using this for­ mula to determine your percentage: Your share of federal AGI Your percentage = Joint federal AGI (not to exceed 100%) Check the “Calculated using ‘as if’ federal return” box on your return. You must include the following forms with both Oregon returns: • A federal Form 1040 or 1040-SR with Schedules 1 through 3 (if applicable), 1040-NR, or 1040-NR-EZ pre­ pared as if you had filed as married filing separately. • A copy of the joint Form 1040 or 1040-SR with Schedules 1 through 3 (if applicable), 1040-NR, or 1040-NR-EZ that you actually filed with the IRS. If the federal form you filed is an amendment, include Form 1040-X and federal returns as amended for your actual and “as if” returns. If possible, mail both spouses’ Oregon returns in the same envelope. Don’t staple the returns together. For more information, see “Filing status” in Publication OR-17. Exemptions Yourself and spouse. If you can’t be 6a & 6b claimed as a dependent on someone else’s return, check the “Regular” exemption box; oth­ erwise, check the box below line 6a, even if the other person doesn’t actually claim you as a dependent. If you’re filing as married filing jointly and no one else can claim your spouse as a dependent on their return, 150-101-043 (Rev. 04-28-20) 10

check the “Regular” exemption box on line 6b for your spouse; otherwise, check the box below line 6b, even if the other person doesn’t actually claim your spouse as a dependent. Severely disabled. Did you or your spouse have a severe disability at the end of 2019? If so, you can claim an additional exemption. This is different from the dis­ abled child exemption. You may qualify for and claim the severely disabled exemption even if someone else can claim you as a dependent. You're considered to have a severe disability if any of the following apply: • You permanently lost the use of one or both feet. • You permanently lost the use of both hands. • You’re permanently blind. • You have a permanent condition that, without special equipment or outside help, limits your ability to earn a living, maintain a household, or transport yourself. • You're unable to earn a living due to a permanent condition or an impairment of indefinite duration. If you have a severe disability, your physician must write a letter describing it. Keep the letter with your records in case we request a copy. If you qualify, check the “Severely disabled” exemp­ tion box on line 6a. If your spouse qualifies, check the “Severely disabled” exemption box on line 6b. Total exemptions for you and spouse. Enter the total number of exemptions claimed for yourself on line 6a and for your spouse on line 6b. All dependents. Enter your dependents’ infor­ 6c mation in order from youngest to oldest. For each dependent, list their first name, last name, relationship code (see Table 3), SSN, and date of birth. In most cases, you will list the same dependents you claimed on your federal return. However, if you have qualifying depen­ dents who aren’t listed on your federal return, you may claim them for Oregon. If you have more than four dependents, check the box and fill out Schedule OR-ADD-DEP with your remain­ ing dependents. Don’t list the same dependents on your return and Schedule OR-ADD-DEP. Include Schedule OR-ADD-DEP with your return. On line 6c, enter the total number of your depen­ dents, including the number from line 1 of Schedule OR-ADD-DEP. Table 3. Relationship codes Title Code Relationships included Son/Daughter SD Son, daughter, adopted child. Stepchild SC Stepson, stepdaughter. Foster child FC Foster child. Sibling SB Brother, sister, half-brother, half-sister, stepbrother, stepsister, brother-in-law, sister-in-law. Parent PT Father, mother, stepfather, stepmother, father-in-law, mother-in-law. Spouse SP Husband, wife. Grandparent GP Grandmother, grandfather. Grandchild GC Grandson, granddaughter. Aunt/Uncle AU Aunt, uncle. Niece/Nephew NN Niece, nephew. Other relative OR Son-in-law, daughter-in-law, cousin, and other related individuals not listed above. No relation NR Any other qualifying individual. Children with a disability. You may be entitled 6d to an additional personal exemption for your dependent child who has a qualifying disability. To qualify, all of the following must be true: • Your child (age 21 or younger) qualified as your dependent for 2019. • Your child was eligible for early intervention services or special education as defined by the State Board of Education of the state where the child attends school. • Your child had an eligible disability as of Decem­ ber 31, 2019 under the federal Individuals with Dis­ abilities Education Act. Eligible disabilities include: — Autism spectrum disorder. — Communication disorder. — Deafblindness. — Developmental delay. — Emotional disturbance. — Hearing impairment. — Intellectual disability. — Orthopedic impairment. — Other health impairment. — Specific learning disability. — Traumatic brain injury. — Visual impairment. 150-101-043 (Rev. 04-28-20) 11

Each year, you must be able to provide an eligibility statement confirming that your child has been diag­ nosed with one of the disabilities listed above and a cover sheet from one of the following: • The child’s Individualized Education Program (IEP). • The child’s Individualized Family Service Plan (IFSP). Keep the statement and cover sheet with your records. Check the “Check if child with qualifying disability“ box next to the name of each child with a qualifying disability. Enter the total number of children with a qualifying disability, including the number of children on line 2 of Schedule OR-ADD-DEP, on line 6d. Total exemptions. Add lines 6a through 6d and 6e enter the total on line 6e. This is your total num­ ber of exemptions. 150-101-043 (Rev. 04-28-20) 12

7 8 Form OR-40 line instructions Don’t enter cents. You must round off cents to the near­ est dollar. For example, $99.49 becomes $99, and $99.50 becomes $100. If you don’t round entries to the nearest dollar, there may be small variations in the totals we use. Federal adjusted gross income (AGI). Enter your federal AGI from Form 1040 or 1040-SR, line 8b; Form 1040-X, line 1C; Form 1040-NR, line 35; or Form 1040-NR-EZ, line 10. You must include a copy (front and back) of your federal return, including Sched- ules 1 through 3 (if applicable), with your Oregon return. This helps us verify your income and process your return faster. If you don’t include your federal return with your Oregon Form OR-40, items claimed on your return may be adjusted or denied. Additions Total additions from Schedule OR-ASC. Enter the total from Schedule OR-ASC, section 1. Include the schedule with your return. For more information about additions, see the instructions for Schedule OR-ASC or “Additions” in Publication OR-17. Subtractions 2019 federal tax liability subtraction. Complete 10 the following worksheet to determine your fed­ eral tax liability subtraction for 2019. Carefully follow the instructions. Don’t confuse your federal tax liabil­ ity on your federal return with the federal tax with­ held on a Form W-2. They aren’t the same. RDPs and those filing as “married filing separately for Oregon only,” use amounts from your actual federal return(s), not your “as if” return. The federal tax liability subtraction limit for 2019 is $6,800 ($3,400 if married filing separately). The subtrac­ tion is further limited by the AGI phase-outs shown in Table 5. Note: Use the worksheet(s) in the “Federal income tax liability” section of Publication OR-17 if any of these situations apply: • You’re amending your 2019 federal return or we cor- rected the federal tax liability subtraction on your original 2019 Oregon return. • A prior year’s federal return was audited or amended, resulting in additional federal tax paid or refunded in 2019. • You paid income tax to a foreign country. • You filed your federal return on Form 1040-NR or 1040-NR-EZ. • You reported recapture taxes or credits on your fed­ eral return. Caution: Don’t include any of the following in your calculation: • Self-employment tax. • Social Security and Medicare tax on tips. • Household employment taxes. • Penalties or interest. 1. Enter your federal tax liability 1. from Form 1040 or 1040-SR, line 14. 2. Enter your excess advance 2. premium tax credit from Form 1040 or 1040-SR, Schedule 2, line 2. 3. Subtract line 2 from line 1 (if less 3. than zero, enter -0-). 4. Enter your additional tax on 4. retirement plans from Form 1040 or 1040-SR, Schedule 2, line 6. 5. Add lines 3 and 4. 5. 6. Enter your American Opportunity 6. credit from Form 1040 or 1040-SR, line 18c. 7. Enter your total premium tax 7. credit from Form 8962, line 24. 8. Add lines 6 and 7. 8. 9. Subtract line 8 from line 5 (if less 9. than zero, enter -0-). 10. Enter your maximum allowable 10. amount from Table 5. Don’t enter more than $6,800 ($3,400 if married filing separately). 11. Enter the smaller of line 9 or line 11. 10. This is your federal tax liability subtraction. 150-101-043 (Rev. 04-28-20) 13

Are you amending your 2019 return? Usually you can't change your federal tax subtraction on your amended return. See the “Federal income tax liability” section in Publication OR-17 for more information before making changes to this subtraction. Table 5. Federal tax liability subtraction AGI phaseout And your Then your federal adjusted maximum gross income is: allowable tax liability If your filing But less subtraction status is: At least— than— is: Single -0- $125,000 $6,800 $125,000 $130,000 $5,450 $130,000 $135,000 $4,100 $135,000 $140,000 $2,700 $140,000 $145,000 $1,350 $145,000 or more -0- Married filing separately -0- $125,000 $3,400 $125,000 $130,000 $2,725 $130,000 $135,000 $2,050 $135,000 $140,000 $1,350 $140,000 $145,000 $675 $145,000 or more -0- Married filing jointly; or Head of household; or Qualifying widow(er) -0- $250,000 $6,800 $250,000 $260,000 $5,450 $260,000 $270,000 $4,100 $270,000 $280,000 $2,700 $280,000 $290,000 $1,350 $290,000 or more -0- 11 Social Security and tier 1 Railroad Retirement Board benefits income. Enter the amount from federal Form 1040 or 1040-SR, line 5b. If you have tier 2, windfall/vested dual, or supplemental Railroad Retirement Board benefits, these are subtracted in sec­ tion 2 of the Schedule OR-ASC, using code 330. For more information, see this topic under “Income” in Publication OR-17. 12 Oregon income tax refund included in federal income. Enter your Oregon state income tax refund from federal Form 1040 or 1040-SR, Schedule 1, line 1. Don’t include local, county, or other states’ tax refunds. 13 Total subtractions from Schedule OR-ASC. Other subtractions not explained here are claimed on Schedule OR-ASC. Enter the total from Schedule OR­ ASC, section 2. Include the schedule with your return. For more information about subtractions, see the instructions for Schedule OR-ASC or “Subtractions” in Publication OR-17. Deductions In general, you can claim Oregon itemized deductions or the standard deduction, whichever is larger, but not both. See the exceptions below for: • Dependents who can be claimed on another taxpay­ er’s return. • Nonresident aliens. • Spouses filing separate returns. Itemized deductions. If you’re itemizing your 16 deductions for Oregon enter the amount from Schedule OR-A, line 23. Note: Don’t enter your federal itemized deductions; the amount allowed for Oregon may be different. If you’re not itemizing, enter -0-. 17 Standard deduction. Generally, your standard deduction is based on your filing status, as shown in Table 6: Table 6. Standard deduction Single $2,270 Married filing jointly $4,545 Married filing separately • If spouse claims standard deduction • If spouse claims itemized deductions $2,270 -0- Head of household $3,655 Qualifying widow(er) $4,545 Standard deduction—Age 65 or older, or blind. If you or your spouse turned age 65 by January 1, 2020 or were blind at the end of the tax year, you're entitled to a larger standard deduction. If you or your spouse are permanently blind, you may also qualify for the severely disabled exemption credit; see the instructions for lines 6a and 6b. Check the applicable boxes on line 17, then multiply the number of boxes checked by: • $1,200 if single or head of household filing status; or • $1,000 for all other filers. Add this amount to the standard deduction for your fil­ ing status from Table 6. Enter the total on line 17. Example. Joni and Mike are married. By January 1, 2020, Joni had turned 61 and Mike had turned 67. Joni files the return as the primary taxpayer. She checks the box for spouse age 65 or older and adds $1,000 to their 150-101-043 (Rev. 04-28-20) 14

standard deduction. Joni enters $5,545 ($4,545 + $1,000) on line 17. Standard deduction—Dependents who can be claimed on another taxpayer’s return. If someone else can claim you as a dependent, your standard deduction is limited to the larger of: • Your earned income plus $350, up to the maximum allowed for your filing status (see Table 6); or • $1,100. This limit applies even if the other person doesn't actu­ ally claim you as a dependent on their return. If you’re a dependent and not married, use the follow­ ing worksheet to figure your standard deduction. If you’re a dependent and married, see “Deductions and modifications” in Publication OR-17. Standard deduction worksheet for single dependents 1. Enter your earned income (see 1. definition below). 2. Additional $350. 2. $350 3. Add lines 1 and 2. 3. 4. Minimum standard deduction. 4. $1,100 5. Enter the larger of line 3 or line 4. 5. 6. Basic standard deduction for 6. $2,270 single. 7. Enter the smaller of line 5 or line 7. 6. 8. If you turned age 65 by 1/1/2020, 8. enter $1,200. Otherwise, enter -0-. 9. If you’re blind, enter $1,200. 9. Otherwise, enter -0-. 10. Add lines 7, 8, and 9. This is your 10. standard deduction. Earned income includes salaries, wages, tips, profes­ sional fees, or other amounts received as pay for work you actually performed, and any part of a scholarship or fellowship grant you received that is included in your gross income. Standard deduction—Nonresident aliens. The stan­ dard deduction for nonresident aliens (as defined by federal law) is -0-. Standard deduction—Married filing separately. The standard deduction for married individuals filing sep­ arately is -0- if one spouse itemizes. This applies even if the standard deduction is more than your itemized deductions. Oregon tax Tax tables. Use the tax tables to find your tax 20 if your taxable income on line 19 is less than $50,000. Find the range for your taxable income, then locate your tax in Column S or Column J: • Use Column S if your filing status is single or mar­ ried filing separately. • Use Column J if your filing status is married filing jointly, head of household, or qualifying widow(er) with dependent child. Tax rate charts. If your taxable income on line 19 is $50,000 or more, calculate your tax using the formula in the tax rate chart for your filing status. • Use Chart S if your filing status is single or married filing separately. • Use Chart J if your filing status is married filing jointly, head of household, or qualifying widow(er) with dependent child. Example 1: Emily, a single taxpayer, has taxable income of $19,525. She uses Column S in the tax tables to find the tax on income that is at least $19,500 but less than $19,600. Emily enters $1,511 on line 20. Example 2: Daniel and Madison are filing a joint return. Their Oregon taxable income is $75,500. They use the formula in Chart J to calculate their tax as follows: Tax on the first $50,000 (from the chart) Oregon taxable income Minus the first $50,000 $75,500 – 50,000 $4,002 Excess over $50,000 $25,500 Multiply excess by 9% x 0.09 Tax on excess over $50,000 + $2,295 Total Oregon tax $6,297 Other tax methods. If you qualify, you can compute your Oregon tax using any of the following methods: Farm income averaging method. Did you have income from a farm? You may use the federal farm income averaging method to compute your Oregon tax even if you didn’t use farm income averaging on your federal return. Download Schedule OR-FIA-40 from our web­ site or contact us to order it. If you use Schedule OR-FIA-40 to calculate your tax, enter the tax amount from Schedule OR-FIA-40, line 24 and check box 20a. Don’t include Schedule OR-FIA-40 with your return. Keep it with your records. Farm asset capital gain method. Did you sell or exchange capital assets primarily used in farming because you were getting out of a farming business? Or, 150-101-043 (Rev. 04-28-20) 15

did you sell or exchange a farming business in which you held at least a 10 percent ownership interest? If so, you may be eligible for a reduced tax rate on the net capital gain from the proceeds. Download Worksheet OR-FCG from our website or contact us to order it. Enter the tax amount from Worksheet OR-FCG, line 9 and check box 20b. Don’t include Worksheet OR-FCG with your return. Keep it with your records. Oregon qualified business income reduced tax rate. Did you have business income from a sole proprietor­ ship, partnership, or S corporation in which you mate­ rially participated? If so, you may qualify to use this reduced tax rate. For details, see Schedule OR-PTE-FY on our website or contact us to order it. Note: If you elect to use this reduced tax rate for quali­ fying income, the election is irrevocable and must be made on your original return. An original return includes an amended return filed on or before the due date, including extensions. You can’t change the elec­ tion after your original return has been filed. If you use Schedule OR-PTE-FY to calculate your tax, enter the tax amount from Schedule OR-PTE-FY, line 14a and check box 20c. Include the schedule with your Oregon return or submit it at www.oregon.gov/dor; click the link for Revenue Online and log in or create an account. Interest on certain installment sales. Did you 21 have installment sales that required you to pay interest on the deferred tax liability for federal pur­ poses? If so, you must also compute interest for Oregon using the same method as for federal. For 2019 and 2020, the interest rate is 6 percent per year, or 0.5 per­ cent (0.005) per month. Credits—Nonrefundable Nonrefundable credits can’t be more than your Oregon tax liability. Carryforward credits allow you to claim unused amounts in a later year. Standard credits can’t be used in any other year. For more information about these and other nonrefundable credits, see the instruc­ tions for Schedule OR-ASC or “Credits” in Publication OR-17. Exemption credit. If your federal AGI is more than $200,000 ($100,000 if your filing status is single or married filing separately), enter -0-; otherwise, use this worksheet to figure your exemption credit. Exemption credit worksheet 1. If your federal AGI is more than $100,000 and your filing status is single or married filing separately, or more than $200,000 for all others, enter -0-; otherwise, enter the number of “regular” exemptions from lines 6a and 6b plus the number of dependents from line 6c. 1. 2. If your federal AGI is more than $100,000, enter -0-; otherwise, enter the number of “Severely disabled” exemptions from line 6a and 6b. 2. 3. If your federal AGI is more than $100,000, enter -0-; otherwise, enter the number of exemptions for children with a qualifying disability from line 6d. 3. 4. Add lines 1, 2, and 3. 4. 5. Line 4 times $206. This is your 5. exemption credit. Political contribution credit. If your federal AGI 24 isn’t more than $100,000 ($200,000 if you’re filing a joint return), you may claim a standard credit of up to $50 ($100 if you’re filing a joint return) for cash contri­ butions you made during 2019 to any: • Qualified political party. • Qualified candidate for federal, state, or local elective office, or the candidate’s campaign, for an election in Oregon. • Political action committee certified in Oregon. Total standard credits from Schedule OR-ASC. 25 All other standard credits are claimed on Sched­ ule OR-ASC. Enter the total of your standard credits from section 3 of the schedule. Include Schedule OR­ ASC with your return. Total carryforward credits from Schedule OR­ 28 ASC. All carryforward credits are claimed on Schedule OR-ASC. Enter your total carryforward cred­ its from section 4 of the schedule. Include Schedule OR-ASC with your return.` Tax payments and refundable credits Oregon income tax withheld. Enter the total 30 Oregon tax withheld from your wages and other income. State tax withheld from wages is shown in box 17 of Form W-2 and in the State area of various 1099 150-101-043 (Rev. 04-28-20) 16 23

forms. Don’t include FICA (Social Security) tax with­ held or tax withheld from your wages by other states. You must include a legible, unaltered copy of your Form W-2 from each job and any Form 1099 showing Oregon income tax withheld with your Oregon return. If you don’t have a Form W-2 or 1099, you must provide other proof of Oregon tax withheld. Proof may include a copy of a final paycheck stub or a letter from your employer. If you file before February 1, 2020, we can only accept a Form W-2 or 1099 as proof. If you have tax to pay, you may want to increase the amount your employer or other payer withholds from your wages. For withholding information, go to www.oregon.gov/dor/personal. Amount applied from your prior year’s 31 tax refund. Enter the amount of any prior- year refund you applied as a payment of 2019 esti­ mated tax. If we adjusted your applied refund, be sure to use the adjusted amount. If you need to verify your applied refund amount, log into or create your Revenue Online account at www.oregon.gov/dor or contact us. Estimated tax payments for 2019. Enter the total 32 estimated tax payments you made before filing your 2019 Oregon return. For calendar-year filers, these payments were due April 15, 2019; June 17, 2019; Sep­ tember 16, 2019; and January 15, 2020. Include all pay­ ments you made up to the date you filed your original or amended return. Don’t include the amount reported on line 31. If you need to verify your estimated pay­ ments, log into or create your Revenue Online account at www.oregon.gov/dor or contact us. Refundable credits Refundable credits reduce the amount of tax that you owe. Any amount that is more than your tax liability is treated the same way as an overpayment. Refund­ able credits not explained here are claimed on Schedule OR-ASC. For more information about refundable credits, see the instructions for Schedule OR-ASC or “Credits” in Pub­ lication OR-17. Earned income credit. Oregon’s earned income credit is a percentage of the earned income tax credit (EITC) claimed on your federal return. The per- centage is based on the age of your youngest dependent at the end of the tax year. You may claim the Oregon earned income credit only if you qualify for the federal EITC. Note to RDPs: You may claim this credit if you would otherwise qualify for the EITC using your “as if” federal return. Use Table 7 and the following worksheet to figure your credit. Table 7. EIC percentage Age of youngest dependent at end of tax year Percentage of federal EITC At least 3 years old, or no dependents 8 percent (0.08) Younger than 3 11 percent (0.11) Earned income credit worksheet 1. Enter your federal EITC from Form 1040 or 1040-SR, line 18a. 1. 2. Enter the percentage from the table as a decimal. 2. 3. Line 1 times line 2. This is your 3. Oregon earned income credit. Kicker (Oregon surplus) credit. The Oregon 34 surplus credit, known as the “kicker,” is a way for state government to return some of your taxes to you when revenues are more than predicted. The Oregon Department of Administrative Services deter­ mines whether there is a surplus and the amount to be returned to taxpayers as a kicker. If there’s a surplus, the kicker may be claimed on the return as a refund­ able tax credit. If there’s no surplus, there’s no kicker. Eligibility. To be eligible for a kicker, you must: 1. File your 2018 Oregon return before you file your 2019 return. 2. Have an Oregon tax liability for 2018. 3. File a 2019 Oregon return, even if you don’t otherwise have a filing requirement. Kicker amount. In general, your kicker is a percentage of your total Oregon personal income tax liability for the prior year, as adjusted or amended. Your total per­ sonal income tax liability is your Oregon income tax before all payments or credits other than the credit for taxes paid to another state. For 2019, your kicker is 17.171 percent of your 2018 total Oregon personal income tax liability. Amended 2018 returns. If your 2018 return is amended or adjusted after you file your 2019 return, we will auto­ matically adjust your kicker amount. If the changes to your 2018 return reduce your tax liability, your kicker amount may be reduced as well. If so, we may send you a bill for the amount of the reduction along with any interest or penalty. 150-101-043 (Rev. 04-28-20) 17 33

Kicker donation. Personal income taxpayers may elect to donate their kicker to the Oregon State School Fund for public K-12 education. This election is irrevocable. When you file your return, you must choose to do one of the following: • Claim all of your kicker credit; or • Donate all of your kicker to the State School Fund. If you want to donate only a part of your kicker, you first have to claim all of your kicker credit on your return. Then, once you receive it, use it to make your donation. The Oregon State School Fund’s address is: Oregon Department of Education Attn: OFA Cashier 255 Capitol St NE Salem OR 97301 How to calculate your kicker amount Online assistance. We can calculate your kicker amount for you at Revenue Online if: • Your filing status was the same for 2018 and 2019, and • If you were married and filing a joint return for 2019, your spouse was the same for both years. Look for “What’s my Kicker” on Revenue Online at www.oregon.gov/dor. Kicker worksheet. This worksheet can help you calcu­ late your kicker amount. It’s divided into three parts: Part A— Calculate your 2018 total personal income tax liability and kicker amount. Part B— Prorate your total personal income tax liabil- ity, if necessary. Part C— Add individual kicker amounts together for joint 2019 returns, if necessary. If you’re completing Part B or Part C, you may need to use Part A or Part B more than once. Same filing and marital status. For most taxpayers, all you need to do is multiply your 2018 total Oregon per­ sonal income tax liability times 0.17171 You can also use Part A of the worksheet. Change in filing or marital status. Some taxpayers who filed a joint return for 2018 must prorate their kicker based on their share of 2018 federal AGI. Some tax­ payers whose filing or marital status was different in 2018 may need to combine their kickers on a joint 2019 return. Use Table 8 to see if you need to prorate your kicker using Part B and/or combine your kickers using Part C. Table 8: Prorated and/or combined kickers Complete Parts A, B, and C if: Your filing status in 2018 was: And your 2019 filing status is: And: Joint Joint You were married in 2019 and you (or your spouse, or both) had a different spouse in 2018. Non-joint Joint You were married in 2019 and your spouse had a different spouse in 2018. Non-joint Joint You were married in 2019 and neither of you were married in 2018. (You may skip Part B.) Complete Parts A and B if: Your filing status in 2018 was: And your 2019 filing status is: And: Joint Non-joint You were divorced in 2019 or you're married but filing sepa­ rate returns. Joint Non-joint Your spouse died in 2018 and their personal representative or estate is filing a separate 2019 return on their behalf. Optional: Complete Part A if: Your filing status in 2018 was: And your 2019 filing status is: And: Joint Joint You had the same spouse in both 2018 and 2019. Non-joint Non-joint Joint Joint or non-joint Your spouse died in 2018 and no separate 2019 return is being filed on their behalf, or your spouse died in 2019. Deceased taxpayer. The surviving spouse of a deceased taxpayer may claim the full amount of the kicker if a joint return was filed for 2018. A deceased taxpayer’s personal representative may file a 2019 return on the taxpayer’s behalf to claim their kicker. How do I find my 2018 total Oregon personal income tax liability? Use Table 9 and your 2018 Oregon return to locate your tax before credits and any credit(s) you claimed for income taxes you paid to another state (using code 802 or 815) on Schedule OR-ASC or OR-ASC-NP. 150-101-043 (Rev. 04-28-20) 18

Table 9: Where to find tax liability If you filed: Tax before credits: Credits using code 802 or 815 from: Form OR-40 Line 22 Schedule OR-ASC, Sec­ tion 3 Form OR-40-N Line 48 Schedule OR-ASC-NP, Section 5 Form OR-40-P Line 47 Kicker worksheet Part A—Total personal income tax liability and kicker. 1. Tax before credits (see Table 9). 1. ________ 2. Credit for income taxes paid to 2. ________ another state using code 802 or 815 (see Table 9). 3. Line 1 minus line 2. This is your 3. ________ total personal income tax liability for 2018. 4. Line 3 times 0.17171. Round to the 4. nearest dollar. This is your kicker. Part B – Prorated kicker. See Table 8. Complete lines 5 through 8 only if you filed a joint return in 2018 and your 2019 filing status is non-joint or joint but with a different spouse. Before you start, determine your share of 2018 federal AGI.* 5. Federal AGI for 2018. Form OR-40, 5. ________ line 7; Form OR-40-N or OR-40-P, line 29F. 6. Your share of federal AGI for 2018. 6. ________ 7. Line 6 divided by line 5. Round to 7. ________ two decimal places. 8. Line 4 times line 7. This is your pro- 8. rated kicker. Part C – Combined kicker. Complete part C only if you’re filing a joint return for 2019 and you and your spouse didn’t file a joint return together for 2019. 9. Kicker amount from your work- 9. ________ sheet, line 4 (or line 8 if you com­ pleted Part B). 10. Your spouse’s kicker from their 10. _______ worksheet, line 4 (or line 8, if they completed Part B). 11. Line 9 plus line 10. This is your 11. combined kicker. *Consider each spouse’s individual income or adjust- ments, such as wages, pensions, or self-employment tax, and use a reasonable method to divide joint income or adjustments, such as capital gains from the sale of jointly-owned property or interest on joint bank accounts. If the 2018 federal AGI on a joint return was zero or less, but the Oregon tax liability was more than zero, contact us for help. Example 1. Hudson and Olivia each filed their 2018 Oregon returns using the single filing status. Hudson’s tax liability was $8,000 and he claimed a $500 credit for income taxes paid to another state on Schedule OR­ ASC. Olivia’s tax liability was $3,000, and she paid state income tax only to Oregon. Hudson and Olivia were married in 2019 and are filing a joint Oregon return. They each complete Part A of the worksheet as follows: Hudson’s worksheet: Part A: 1. Tax before credits $ 8,000 2. Credit for tax paid – 500 3. Total personal tax liability $ 7,500 4. Line 3 times 0.17171 $ 1,288 Olivia’s worksheet: Part A: 1. Tax before credits $ 3,000 2. Credit for tax paid -0- 3. Total personal tax liability $ 3,000 4. Line 3 times 0.17171 $ 515 They skip Part B because neither one filed a joint return for 2018. They complete Part C to find their combined kicker: 9. Hudson’s kicker from line 4 of his worksheet $ 1,288 10. Olivia’s kicker from line 4 of her worksheet $ 515 11. Line 9 plus line 10 $ 1,803 Hudson and Olivia’s combined kicker is $1,803. Example 2: Ella and Emerson filed a joint 2018 Oregon return. They were divorced in 2019 and are filing sepa­ rate returns. On their 2018 return, their tax before cred­ its was $6,500, and they had a $300 credit for income tax they paid to another state. Their 2018 federal AGI was $90,000; Ella’s share was $40,000 and Emerson’s share was $50,000. Each completes Parts A and B of the work­ sheet to find their prorated kicker. Ella’s worksheet: Part A: 1. Tax before credits $ 6,500 2. Credit for tax paid – 300 3. Total personal tax liability $ 6,200 4. Line 3 times 0.17171 $ 1,065 150-101-043 (Rev. 04-28-20) 19

Part B: 5. Federal AGI $ 90,000 6. Ella’s share of AGI $ 40,000 7. Line 6 divided by line 5 0.44 8. Line 4 times line 7 $ 469 Emerson’s worksheet: Part A: 1. Tax before credits $ 6,500 2. Credit for tax paid – 300 3. Total personal tax liability $ 6,200 4 Line 3 times 0.17171 $ 1,065 Part B: 5. Federal AGI $ 90,000 6. Emerson’s share of AGI $ 50,000 7. Line 6 divided by line 5 0.56 8. Line 4 times line 7 $ 596 Ella’s prorated kicker is $469 and Emerson’s prorated kicker is $596. Example 3: Cortney and Orlando filed a joint Oregon return in 2018. Their Oregon tax before credits was $7,500, and they didn’t pay income taxes to any other state. Their federal AGI was $80,000; Cortney’s share was $48,000 and Orlando’s share was $32,000. They were divorced in early 2019, and Cortney married Jus­ tin later that year. Justin had filed a non-joint Oregon return for 2018. His Oregon tax before credits was $2,000 and he claimed a $200 credit for taxes paid to another state. Orlando didn’t remarry in 2019. Orlando, Cortney, and Justin figure their kickers as follows: Orlando’s worksheet: Part A: 1. Tax before credits $ 7,500 2. Credit for tax paid -0- 3. Total personal tax liability $ 7,500 4. Line 3 times 0.17171 $ 1,288 Part B: 5. Federal AGI $ 80,000 6. Orlando’s share of AGI $ 32,000 7. Line 6 divided by line 5 0.40 8. Line 4 times line 7 $ 515 Cortney’s worksheet: Part A: 1. Tax before credits $ 7,500 2. Credit for tax paid -0- 3. Total personal tax liability $ 7,500 4. Line 3 times 0.17171 $ 1,288 Part B: 5. Federal AGI $ 80,000 6. Cortney’s share of AGI $ 48,000 7. Line 6 divided by line 5 0.60 8. Line 4 times line 7 $ 773 Justin’s worksheet: Part A: 1. Tax before credits $ 2,000 2. Credit for tax paid – 200 3. Total personal tax liability $ 1,800 4. Line 3 times 0.17171 $ 309 Justin skips Part B because he filed a non-joint return for 2018. He and Cortney complete Part C: 9. Cortney’s kicker from line 8 of her worksheet $ 773 10. Justin’s kicker from line 4 of his worksheet $ 309 11. Line 9 plus line 10 $ 1,082 Cortney and Justin’s combined kicker is $1,082. Orlan­ do’s kicker is $515. Claim your kicker credit. If you’re claiming your kicker credit, enter the amount from line 4, line 8, or line 11 of the worksheet, as applicable, on line 34. Donate your kicker. If you elect to donate your kicker to the Oregon State School Fund, enter -0- on line 34 and see the instructions for line 51. Reminder: This elec­ tion is irrevocable. Note about offsets: If you claim the kicker credit and it reduces your 2019 tax liability to zero, any excess will be treated like a refund of overpaid tax. This means that it may be offset (applied as a payment) against any tax or other liabilities you owe before the balance is refunded to you or applied (see Refund applications, above). If you donate your kicker, it may be used first to offset tax or other liabilities you owe, with any remain­ ing amount donated to the Oregon State School Fund. If this happens, we’ll send you a notice to let you know. Total refundable credits from Schedule OR-ASC. 35 Enter your total refundable credits from Sched­ ule OR-ASC, section 5. Include Schedule OR-ASC with your return. Penalties and interest Your 2019 tax must be paid by July 15, 2020, even 39 if you requested an extension of time to file your return. Your 2019 return must be filed by July 15, 2020. If you requested an extension, your return must be filed by October 15, 2020. 150-101-043 (Rev. 04-28-20) 20

Round the total of penalties and interest to the near­ est whole dollar. For more information and examples showing how penalties and interest are calculated, see “Interest and penalties” in Publication OR-17. Penalties Penalty amounts are based on the tax after all credits shown on your return. To find your tax after all cred­ its, start with your tax after standard and carryforward credits on line 29, then subtract the refundable credit amounts on lines 33, 34, and 35. • Failure-to-file penalty. Include a penalty for failure to file a return if: — Your return is filed more than three months after the due date (or extension due date); and — You didn’t pay all of your tax by July 15, 2020. The penalty for failure to file is 20 percent of your tax after all credits that wasn’t paid by July 15, 2020. • Failure-to-pay penalty. Include a penalty for failure to pay if: — Less than 90 percent of your tax after all credits was paid by July 15, 2020, or — You paid at least 90 percent of your tax after cred­ its by July 15, 2020 but you aren’t paying the bal­ ance of unpaid tax in full when you file. The penalty for failure to pay is 5 percent of your tax after all credits that wasn’t paid by July 15, 2020. Failure to file and pay. If both penalties apply, your total penalty will be 25 percent of your tax after all credits that wasn’t paid by July 15, 2020. Interest on unpaid tax You’ll owe interest on the amount of tax that wasn’t paid by July 15, 2020. Interest starts accruing on July 16 and continues to accrue every day, including the date of your payment. Interest is figured daily, based on a 365-day year. The annual interest rate for 2020 is 6 percent, or 0.0164 per­ cent per day. To figure your interest, count the number of days start­ ing with July 16, 2020 and ending with the date of your payment. Multiply your unpaid tax by the number of days, then multiply by 0.000164 (the daily rate con­ verted to a decimal). Interest rate increase. If we bill you for unpaid tax, and the tax isn’t paid in full within 60 days from the date of our billing notice, the annual interest rate increases by 4 percentage points, to 10 percent. Amended return. If you’re amending your return, cal­ culate the interest based on the additional amount of tax you must pay (line 5 of the Amended worksheet). Interest on underpayment of estimated tax. 40 Underpayment interest is charged if: • Your tax after all credits and withholding is $1,000 or more; • You were required to make estimated tax payments; • One or more of your required installments was underpaid; and • You don’t qualify for an exception. Note: You could be charged interest on underpayment of estimated tax even if line 37 shows a refund. See Publication OR-10 to determine if you owe under­ payment interest or qualify for an exception. Down­ load the publication from our website or contact us to order it. If you owe underpayment interest, enter the amount from line 33 of Form OR-10. If you qualify for an excep­ tion, enter the exception number from line 1 of the form inside box 40a. If you used Worksheet OR-10-AI to fig­ ure your interest, check box 40b. Include Form OR-10 with your return (along with any required statements if you’re claiming an exception). Keep Worksheet OR­ 10-AI with your records. Amount due Amount you owe. Enter your total unpaid tax 42 plus penalties and interest. Note: If you have an overpayment on line 37 and the overpayment is less than the total penalties and interest you entered on line 41, enter the amount from line 41 minus the amount on line 37. Payment options You may pay electronically from your checking or sav­ ings account, by credit card, or with a check, cashier’s check, or money order. Cash payments can be made only at our main office in Salem. If the amount due is less than $2, no payment is required. Electronic payment from your checking or savings account You can pay your current year income taxes, 2020 esti­ mated income taxes, any prior year taxes due, and amended return taxes directly from your checking or savings account. There is no fee to use this service. This option is available only through our website. Go to www.oregon.gov/dor and click the link for Revenue Online. Direct debit may be available with e-filed returns at the time of filing. 150-101-043 (Rev. 04-28-20) 21

Credit card payments You can pay with your Discover, MasterCard, or Visa credit card. The service provider will charge you a convenience fee. The service provider will tell you what the fee is during the transaction; you will have the option to continue or cancel the transaction before entering your credit card information. If you complete the credit card transaction, you will receive a confirma­ tion number. Keep this confirmation number as proof of payment—don’t send it with your return. To pay by credit card, go to www.oregon.gov/dor and click the link for Revenue Online. Check or money order • Make your check or money order payable to “Oregon Department of Revenue.” • Write all of the following on your payment: — The tax year (2019). — The form you’re filing (Oregon Form OR-40). — The last four digits of your SSN or ITIN. • Use blue or black ballpoint ink. Don’t use red or pur­ ple ink or gel pens. • Don’t send cash or a postdated check. Form OR-40-V. Use the voucher only if you’re mak­ ing a separate payment by check, cashier’s check, or money order. Don’t use the voucher if you’re including a payment with your return or making an electronic payment. Payment plan. If you can’t pay in full now, pay what you can. Contact us and we will help you set up a payment plan for the amount you don’t pay with your return. Refund Refund. Enter your overpayment from line 43 37 minus any penalty or interest from line 41. Note: If the amount on line 41 is more than the over­ payment on line 37, see the instructions for line 42. You have three years from the due date of the return to file a claim for your refund. By law, we can’t issue a refund if you file your return more than three years after the return’s due date (without extensions) or if the refund is less than $1. For more information about the time limit for claiming a refund, see “Payments and refunds” in Publication OR-17. Interest on refunds. See “Payments and refunds” in Publication OR-17 for information about interest paid on refunds. Refund applications If line 43 shows a refund, you may use some or all of it to: • Make an estimated tax payment for a later year. • Donate to one or more of the charitable organizations listed on Schedule OR-DONATE. • Contribute to the political party of your choice. • Make a deposit to an Oregon college or MFS 529 sav­ ings plan account. Each of these applications will reduce your refund. The combined total of all applications can’t be more than the amount of your refund. Note: A refund of overpaid tax will be offset against outstanding debt before any amount is applied or refunded to you. Instructions for amended returns. If line 5 of the Amended worksheet shows a refund, you can use some or all of it for the refund applications listed above. However, you can’t reduce any amounts you’ve already applied from a refund on your original return. See the instructions for each application for details. Open estimated tax account. Enter the amount 44 of your refund you want to apply as a tax pay­ ment for a later year. This amount will be applied to your open estimated tax account (to a year where you will be filing a tax return). Generally, unless you’re fil­ ing a delinquent or amended return, the payment will be applied to the 2020 tax year. For more information, see “Payments and refunds” in Publication OR-17. Instructions for amended returns. Enter the amount, if any, from a refund on your original return that you’ve already applied as an estimated tax payment for a later year. If line 5 of the Amended worksheet shows a refund and you want to apply some or all of it as an estimated tax payment, include the amount you want to apply. Charitable checkoff. Enter the amount from line 45 30 of Schedule OR-DONATE. For more informa­ tion, see the schedule instructions. Note: If your refund—after any application to an open estimated tax account—is less than your total donation amount, your donations will be prorated. To make direct donations instead, you can find each charity’s address listed on our website. Don’t mail your donations to us. Instructions for amended returns. Enter the amount, if any, from a refund on your original return that you applied as charitable donations using Schedule OR­ DONATE. If line 5 of the Amended worksheet shows a refund, you can donate some or all of it to one or more of the listed charities. Include this amount and an 150-101-043 (Rev. 04-28-20) 22

amended Schedule OR-DONATE with your amended return. Note: The refund from your amended return will be applied as a donation for the calendar year in which you’re filing it. 46 Political party checkoff. You may use your refund to contribute $3 to the Oregon political party of your choice. If you’re filing a joint return, you and your spouse may each contribute $3. Note: Your contribution will reduce your refund and does not qualify for the political contribution credit. To make a contribution: 1. Designate the political party of your choice using the party’s code from the alphabetized list below. — If you contribute, enter one code in box 46a. — If your spouse contributes on a joint return, enter one code in box 46b. Enter only one code per taxpayer. Spouses filing a joint return don’t have to enter the same code. • Constitution Party of Oregon [code 500]. • Democratic Party of Oregon [code 501]. • Independent Party of Oregon [code 502]. • Libertarian Party of Oregon [code 503]. • Oregon Republican Party [code 504]. • Pacific Green Party of Oregon [code 505]. • Progressive Party [code 506]. • Working Families Party of Oregon [code 507]. 2. Enter your total contribution amount. — If you or your spouse contribute, enter $3. — If both you and your spouse contribute on a joint return, enter $6. Note: Your political party contribution won’t be made if: • Your refund—after any application to an open esti­ mated tax account or charitable checkoff donation— is less than your total contribution amount. • You enter an amount but don’t designate a party (or parties). • You designate a party (or parties) but don’t enter an amount. • You enter more than one party code per taxpayer. Instructions for amended returns. Enter the amount, if any, from a refund on your original return that you applied as a political party contribution. If line 5 of the Amended worksheet shows a refund and you didn’t make the maximum political party contribution on your original return, you may use the refund to make a contribution on your amended return. Oregon college or MFS 529 savings plan. Enter 47 the total from Schedule OR-529. For minimum deposit amounts and other information, see the sched­ ule instructions. Note: If the amount of your refund—after any applica­ tion to an open estimated tax account, charitable check­ off donation, or political party contribution—is less than the total amount you want to deposit, no deposit will be made. Instructions for amended returns. Enter the amount, if any, from a refund on your original return that you applied as an Oregon college or MFS 529 savings plan deposit. If line 5 of the Amended worksheet shows a refund, add the amount you want to apply as a deposit and include an amended Schedule OR-529 with your amended return. The refund will be applied for the year in which you’re filing the amended return. Net refund. You must reduce your refund by 49 any amounts applied to your open estimated tax account, charitable checkoff donations, political party contributions, and Oregon college or MFS 529 savings plan accounts. By law, we can’t issue or apply a refund if you file your return more than three years after the return’s due date (excluding extensions). Direct deposit Direct deposit. In most cases, we can deposit 50 your refund directly into your checking or sav­ ings account instead of mailing you a check. However, federal banking regulations prevent us from making a refund by direct deposit if the final destination is an account outside the U.S. In that case, we must issue a paper check instead. Before you enter your information, verify that your deposit will be accepted and confirm your routing and account numbers. You can find a diagram of a personal check showing where these numbers are located in the “Payments and refunds” section of Publication OR-17. Follow these steps to make sure your refund will be deposited into the correct account: 1. Check the box if the final destination for your refund would be an account outside the U.S. Note: If you check this box, you will be issued a paper check. 2. Check the appropriate box, either checking or sav­ ings, but not both. 3. Enter your nine-digit routing number. Routing numbers begin with the digits 01 through 12, 21 through 32, or 61 through 72. 4. Enter your account number. Account numbers can be up to 17 characters (both numbers and letters). Don’t include hyphens, spaces, or special symbols. 5. Double-check the account and routing numbers. These numbers can’t be changed after the return is filed. 150-101-043 (Rev. 04-28-20) 23

51 Kicker donation Before you file Kicker donation. You may choose to donate all of your kicker to the Oregon State School Fund. The election to donate your kicker can’t be changed. No partial donations are allowed. If any amount other than -0- is entered on line 34, your donation won’t be made. To make the donation: 1. See the instructions for line 34 to calculate your kicker amount. 2. Make sure that you’ve entered -0- on line 34. 3. Check box 51a. 4. Enter your entire kicker amount on line 51b. Reminder: This election is irrevocable. See the instructions for calculating your kicker for more information. Signature block Signature(s). Be sure to sign and date your return. If you’re filing a joint return, both taxpayers must sign. By signing the return, you acknowledge, under penalty of false swearing, that the information on the return is true, correct, and complete. Minor child’s return. If your child can’t sign their tax return, you may sign the child’s name as their legal agent. Sign the child’s name and then write “By [your signature], parent (or other legal guardian) of minor child.” Preparer signature. Anyone who prepares, advises, or assists in preparing personal income tax returns in exchange for compensation of any kind must be licensed to prepare Oregon returns and must sign the return. Signing the return doesn't grant your preparer the right to represent you or make decisions on your behalf. See the Tax Information Authorization and Power of Attorney for Representation form and instructions on our website for more information. Contact the following agencies to check the status of your Oregon tax practitioner: • State Board of Tax Practitioners at (503) 378-4034 (Salem) for licensed tax consultants or preparers, or go to www.oregon.gov/obtp. • State Board of Accountancy at (503) 378-4181 (Salem) for public accountants and certified public accoun­ tants, or go to www.oregon.gov/boa. Preparer license number. Licensed tax consultants and tax preparers: enter your license number. CPAs: enter your certificate number. Tax-Aide volunteers: enter your TCE site number. All others: leave blank. Don’t enter your driver license number. Copy of federal return. Before you assemble your Ore­ gon return, make a copy of both sides of your federal Form 1040 or 1040-SR along with Schedules 1 through 3 (as applicable), 1040-X, 1040-NR, or 1040-NR-EZ. Don’t include any other federal schedules or an exten­ sion request unless instructed otherwise. Keep these with your records; we may ask for them later. If you created an “as if” federal return, use blue or black ink to label it “as if” on the top left corner. Include it along with the copy of your actual federal return (and any amendments). Failure to include your federal return will delay pro­ cessing, and items claimed on your Oregon return may be adjusted or denied. Amended Oregon return. If you’re amending your Ore­ gon return due to changes to your federal return or a return you filed with another state, include a copy of your amended or corrected federal or other state return or audit report. If you’re amending only your Oregon return, include a copy of your original federal or other state return. Assemble your Oregon return. Assemble your return in the order shown below. If a form has more than one page, be sure that you’ve included all pages and that they’re all from the same 2019 form. For example, if you’re filing Schedule OR-WFHDC, be sure that “2019 Schedule OR-WFHDC” is printed at the top of each page and that you’ve included all three pages. Important: Don’t use staples, paperclips, tape, or other fasteners. Doing so will delay processing. 1. Payment by check or money order, if any. Don’t use a voucher. 2. Form(s) W-2 and 1099 showing Oregon tax withheld. 3. Form OR-40. 4. Schedule OR-A. 5. Schedule OR-ASC. 6. Schedule OR-ADD-DEP. 7. Schedule OR-DONATE. 8. Schedule OR-529. 9. Schedule OR-PTE-FY. 10. Form OR-10. 11. Schedule OR-WFHDC. 12. Other Oregon schedules required to be included with your return. 13. If you’re an RDP filing separately for Oregon, your RDP’s Oregon return. 14. Your federal return(s) and schedules. Note: If you’re making an estimated tax payment for 2020 by check or money order, send the payment in a separate envelope with a completed Form OR-40-V. Don’t include your 2020 payment or voucher with your 2019 return. 150-101-043 (Rev. 04-28-20) 24

Avoid processing delays Type or clearly print your name, SSN, date of birth, complete mailing address, and daytime phone number on your return. Include all pages of your Oregon return. Double-check your figures and other numbers, includ­ ing your SSN. Errors will delay processing. Common mistakes are: • Math errors. • A wrong amount claimed for the federal tax liability subtraction. • Using the wrong line or column on the tax tables. • Using the wrong tax chart. If you have tax to pay, review the instructions for line 42. Verify your account information if you’re requesting a refund by direct deposit. Sign your return. Both spouses must sign a joint return. Include legible copies of all W-2 and 1099 forms show­ ing Oregon income tax withheld. Place them on top of your return along with any payment by check, cashier’s check, or money order. Include a copy of your federal return (front and back) with your Oregon return. Include federal Schedules 1 through 3 (if applicable), but don’t include other fed­ eral schedules unless otherwise instructed. Place it behind all Oregon forms and schedules. Payment by check, cashier’s check, or money order should be placed on top of your return. Don’t mail cash. Don’t use a voucher. Don’t use staples, paper clips, tape, or other fasteners. Mail your return in a stamped envelope. Use a busi­ ness-size (4 × 9½ inches) or larger envelope with ade­ quate postage. Don’t use a smaller envelope—it delays processing. Tax return mailing addresses Mail refund returns or Mail tax-to-pay no-tax-due returns to: returns to: REFUND Oregon Department of Revenue PO Box 14700 PO Box 14555 Salem OR 97309-0930 Salem OR 97309-0940 150-101-043 (Rev. 04-28-20) 25

2019 Tax Tables for Form OR-40 S Use column S if you are: • Single. • Married filing separately. Use column J if you are: J • Married filing jointly. • Head of household. • Widow(er) with dependent child. If income from Form OR-40, line 19 is: And you use column: At least: But less than: S J Your tax is: If income from Form OR-40, line 19 is: And you use column: At least: But less than: S J Your tax is: If income from Form OR-40, line 19 is: And you use column: At least: But less than: S J Your tax is: If income from Form OR-40, line 19 is: And you use column: At least: But less than: S J Your tax is: 0 – 20 0 0 20 – 50 2 2 50 – 100 4 4 100 – 200 8 8 200 – 300 13 13 300 – 400 18 18 400 – 500 23 23 500 – 600 28 28 600 – 700 33 33 700 – 800 38 38 800 – 900 43 43 900 – 1,000 48 48 1,000 – 1,100 53 53 1,100 – 1,200 58 58 1,200 – 1,300 63 63 1,300 – 1,400 68 68 1,400 – 1,500 73 73 1,500 – 1,600 78 78 1,600 – 1,700 83 83 1,700 – 1,800 88 88 1,800 – 1,900 93 93 1,900 – 2,000 98 98 2,000 – 2,100 103 103 2,100 – 2,200 108 108 2,200 – 2,300 113 113 2,300 – 2,400 118 118 2,400 – 2,500 123 123 2,500 – 2,600 128 128 2,600 – 2,700 133 133 2,700 – 2,800 138 138 2,800 – 2,900 143 143 2,900 – 3,000 148 148 3,000 – 3,100 153 153 3,100 – 3,200 158 158 3,200 – 3,300 163 163 3,300 – 3,400 168 168 3,400 – 3,500 173 173 3,500 – 3,600 178 178 3,600 – 3,700 185 183 3,700 – 3,800 192 188 3,800 – 3,900 199 193 3,900 – 4,000 206 198 $ 0 $ 4,000 $ 9,000 $ 14,000 $ 50 $ 1,000 $ 2,000 $ 3,000 $ 5,000 $ 6,000 $ 7,000 $ 8,000 $ 10,000 $ 11,000 $ 12,000 $ 13,000 $ 15,000 $ 16,000 $ 17,000 $ 18,000 4,000 – 4,100 213 203 4,100 – 4,200 220 208 4,200 – 4,300 227 213 4,300 – 4,400 234 218 4,400 – 4,500 241 223 4,500 – 4,600 248 228 4,600 – 4,700 255 233 4,700 – 4,800 262 238 4,800 – 4,900 269 243 4,900 – 5,000 276 248 5,000 – 5,100 283 253 5,100 – 5,200 290 258 5,200 – 5,300 297 263 5,300 – 5,400 304 268 5,400 – 5,500 311 273 5,500 – 5,600 318 278 5,600 – 5,700 325 283 5,700 – 5,800 332 288 5,800 – 5,900 339 293 5,900 – 6,000 346 298 6,000 – 6,100 353 303 6,100 – 6,200 360 308 6,200 – 6,300 367 313 6,300 – 6,400 374 318 6,400 – 6,500 381 323 6,500 – 6,600 388 328 6,600 – 6,700 395 333 6,700 – 6,800 402 338 6,800 – 6,900 409 343 6,900 – 7,000 416 348 7,000 – 7,100 423 353 7,100 – 7,200 430 359 7,200 – 7,300 437 366 7,300 – 7,400 444 373 7,400 – 7,500 451 380 7,500 – 7,600 458 387 7,600 – 7,700 465 394 7,700 – 7,800 472 401 7,800 – 7,900 479 408 7,900 – 8,000 486 415 8,000 – 8,100 493 422 8,100 – 8,200 500 429 8,200 – 8,300 507 436 8,300 – 8,400 514 443 8,400 – 8,500 521 450 8,500 – 8,600 528 457 8,600 – 8,700 535 464 8,700 – 8,800 542 471 8,800 – 8,900 549 478 8,900 – 9,000 557 485 9,000 – 9,100 566 492 9,100 – 9,200 575 499 9,200 – 9,300 584 506 9,300 – 9,400 593 513 9,400 – 9,500 602 520 9,500 – 9,600 611 527 9,600 – 9,700 620 534 9,700 – 9,800 629 541 9,800 – 9,900 638 548 9,900 – 10,000 647 555 10,000 – 10,100 656 562 10,100 – 10,200 665 569 10,200 – 10,300 674 576 10,300 – 10,400 683 583 10,400 – 10,500 692 590 10,500 – 10,600 701 597 10,600 – 10,700 710 604 10,700 – 10,800 719 611 10,800 – 10,900 728 618 10,900 – 11,000 737 625 11,000 – 11,100 746 632 11,100 – 11,200 755 639 11,200 – 11,300 764 646 11,300 – 11,400 773 653 11,400 – 11,500 782 660 11,500 – 11,600 791 667 11,600 – 11,700 800 674 11,700 – 11,800 809 681 11,800 – 11,900 818 688 11,900 – 12,000 827 695 12,000 – 12,100 836 702 12,100 – 12,200 845 709 12,200 – 12,300 854 716 12,300 – 12,400 863 723 12,400 – 12,500 872 730 12,500 – 12,600 881 737 12,600 – 12,700 890 744 12,700 – 12,800 899 751 12,800 – 12,900 908 758 12,900 – 13,000 917 765 13,000 – 13,100 926 772 13,100 – 13,200 935 779 13,200 – 13,300 944 786 13,300 – 13,400 953 793 13,400 – 13,500 962 800 13,500 – 13,600 971 807 13,600 – 13,700 980 814 13,700 – 13,800 989 821 13,800 – 13,900 998 828 13,900 – 14,000 1,007 835 14,000 – 14,100 1,016 842 14,100 – 14,200 1,025 849 14,200 – 14,300 1,034 856 14,300 – 14,400 1,043 863 14,400 – 14,500 1,052 870 14,500 – 14,600 1,061 877 14,600 – 14,700 1,070 884 14,700 – 14,800 1,079 891 14,800 – 14,900 1,088 898 14,900 – 15,000 1,097 905 15,000 – 15,100 1,106 912 15,100 – 15,200 1,115 919 15,200 – 15,300 1,124 926 15,300 – 15,400 1,133 933 15,400 – 15,500 1,142 940 15,500 – 15,600 1,151 947 15,600 – 15,700 1,160 954 15,700 – 15,800 1,169 961 15,800 – 15,900 1,178 968 15,900 – 16,000 1,187 975 16,000 – 16,100 1,196 982 16,100 – 16,200 1,205 989 16,200 – 16,300 1,214 996 16,300 – 16,400 1,223 1,003 16,400 – 16,500 1,232 1,010 16,500 – 16,600 1,241 1,017 16,600 – 16,700 1,250 1,024 16,700 – 16,800 1,259 1,031 16,800 – 16,900 1,268 1,038 16,900 – 17,000 1,277 1,045 17,000 – 17,100 1,286 1,052 17,100 – 17,200 1,295 1,059 17,200 – 17,300 1,304 1,066 17,300 – 17,400 1,313 1,073 17,400 – 17,500 1,322 1,080 17,500 – 17,600 1,331 1,087 17,600 – 17,700 1,340 1,094 17,700 – 17,800 1,349 1,101 17,800 – 17,900 1,358 1,109 17,900 – 18,000 1,367 1,118 18,000 – 18,100 1,376 1,127 18,100 – 18,200 1,385 1,136 18,200 – 18,300 1,394 1,145 18,300 – 18,400 1,403 1,154 18,400 – 18,500 1,412 1,163 18,500 – 18,600 1,421 1,172 18,600 – 18,700 1,430 1,181 18,700 – 18,800 1,439 1,190 18,800 – 18,900 1,448 1,199 18,900 – 19,000 1,457 1,208 150-101-043 (Rev. 04-28-20) 26

2019 Tax Tables for Form OR-40 S Use column S if you are: • Single. • Married filing separately. Use column J if you are: J • Married filing jointly. • Head of household. • Widow(er) with dependent child. If income from Form OR-40, line 19 is: And you use column: At least: But less than: S J Your tax is: If income from Form OR-40, line 19 is: And you use column: At least: But less than: S J Your tax is: If income from Form OR-40, line 19 is: And you use column: At least: But less than: S J Your tax is: If income from Form OR-40, line 19 is: And you use column: At least: But less than: S J Your tax is: 19,000 – 19,100 1,466 1,217 19,100 – 19,200 1,475 1,226 19,200 – 19,300 1,484 1,235 19,300 – 19,400 1,493 1,244 19,400 – 19,500 1,502 1,253 19,500 – 19,600 1,511 1,262 19,600 – 19,700 1,520 1,271 19,700 – 19,800 1,529 1,280 19,800 – 19,900 1,538 1,289 19,900 – 20,000 1,547 1,298 20,000 – 20,100 1,556 1,307 20,100 – 20,200 1,565 1,316 20,200 – 20,300 1,574 1,325 20,300 – 20,400 1,583 1,334 20,400 – 20,500 1,592 1,343 20,500 – 20,600 1,601 1,352 20,600 – 20,700 1,610 1,361 20,700 – 20,800 1,619 1,370 20,800 – 20,900 1,628 1,379 20,900 – 21,000 1,637 1,388 21,000 – 21,100 1,646 1,397 21,100 – 21,200 1,655 1,406 21,200 – 21,300 1,664 1,415 21,300 – 21,400 1,673 1,424 21,400 – 21,500 1,682 1,433 21,500 – 21,600 1,691 1,442 21,600 – 21,700 1,700 1,451 21,700 – 21,800 1,709 1,460 21,800 – 21,900 1,718 1,469 21,900 – 22,000 1,727 1,478 22,000 – 22,100 1,736 1,487 22,100 – 22,200 1,745 1,496 22,200 – 22,300 1,754 1,505 22,300 – 22,400 1,763 1,514 22,400 – 22,500 1,772 1,523 22,500 – 22,600 1,781 1,532 22,600 – 22,700 1,790 1,541 22,700 – 22,800 1,799 1,550 22,800 – 22,900 1,808 1,559 22,900 – 23,000 1,817 1,568 23,000 – 23,100 1,826 1,577 23,100 – 23,200 1,835 1,586 23,200 – 23,300 1,844 1,595 23,300 – 23,400 1,853 1,604 23,400 – 23,500 1,862 1,613 23,500 – 23,600 1,871 1,622 23,600 – 23,700 1,880 1,631 23,700 – 23,800 1,889 1,640 23,800 – 23,900 1,898 1,649 23,900 – 24,000 1,907 1,658 $ 19,000 $ 24,000 $ 29,000 $ 34,000 $ 20,000 $ 21,000 $ 22,000 $ 23,000 $ 25,000 $ 26,000 $ 27,000 $ 28,000 $ 30,000 $ 31,000 $ 32,000 $ 33,000 $ 35,000 $ 36,000 $ 37,000 $ 38,000 24,000 – 24,100 1,916 1,667 24,100 – 24,200 1,925 1,676 24,200 – 24,300 1,934 1,685 24,300 – 24,400 1,943 1,694 24,400 – 24,500 1,952 1,703 24,500 – 24,600 1,961 1,712 24,600 – 24,700 1,970 1,721 24,700 – 24,800 1,979 1,730 24,800 – 24,900 1,988 1,739 24,900 – 25,000 1,997 1,748 25,000 – 25,100 2,006 1,757 25,100 – 25,200 2,015 1,766 25,200 – 25,300 2,024 1,775 25,300 – 25,400 2,033 1,784 25,400 – 25,500 2,042 1,793 25,500 – 25,600 2,051 1,802 25,600 – 25,700 2,060 1,811 25,700 – 25,800 2,069 1,820 25,800 – 25,900 2,078 1,829 25,900 – 26,000 2,087 1,838 26,000 – 26,100 2,096 1,847 26,100 – 26,200 2,105 1,856 26,200 – 26,300 2,114 1,865 26,300 – 26,400 2,123 1,874 26,400 – 26,500 2,132 1,883 26,500 – 26,600 2,141 1,892 26,600 – 26,700 2,150 1,901 26,700 – 26,800 2,159 1,910 26,800 – 26,900 2,168 1,919 26,900 – 27,000 2,177 1,928 27,000 – 27,100 2,186 1,937 27,100 – 27,200 2,195 1,946 27,200 – 27,300 2,204 1,955 27,300 – 27,400 2,213 1,964 27,400 – 27,500 2,222 1,973 27,500 – 27,600 2,231 1,982 27,600 – 27,700 2,240 1,991 27,700 – 27,800 2,249 2,000 27,800 – 27,900 2,258 2,009 27,900 – 28,000 2,267 2,018 28,000 – 28,100 2,276 2,027 28,100 – 28,200 2,285 2,036 28,200 – 28,300 2,294 2,045 28,300 – 28,400 2,303 2,054 28,400 – 28,500 2,312 2,063 28,500 – 28,600 2,321 2,072 28,600 – 28,700 2,330 2,081 28,700 – 28,800 2,339 2,090 28,800 – 28,900 2,348 2,099 28,900 – 29,000 2,357 2,108 29,000 – 29,100 2,366 2,117 29,100 – 29,200 2,375 2,126 29,200 – 29,300 2,384 2,135 29,300 – 29,400 2,393 2,144 29,400 – 29,500 2,402 2,153 29,500 – 29,600 2,411 2,162 29,600 – 29,700 2,420 2,171 29,700 – 29,800 2,429 2,180 29,800 – 29,900 2,438 2,189 29,900 – 30,000 2,447 2,198 30,000 – 30,100 2,456 2,207 30,100 – 30,200 2,465 2,216 30,200 – 30,300 2,474 2,225 30,300 – 30,400 2,483 2,234 30,400 – 30,500 2,492 2,243 30,500 – 30,600 2,501 2,252 30,600 – 30,700 2,510 2,261 30,700 – 30,800 2,519 2,270 30,800 – 30,900 2,528 2,279 30,900 – 31,000 2,537 2,288 31,000 – 31,100 2,546 2,297 31,100 – 31,200 2,555 2,306 31,200 – 31,300 2,564 2,315 31,300 – 31,400 2,573 2,324 31,400 – 31,500 2,582 2,333 31,500 – 31,600 2,591 2,342 31,600 – 31,700 2,600 2,351 31,700 – 31,800 2,609 2,360 31,800 – 31,900 2,618 2,369 31,900 – 32,000 2,627 2,378 32,000 – 32,100 2,636 2,387 32,100 – 32,200 2,645 2,396 32,200 – 32,300 2,654 2,405 32,300 – 32,400 2,663 2,414 32,400 – 32,500 2,672 2,423 32,500 – 32,600 2,681 2,432 32,600 – 32,700 2,690 2,441 32,700 – 32,800 2,699 2,450 32,800 – 32,900 2,708 2,459 32,900 – 33,000 2,717 2,468 33,000 – 33,100 2,726 2,477 33,100 – 33,200 2,735 2,486 33,200 – 33,300 2,744 2,495 33,300 – 33,400 2,753 2,504 33,400 – 33,500 2,762 2,513 33,500 – 33,600 2,771 2,522 33,600 – 33,700 2,780 2,531 33,700 – 33,800 2,789 2,540 33,800 – 33,900 2,798 2,549 33,900 – 34,000 2,807 2,558 34,000 – 34,100 2,816 2,567 34,100 – 34,200 2,825 2,576 34,200 – 34,300 2,834 2,585 34,300 – 34,400 2,843 2,594 34,400 – 34,500 2,852 2,603 34,500 – 34,600 2,861 2,612 34,600 – 34,700 2,870 2,621 34,700 – 34,800 2,879 2,630 34,800 – 34,900 2,888 2,639 34,900 – 35,000 2,897 2,648 35,000 – 35,100 2,906 2,657 35,100 – 35,200 2,915 2,666 35,200 – 35,300 2,924 2,675 35,300 – 35,400 2,933 2,684 35,400 – 35,500 2,942 2,693 35,500 – 35,600 2,951 2,702 35,600 – 35,700 2,960 2,711 35,700 – 35,800 2,969 2,720 35,800 – 35,900 2,978 2,729 35,900 – 36,000 2,987 2,738 36,000 – 36,100 2,996 2,747 36,100 – 36,200 3,005 2,756 36,200 – 36,300 3,014 2,765 36,300 – 36,400 3,023 2,774 36,400 – 36,500 3,032 2,783 36,500 – 36,600 3,041 2,792 36,600 – 36,700 3,050 2,801 36,700 – 36,800 3,059 2,810 36,800 – 36,900 3,068 2,819 36,900 – 37,000 3,077 2,828 37,000 – 37,100 3,086 2,837 37,100 – 37,200 3,095 2,846 37,200 – 37,300 3,104 2,855 37,300 – 37,400 3,113 2,864 37,400 – 37,500 3,122 2,873 37,500 – 37,600 3,131 2,882 37,600 – 37,700 3,140 2,891 37,700 – 37,800 3,149 2,900 37,800 – 37,900 3,158 2,909 37,900 – 38,000 3,167 2,918 38,000 – 38,100 3,176 2,927 38,100 – 38,200 3,185 2,936 38,200 – 38,300 3,194 2,945 38,300 – 38,400 3,203 2,954 38,400 – 38,500 3,212 2,963 38,500 – 38,600 3,221 2,972 38,600 – 38,700 3,230 2,981 38,700 – 38,800 3,239 2,990 38,800 – 38,900 3,248 2,999 38,900 – 39,000 3,257 3,008 150-101-043 (Rev. 04-28-20) 27

2019 Tax Tables for Form OR-40 S Use column S if you are: • Single. • Married filing separately. Use column J if you are: J • Married filing jointly. • Head of household. • Widow(er) with dependent child. If income from Form OR-40, line 19 is: And you use column: If income from Form OR-40, line 19 is: And you use column: If income from Form OR-40, line 19 is: And you use column: If income from Form OR-40, line 19 is: And you use column: But At less least: than: S J But At less least: than: S J But At less least: than: S J But At less least: than: S J Your tax is: Your tax is: Your tax is: Your tax is: $ 39,000 $ 42,000 $ 45,000 $ 48,000 39,000 – 39,100 3,266 3,017 42,000 – 42,100 3,536 3,287 45,000 – 45,100 3,806 3,557 48,000 – 48,100 4,076 3,827 39,100 – 39,200 3,275 3,026 42,100 – 42,200 3,545 3,296 45,100 – 45,200 3,815 3,566 48,100 – 48,200 4,085 3,836 39,200 – 39,300 3,284 3,035 42,200 – 42,300 3,554 3,305 45,200 – 45,300 3,824 3,575 48,200 – 48,300 4,094 3,845 39,300 – 39,400 3,293 3,044 42,300 – 42,400 3,563 3,314 45,300 – 45,400 3,833 3,584 48,300 – 48,400 4,103 3,854 39,400 – 39,500 3,302 3,053 42,400 – 42,500 3,572 3,323 45,400 – 45,500 3,842 3,593 48,400 – 48,500 4,112 3,863 39,500 – 39,600 3,311 3,062 42,500 – 42,600 3,581 3,332 45,500 – 45,600 3,851 3,602 48,500 – 48,600 4,121 3,872 39,600 – 39,700 3,320 3,071 42,600 – 42,700 3,590 3,341 45,600 – 45,700 3,860 3,611 48,600 – 48,700 4,130 3,881 39,700 – 39,800 3,329 3,080 42,700 – 42,800 3,599 3,350 45,700 – 45,800 3,869 3,620 48,700 – 48,800 4,139 3,890 39,800 – 39,900 3,338 3,089 42,800 – 42,900 3,608 3,359 45,800 – 45,900 3,878 3,629 48,800 – 48,900 4,148 3,899 39,900 – 40,000 3,347 3,098 42,900 – 43,000 3,617 3,368 45,900 – 46,000 3,887 3,638 48,900 – 49,000 4,157 3,908 $ 40,000 $ 43,000 $ 46,000 $ 49,000 40,000 – 40,100 3,356 3,107 43,000 – 43,100 3,626 3,377 46,000 – 46,100 3,896 3,647 49,000 – 49,100 4,166 3,917 40,100 – 40,200 3,365 3,116 43,100 – 43,200 3,635 3,386 46,100 – 46,200 3,905 3,656 49,100 – 49,200 4,175 3,926 40,200 – 40,300 3,374 3,125 43,200 – 43,300 3,644 3,395 46,200 – 46,300 3,914 3,665 49,200 – 49,300 4,184 3,935 40,300 – 40,400 3,383 3,134 43,300 – 43,400 3,653 3,404 46,300 – 46,400 3,923 3,674 49,300 – 49,400 4,193 3,944 40,400 – 40,500 3,392 3,143 43,400 – 43,500 3,662 3,413 46,400 – 46,500 3,932 3,683 49,400 – 49,500 4,202 3,953 40,500 – 40,600 3,401 3,152 43,500 – 43,600 3,671 3,422 46,500 – 46,600 3,941 3,692 49,500 – 49,600 4,211 3,962 40,600 – 40,700 3,410 3,161 43,600 – 43,700 3,680 3,431 46,600 – 46,700 3,950 3,701 49,600 – 49,700 4,220 3,971 40,700 – 40,800 3,419 3,170 43,700 – 43,800 3,689 3,440 46,700 – 46,800 3,959 3,710 49,700 – 49,800 4,229 3,980 40,800 – 40,900 3,428 3,179 43,800 – 43,900 3,698 3,449 46,800 – 46,900 3,968 3,719 49,800 – 49,900 4,238 3,989 40,900 – 41,000 3,437 3,188 43,900 – 44,000 3,707 3,458 46,900 – 47,000 3,977 3,728 49,900 – 50,000 4,247 3,998 $ 41,000 $ 44,000 $ 47,000 41,000 – 41,100 3,446 3,197 44,000 – 44,100 3,716 3,467 47,000 – 47,100 3,986 3,737 41,100 – 41,200 3,455 3,206 44,100 – 44,200 3,725 3,476 47,100 – 47,200 3,995 3,746 41,200 – 41,300 3,464 3,215 44,200 – 44,300 3,734 3,485 47,200 – 47,300 4,004 3,755 41,300 – 41,400 3,473 3,224 44,300 – 44,400 3,743 3,494 47,300 – 47,400 4,013 3,764 41,400 – 41,500 3,482 3,233 44,400 – 44,500 3,752 3,503 47,400 – 47,500 4,022 3,773 41,500 – 41,600 3,491 3,242 44,500 – 44,600 3,761 3,512 47,500 – 47,600 4,031 3,782 41,600 – 41,700 3,500 3,251 44,600 – 44,700 3,770 3,521 47,600 – 47,700 4,040 3,791 41,700 – 41,800 3,509 3,260 44,700 – 44,800 3,779 3,530 47,700 – 47,800 4,049 3,800 41,800 – 41,900 3,518 3,269 44,800 – 44,900 3,788 3,539 47,800 – 47,900 4,058 3,809 41,900 – 42,000 3,527 3,278 44,900 – 45,000 3,797 3,548 47,900 – 48,000 4,067 3,818 2019 Tax rate charts Chart S: For persons filing single or married/RDP filing separately— If your taxable income is $50,000 or more but not over $125,000 .......... your tax is $4,251 plus 9% of excess over $50,000 If your taxable income is over $125,000 ......................................................your tax is $11,001 plus 9.9% of excess over $125,000 Chart J: For persons filing jointly, head of household, or qualifying widow(er) with dependent child— If your taxable income is $50,000 or more but not over $250,000 .......... your tax is $4,002 plus 9% of excess over $50,000 If your taxable income is over $250,000.................................................... your tax is $22,002 plus 9.9% of excess over $250,000 150-101-043 (Rev. 04-28-20) 28

Office use only Oregon Department of Revenue 2019 Form OR-40 Oregon Individual Income Tax Return for Full-year Residents Page 1 of 4, 150-101-040 (Rev. 09-19-19 ver. 01) LAST NAME SPOUSE’S LAST NAME FIRST NAME INITIAL SPOUSE’S ŸRST NAME INITIAL SOCIAL SECURITY NO . (SSN) SPOUSE’S SSN DECEASED DECEASED APPLIED FOR ITIN APPLIED FOR ITIN Dependents. List your dependents in order from youngest to oldest. If more than four, check this box and include Schedule OR-ADD-DEP Amended return. If amending for an NOL, tax year the NOL was generated: Calculated using “as if” federal return. Short-year tax election. Federal disaster relief. Extension filed. Federal Form 8886. Form OR-24. Submit original form—do not submit photocopy Space for 2-D barcode—do not write in box below Fiscal year ending: 00461901010000 FIRST TIME USING THIS SSN (SEE INSTRUCTIONS) FIRST TIME USING THIS SSN (SEE INSTRUCTIONS) Filing status (check only one box) 1. Single. 2. Married filing jointly. 3. Married filing separately (enter spouse’s information above). 4. Head of household (with qualifying dependent). 5. Qualifying widow(er) with dependent child. PHONE CURRENT MAILING ADDRESS COUNTRY Exemptions Total 6a. Credits for yourself: Regular Severely disabled .... 6a. Check box if someone else can claim you as a dependent. 6b. Credits for spouse: Regular Severely disabled ....6b. Check box if someone else can claim your spouse as a dependent. DATE OF BIRTH (MM/DD/YYYY) SPOUSE’S DATE OF BIRTH CITY STATE ZIP CODE

– – – – / / ( – ) / / / / with your return. FIRST NAME LAST NAME CODE * DEPENDENT’S SSN DEPENDENT’S DATE OF BIRTH (MM/DD/YYYY) CHECK IF CHILD WITH QUALIFYING DISABILITY – – / / – – / / – – / / – – / / *DEPENDENT RELATIONSHIP CODE (SEE INSTRUCTIONS ). 6c. Total number of dependents. ........................................................................................................................................................................... 6c. 6d. Total number of dependent children with a qualifying disability (see instructions). ......................................................................................... 6d. 6e. Total exemptions. Add 6a through 6d.................................................................................................................................................... Total. 6e.

2019 Form OR-40 00461901020000 Page 2 of 4, 150-101-040 Oregon Department of Revenue (Rev. 09-19-19 ver. 01) NAME SSN – – Note: Reprint page 1 if you make changes to this page. Taxable income 7. Federal adjusted gross income from federal Form 1040 or 1040-SR, line 8b; 1040-NR, line 35; 1040-NR-EZ, line 10; or 1040-X, line 1C (see instructions). ..................................................................................... 7. 8. Total additions from Schedule OR-ASC, section 1. ................................................................................................. 8. 9. Income after additions. Add lines 7 and 8. ............................................................................................................... 9. .00 .00 .00 Subtractions 10. 2019 federal tax liability. See instructions for the correct amount: $0-$6,800. ................................................... 10. 11. Social Security included on federal Form 1040 or 1040-SR, line 5b.. ..................................................................... 11. 12. Oregon income tax refund included in federal income. ........................................................................................... 12. 13. Total subtractions from Schedule OR-ASC, section 2. ............................................................................................ 13. 14. Total subtractions. Add lines 10 through 13. ........................................................................................................... 14. 15. Income after subtractions. Line 9 minus line 14. ...................................................................................................... 15. .00 .00 .00 .00 .00 .00 Deductions 16. Oregon itemized deductions. Enter your Oregon itemized deductions from Schedule OR-A, line 23. If you are not itemizing your deductions, enter -0-. ........................................................................................................... 16. 17. Standard deduction. Enter your standard deduction (see instructions)................................................................. 17. You were: 17a. 65 or older 17b. Blind Your spouse was: 17c. 65 or older 17d. Blind 18. Enter the larger of line 16 or 17. ............................................................................................................................... 18. 19. Oregon taxable income. Line 15 minus line 18. If line 18 is more than line 15, enter -0-. ....................................... 19. .00 .00 .00 .00 Oregon tax 20. Tax. Check the appropriate box if you’re using an alternative method to calculate your tax (see instructions). ..... 20. 20a. Schedule OR-FIA-40 20b. Worksheet OR-FCG 20c. Schedule OR-PTE-FY 21. Interest on certain installment sales. ........................................................................................................................ 21. 22. Total tax before credits. Add lines 20 and 21. ......................................................................................................... 22. .00 .00 Standard and carryforward credits 23. Exemption credit. If the amount on line 7 is $100,000 or less, multiply your total exemptions on line 6e by $206. Otherwise, see instructions. ........................................................................................................... 23. 24. Political contribution credit. See limits in instructions........................................................................................... 24. 25. Total standard credits from Schedule OR-ASC, section 3....................................................................................... 25. 26. Total standard credits. Add lines 23 through 25. ...................................................................................................... 26. 27. Tax minus standard credits. Line 22 minus line 26. If line 26 is more than line 22, enter -0-................................... 27. 28. Total carryforward credits claimed this year from Schedule OR-ASC, section 4. Line 28 can’t be more than line 27 (see Schedule OR-ASC instructions). ................................................................................................... 28. 29. Tax after standard and carryforward credits. Line 27 minus line 28. ........................................................................ 29. .00 .00 .00 .00 .00 .00 .00 .00

2019 Form OR-40 00461901030000 Page 3 of 4, 150-101-040 Oregon Department of Revenue (Rev. 09-19-19 ver. 01) NAME SSN – – Note: Reprint page 1 if you make changes to this page. Payments and refundable credits 30. Oregon income tax withheld. Include a copy of your Forms W-2 and 1099. ....................................................... 30. 31. Amount applied from your prior year’s tax refund. .................................................................................................. 31. 32. Estimated tax payments for 2019. Include all payments you made prior to the filing date of this return. Do not include the amount you already reported on line 31. ................................................................................... 32. 33. Earned income credit (see instructions). .................................................................................................................. 33. 34. Kicker (Oregon surplus credit). Enter your kicker credit amount (see instructions). If you elect to donate your kicker to the State School Fund, enter -0- and see line 51. ................................. 34. 35. Total refundable credits from Schedule OR-ASC, section 5. ................................................................................... 35. 36. Total payments and refundable credits. Add lines 30 through 35. .......................................................................... 36. .00 .00 .00 .00 .00 .00 .00 Tax to pay or refund 37. Overpayment of tax. If line 29 is less than line 36, you overpaid. Line 36 minus line 29....................................... 37. 38. Net tax. If line 29 is more than line 36, you have tax to pay. Line 29 minus line 36. .............................................. 38. 39. Penalty and interest for filing or paying late (see instructions)................................................................................. 39. 40. Interest on underpayment of estimated tax. Include Form OR-10......................................................................... 40. Exception number from Form OR-10, line 1: 40a. Check box if you annualized: 40b. 41. Total penalty and interest due. Add lines 39 and 40. ............................................................................................... 41. 42. Net tax including penalty and interest. Line 38 plus line 41. ............................... This is the amount you owe. 42. 43. Overpayment less penalty and interest. Line 37 minus line 41. ......................................... This is your refund. 43. 44. Estimated tax. Fill in the portion of line 43 you want applied to your open estimated tax account......................... 44. 45. Charitable checkoff donations from Schedule OR-DONATE, line 30....................................................................... 45. 46. Political party $3 checkoff. Party code: 46a. You. 46b. Spouse. ................................... 46. 47. Oregon 529 college savings plan deposits from Schedule OR-529 (see instructions). ........................................... 47. 48. Total. Add lines 44 through 47. Total can’t be more than your refund on line 43. .................................................... 48. 49. Net refund. Line 43 minus line 48. ....................................................................................This is your net refund. 49. .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 Direct deposit 50. For direct deposit of your refund, see instructions. Check the box if the final deposit destination is outside the United States: Type of account: Checking or Savings Routing number: Account number: Kicker donation 51. Kicker donation. If you elect to donate your kicker to the State School Fund, check this box: 51a. Complete the kicker worksheet, located in the instructions, and enter the amount here. This election is irrevocable..................................................................................................................................51b. .00

2019 Form OR-40 00461901040000 Page 4 of 4, 150-101-040 Oregon Department of Revenue (Rev. 09-19-19 ver. 01) NAME SSN – – Note: Reprint page 1 if you make changes to this page. Sign here. Under penalty of false swearing, I declare that the information in this return is true, correct, and complete. YOUR SIGNATURE X DATE / / SPOUSE’S SIGNATURE (IF FILING JOINTLY, BOTH MUST SIGN) X DATE / / SIGNATURE OF PREPARER OTHER THAN TAXPAYER X PREPARER PHONE ( ) – PREPARER LICENSE NUMBER, IF PROFESSIONALLY PREPARED PREPARER ADDRESS CITY STATE ZIP CODE

Signing this return does not grant your preparer the right to represent you or make decisions on your behalf. For more information, see the instructions for the Tax Information Authorization and Power of Attorney for Representation form on our website. Important: Include a copy of your federal Form 1040, 1040-SR, 1040-X, 1040-NR, or 1040-NR-EZ. Without this information, we may adjust your return. Make your payment (if you have an amount due on line 42) • Online payments: Visit our website at www.oregon.gov/dor. • Mailing your payment: Make your check or money order payable to the Oregon Department of Revenue. Write “2019 Oregon Form OR-40” and the last four digits of your SSN or ITIN on your check or money order. Include your payment with this return. Don’t use the Form OR-40-V payment voucher unless you’re sending us a separate payment. Send in your return • Non-2-D barcode. If the 2-D barcode area on the front of this return is blank: — Mail tax-due returns to: Oregon Department of Revenue, PO Box 14555, Salem OR 97309-0940. — Mail refund and no-tax-due returns to: Oregon Department of Revenue, PO Box 14700, Salem OR 97309-0930. • 2-D barcode. If the 2-D barcode area on the front of this return is filled in: — Mail tax-due returns to: Oregon Department of Revenue, PO Box 14720, Salem OR 97309-0463. — Mail refund and no-tax-due returns to: Oregon Department of Revenue, PO Box 14710, Salem OR 97309-0460. Amended statement. Complete this section only if you’re amending your 2019 return or filing with a new SSN. If filing an amended return, use this space to explain what you’re changing. Include the return line numbers and the reason for each change. If your filing status has changed, explain why. Include all supporting forms and schedules when you file your amended return, even if you haven’t changed anything on them. If filing with a new SSN, enter your former identification number.

Form OR-40-V Page 1 of 1, 150-101-172 Oregon Department of Revenue (Rev. 07-17-19, ver. 02) Oregon Individual Income Tax Payment Voucher and Instructions Online payments: You can make payments anytime at www.oregon.gov/dor. Don’t use Form OR-40-V with online payments. Payments with a return: If you’re mailing a payment with your tax return, send the payment and return in the same envelope and don’t use Form OR-40-V. We accept checks, money orders, and cashier’s checks. Don’t mail cash. See the instructions for the return you are filing for the mailing address to send your return and payment. Payments without a return: If you’re mailing a payment without a return, mail your check, money order, or cashier’s check with Form OR-40-V to: Oregon Department of Revenue PO Box 14950 Salem OR 97309-0950 Write “2019 Form OR-40-V” and the last four digits of your SSN or ITIN on your check. Form OR-40-V instructions Tax year. Enter the month, day, and year for the beginning and end date of the tax year you are submitting the payment for. For most filers this will be January 1 through December 31 of the tax year. Example: For tax year 2019, enter: Begins: 01/01/2019. Ends: 12/31/2019. Payment type. Check the appropriate box for the type of payment being made. Taxpayer information. Completely fill out the information on the form. If your address has changed since the last time you filed a return, complete a Change of Address/Name form and mail it to us. Your address will not be updated using information on Form OR-40-V. Note: If you are viewing this form electronically and you see a solid box instead of letters or numbers, adjust the view size to 100 percent and press the tab key to move through the fields. Cut on dashed line below to detach voucher. Visit www.oregon.gov/dor/forms to print more vouchers. Form OR-40-V, Oregon Individual Income Tax Payment Voucher • Tax year: OFFICE USE ONLY • • Payment type (check only one): Begins: / /

Ends: / / Original return Amended return FIRST NAME INITIAL LAST NAME SSN – – SPOUSE’S FIRST NAME INITIAL SPOUSE’S LAST NAME SSN – – CURRENT MAILING ADDRESS CITY STATE ZIP CODE

CONTACT PHONE ( ) – Extension payment Estimated payment Enter payment amount 150-101-172 (Rev. 07-17-19, ver. 02) . 00 $

2019 Schedule OR-ASC Office use only Page 1 of 1, 150-101-063 Oregon Department of Revenue 15601901010000 (Rev. 10-31-19 ver. 01) Oregon Adjustments for Form OR-40 Filers Submit original form—do not submit photocopy. FIRST NAME INITIAL LAST NAME SOCIAL SECURITY NUMBER (SSN) – – SPOUSE’S FIRST NAME INITIAL SPOUSE’S LAST NAME SPOUSE’S SSN – – Use Schedule OR-ASC to claim any of the following that aren’t included on Form OR-40: • Additions. • Carryforward credits. • Subtractions. • Refundable credits. • Standard credits. Identify the code you’re claiming and enter the information requested in the corresponding section. Enter the total from each section on the line indicated for Form OR-40. For more information, refer to the instructions or Publication OR-17. Section 1: Additions (codes 103–165) Section 2: Subtractions (codes 300–361) Code Amount Code Amount 1b. .00 .00 .00 .00 .00 .00 2b. 2a. 1a. 1d. 2d. 2c. 1c. 1f. 2f. 2e. 1e. 1h. 2h. 2g. 1g. 1j. 2j. 2i. 1i. Enter total on Form OR-40, line 8 line 13 Enter total on Form OR-40, .00 .00 .00 .00 .00 .00 Section 3: Standard credits (codes 802–815) State abbreviation Code Amount (if claiming code 802 or 815) 3b. 3a. .00 .00 .00 .00 .00 .00 3c. 3e. 3d. 3f. 3h. 3g. 3i. 3k. 3j. 3l. 3n. 3m. 3o. Enter total on Form OR-40, line 25 Section 4: Carryforward credits (codes 835–871) Code Amount from prior year Amount awarded this year Total used this year 4b. .00 .00 .00 .00 .00 4c. .00 .00 .00 .00 .00 4d. 4a. 4f. 4g. 4h. 4e. 4j. 4k. 4l. 4i. 4n. 4o. 4p. 4m. 4r. 4t. 4s. 4q. Enter total on Form OR-40, line 28 Section 5: Refundable credits (codes 890–895) Code Amount 5b. 5a. 5d. 5c. 5f. 5e. Enter total on Form OR-40, .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 line 35 —You must include this schedule with your Oregon income tax return—

Congress extended several tax provisions by passing Public Law 116-94. As a result, these instructions were updated on January 8, 2020. Instructions for Schedules OR-ASC and OR-ASC-NP 2019 New information Subtractions • Special Oregon medical subtraction. You or your spouse must have turned age 65 by the end of the tax year to qualify for the subtraction. Note: Due to the extended decrease in the medical expense deduction floor in Public Law 116-94, the example on page 4 was updated on December 31, 2019. • Oregon college or MFS 529 savings plan and ABLE account limits. Contribution limits have increased to $4,865 for taxpayers filing joint returns and $2,435 for all others. Contributions must have been made by the end of tax year 2019 to qualify for this subtraction. For more information, see Publication OR-17. • First-time home buyer subtraction. If you’re saving to purchase your first home, you can use a tax-favored account. Contributions and accounts earnings can be claimed as a subtraction. Limitations apply; see “First- time home buyer savings account” in Publication OR-17. • Updated December 2019: Tuition and fees. Congress extended the deduction for qualified tuition and fees for tax year 2019 when it passed Public Law 116-94. You can find information about the related Oregon subtraction on page 2. General instructions In general. Use the schedule that matches the return form you’re filing: • Form OR-40 filers: Use Schedule OR-ASC. • Form OR-40-N and Form OR-40-P filers: Use Schedule OR-ASC-NP. Include the schedule when you file your return. Note for Schedule OR-ASC-NP filers: Just as it is on your nonresident or part-year return, the federal column is where you enter amounts that would be reported on your Oregon return if you were a full-year resident. The Oregon column is for reporting amounts for the part of the year when you were a resident or had income from Oregon sources when you were a nonresident. Not enough room? Use extra copies of the schedule if you need more space, and enter only the total(s) on your return. Include any extra copies of the schedule when you file your return. Round all cents to the nearest dollar. For example, $99.49 becomes $99, and $99.50 becomes $100. Codes. Every item entered on the schedule must be identified with a numerical code. A list of these can be found in Publication OR-CODES, included with these instructions. If you’re using the same code for several amounts (other than code 802 or 815, for income taxes paid to other states), total the amounts and enter the code only once. Section instructions Follow the instructions below for completing each section of the schedule. Explanations are provided for some items that are commonly claimed by many taxpayers. For more details about these or other items, refer to Publication OR-17. Note: The instructions for the Adjustments and Modifica­ tions sections don’t apply to Schedule OR-ASC filers. Adjustments (codes 002–005) Schedule OR-ASC-NP filers only: Section 1 Adjustments claimed on your federal return reduce your federal taxable income. For detailed information, see “Adjustments” in Publication OR-17. Step 1: Enter adjustments you claimed on your federal return that aren’t listed on Form OR-40-N or Form OR-40-P. Enter the code, the federal amount, and the Oregon amount for each adjustment. Use each code only once. Step 2: Enter the totals for the federal and Oregon col­ umns on Form OR-40-N or Form OR-40-P, lines 27F and 27S. Additions (codes 103–165) Additions are items the federal government doesn’t tax but Oregon does. For detailed information, see “Additions” in Publication OR-17. Step 1: Schedule OR-ASC: Enter the code and the amount of each addition in Section 1. Schedule OR-ASC-NP: Enter the code, the fed­ eral amount, and the Oregon amount for each addition in Section 2. The federal and Oregon amounts may be different. Use each code only once. Step 2: Enter these total(s) on Form OR-40, line 8; Form OR-40-N or Form OR-40-P, lines 30F and 30S. 150-101-063-1 (Rev. 02-20-20) 1

Subtractions (codes 300–361) Subtractions are items the federal government taxes but Oregon doesn’t. Some commonly claimed subtractions are explained below. Note: You can only subtract amounts that are included in your Oregon income. Amounts that aren’t included in your Oregon income can’t be sub­ tracted. For detailed information, see “Subtractions” in Publication OR-17. Step 1: Schedule OR-ASC: Enter the code and the amount of each subtraction in Section 2. Schedule OR-ASC-NP: Enter the code, the federal amount, and the Oregon amount for each subtrac­ tion that isn’t listed on the return in Section 3. The federal and Oregon amounts may be different, but the amount in the Oregon column can’t be more than the amount in the federal column. Use each code only once. Step 2: Enter the total(s) on Form OR-40, line 13; Form OR-40-N or Form OR-40-P, lines 33F and 33S. Federal pension income [code 307]. You may be able to sub­ tract some or all of your federal pension included in 2019 federal income. This includes retirement benefits paid to the retiree or their beneficiary. It does not include disabil­ ity payments if you have not reached the minimum retire­ ment age. The subtraction amount is based on the number of months of federal service or points earned before and after October 1, 1991: • If all your months of federal service or points were before October 1, 1991, subtract 100 percent of the tax­ able amount of federal pension income you reported on your federal return. • If you have no months of service or points before October 1, 1991, you cannot subtract any federal pension income. • If your service or points occurred both before and after October 1, 1991, subtract a percentage of the tax­ able federal pension income you reported on your fed­ eral return. To determine your percentage, divide your months of service or points earned before October 1, 1991, by your total months of service or points earned. Round to three places (example: 0.4576 = 45.8 percent). Once you determine your percentage, it will remain the same year to year. For more than one pension, figure the percentage and sub­ traction amount separately for each pension. Add the sepa­ rate amounts together to be reported on one line of Sched­ ule OR-ASC or Schedule OR-ASC-NP. Schedule OR-ASC-NP filers: Use the following worksheet to determine your subtraction amount for each column. Federal column 2. Divide months of service or points earned before October 1, 1991, by total months of service or points earned. Round to three decimal places. 2. 3. Line 1 times line 2. Round to the nearest dollar and enter here and in the federal column of Section 3. 3. Oregon column 4. Federal pension included in the Oregon column, Form OR-40-N or Form OR-40-P, line 16S. 4. 5. Your percentage from line 2. 5. 6. Multiply line 4 by line 5. Enter here and in the Oregon column of Section 3. 6. Federal education credits (tuition and fees deduction) [code 308]. If you’re claiming the American Opportunity or Lifetime Learning credit on your federal return, you may qualify for this subtraction. If you weren’t allowed a federal tuition and fees deduction because you’re claiming the federal credit, you may claim an Oregon subtraction for the amount you would have been allowed on your federal return. You can claim your expenses, up to the federal limit ($4,000 or $2,000, depending on your income), unless: • Your filing status is married filing separately; • Another person can claim you as a dependent on their return; • Your federal modified adjusted gross income is more than $80,000 ($160,000 if your filing status is married fil­ ing jointly); or • You’re claiming a deduction for these expenses on your federal return. Schedule OR-ASC-NP filers: Federal column. Enter the amount of the tuition and fees deduction you would have claimed on your federal return if you hadn’t claimed the federal credit. The maximum deduction you can claim is $4,000 or $2,000, depending on your income. Oregon column. For the part of the year you were a non­ resident, calculate your subtraction using the following formula: Oregon source income Qualified tuition while a nonresident Nonresident X and fees paid while = deduction Total income a nonresident while a nonresident 1. Federal pension included in the federal column, Form OR-40-N or Form OR-40-P, line 16F. 1. Add the amount of qualified education expenses you paid while an Oregon resident. Enter the smaller of this amount or the amount entered in the federal column. 150-101-063-1 (Rev. 02-20-20) 2

Interest and dividends on U.S. bonds and notes [code 315]. Subtract interest and dividends from qualifying U.S. bonds reported on your federal return, such as interest from U.S. Series EE and I Bonds. See this topic under “Subtractions” in Publication OR-17 for a complete list of qualifying bonds and notes. Schedule OR-ASC-NP filers: Federal column. Enter qualifying interest or dividends that you reported on line 8F or 9F of the federal column on your return. Oregon column. Enter qualifying interest or dividends that you reported on line 8S or 9S of the Oregon column of your return. Oregon income tax refund [code 325 , Schedule OR-ASC-NP filers only]. This subtraction is for Oregon state income tax refunds only. Do not include other local, county, or other states’ tax refunds. Schedule OR-ASC filers: This subtraction is reported on line 12 of Form OR-40, not on this schedule. Schedule OR-ASC-NP filers: Federal column. Enter your Oregon state income tax refund only if you included it on line 10F of the federal column on your return. Oregon column. Enter your Oregon state income tax refund only if you included it on line 10S of the Oregon column on your return. Special Oregon medical subtraction [code 351]. You may qualify for the special Oregon medical subtraction if: • You or your spouse turned age 65 by the end of the tax year; • Your federal adjusted gross income (AGI) isn’t more than $200,000 ($100,000 if your filing status is single or mar­ ried filing separately); and • You or your spouse have qualifying medical or dental expenses. Medical or dental expenses qualify if they can be included in itemized deductions. See IRS Publication 502 to see which expenses qualify. You can’t subtract expenses: • For anyone under age 65; • For dependents, regardless of their age; or • That are deducted elsewhere on your return. If you qualify, use the Special Oregon medical subtrac­ tion worksheet and the limits in Table 1 to determine the amount of your subtraction. Shared expenses. Did you have medical expenses or dental expenses for more than one person? If so, you must deter­ mine which expenses belong to each qualifying taxpayer. Start by totaling all expenses for each qualifying taxpayer. If you have expenses that are for more than one person, such as insurance premiums, split the expense by the most reasonable method. For example, two qualifying taxpayers filing jointly who paid $4,000 in insurance premiums dur­ ing the year could split the expenses in half, or $2,000 each. For more information and examples, see “Special Oregon medical” under “Subtractions” in Publication OR-17. Special Oregon medical subtraction worksheet instructions For worksheet lines 1 through 7, complete column (A) for yourself first, then complete column (B) for your spouse. Line 1: Medical and dental expenses for each taxpayer— Enter each person’s qualifying medical and dental expenses that you’re claiming as itemized deductions on Schedule OR-A. Enter your expenses in column (A) and your spouse’s expenses in column (B). If you’re not including medical expenses in your Oregon itemized deductions or you’re claiming the standard deduction on your Oregon return, skip lines 2–4, enter the amount from line 1 on line 5, and go to line 6. Line 2: Total medical and dental expenses—Enter the total medical and dental expenses you’re claiming as an item­ ized deduction (Schedule OR-A, line 1). Line 3: Line 1 divided by line 2. Round to three decimal places. For example, 0.7308 is rounded to 0.731. Line 4: Enter the lesser of the amount on line 2, above, or the amount on line 3 of your Schedule OR-A. Line 5: Multiply line 3 times line 4 and round to whole dol­ lars. (For example: $101.49 is rounded to $101.) Line 6: Enter the maximum allowable medical subtraction for your filing status and federal AGI from Table 1. Don’t enter more than $1,800 in each column. Line 7: Enter the smaller of line 5 or line 6. Line 8: Combine the amounts from line 7, columns (A) and (B). This is your special Oregon medical subtraction. Enter this amount in section 2 of Schedule OR-ASC or in both the federal and Oregon columns on Schedule OR-ASC­ NP, Section 3. 150-101-063-1 (Rev. 02-20-20) 3

Special Oregon medical subtraction worksheet Column (A) Column (B) You Spouse 1. Medical and dental 1. 1. expenses for each qualifying taxpayer. 2. Total medical and 2. 2. dental expenses claimed (Schedule OR-A, line 1). 3. Line 1 divided by 3. 3. line 2. Round to three decimal places. 4. Enter the smaller 4. 4. of line 2, above, or Schedule OR-A, line 3. 5. Line 3 times line 4. 5. 5. Round to the nearest dollar. 6. Maximum allowable 6. 6. medical subtraction from Table 1. 7. Enter the smaller of 7. 7. line 5 or line 6. 8. Combine the amounts 8. from line 7, columns (A) and (B). This is your special Oregon medical subtraction. Table 1. Special Oregon medical subtraction— maximum amount If your filing status is: And your federal adjusted gross income from Form OR-40, line 7 or Form OR­ 40-N or OR-40-P, line 29F is: Then your maximum allowable medical subtraction per qualifying- taxpayer is: At least— But less than— Married filing jointly; or Head of household; or Qualifying widow(er) -0­ $50,000 $1,800 $50,000 $100,000 $1,400 $100,000 $200,001 $1,000 $200,001 or more -0­ Single; or Married filing separately -0- $25,000 $25,000 $50,000 $50,000 $100,001 $100,001 or more $1,800 $1,400 $1,000 -0- Example 1. Jerry and Claudia were ages 66 and 65 on December 31, 2019. They are filing a joint nonresident return with a federal AGI of $55,000 and Oregon source income of $40,000. They are itemizing deductions for Oregon. In 2019, they paid $5,700 in medical expenses that they claimed on Schedule OR-A. Of that, $3,500 was for Jerry’s expenses, $1,000 for Claudia’s expenses, and $1,200 for Claudia’s mother, whom they claim as a dependent. Both Jerry’s and Claudia’s expenses qualify for the special Oregon medi­ cal subtraction. Since Claudia’s mother is a dependent, her expenses don’t qualify for the subtraction. Jerry and Clau­ dia determine their subtraction as follows. Special Oregon medical subtraction worksheet Column (A) Jerry Column (B) Claudia 1. Medical and dental expenses for each qualifying taxpayer. 1. $3,500 1. $1,000 2. Total medical and dental expenses claimed (Schedule OR-A, line 1). 2. $5,700 2. $5,700 3. Line 1 divided by line 2. Round to three decimal places. 3. 0.614 3. 0.175 4. Enter the smaller of line 2, above, or Schedule OR-A, line 3. 4. $4,125 4. $4,125 5. Line 3 times line 4. Round to the nearest dollar. 5. $2,533 5. $722 6. Maximum allowable medical subtraction from Table 1. 6. $1,400 6. $1,400 7. Enter the smaller of line 5 or line 6. 7. $1,400 7. $722 8. Combine the amounts from line 7, columns (A) and (B). This is your special Oregon medical subtraction. 8. $2,122 Modifications (codes 600–652) Schedule OR-ASC-NP filers only: Section 4 Modifications are items that further adjust your Oregon taxable income. For detailed information, see “Additions,” “Subtractions,” or “Other items” in Publication OR-17. Step 1: Enter the code and the amount of any modifi­ cations that aren’t listed on the return. Use each code only once. Use a minus sign if the modifica­ tion is negative. Step 2: Enter the total on Form OR-40-N or Form OR-40-P, line 41. 150-101-063-1 (Rev. 02-20-20) 4

Standard credits (codes 802–815) Schedule OR-ASC: Section 3 Schedule OR-ASC-NP: Section 5 Standard credits are nonrefundable credits that can only be claimed on the current year’s tax return. Credit amounts that aren’t used in the current tax year are lost. If you’re also claiming carryforward or refundable credits, use your stan­ dard credits first. For detailed information, see “Standard credits” in Publication OR-17. Schedule OR-ASC-NP filers: Some Oregon credits must be multiplied by your Oregon percentage. These prorated credits are signified by “PR” on Publication OR-CODES. To prorate a credit, multiply the credit amount by your Oregon percentage on line 35 of Form OR-40-N or Form OR-40-P before you enter it on Schedule OR-ASC-NP. Step 1: Enter the code and the amount for each credit you’re claiming with a code between 802–815. If you’re using code 802 or 815 to claim credits for taxes paid to more than one other state on income that was also taxed by Oregon, enter each credit on a separate line. Except for codes 802 and 815, use each code only once. Step 2: If you’re claiming a credit for income taxes paid to another state, enter that state’s two-letter postal abbreviation in the corresponding box. If you aren’t claiming this credit, leave this box blank. Step 3: Enter the total standard credit amount on Form OR-40, line 25; Form OR-40-N, line 50; or Form OR-40-P, line 49. Carryforward credits (codes 835–871) Schedule OR-ASC: Section 4 Schedule OR-ASC-NP: Section 6 Carryforward credits are nonrefundable credits for which any unused portion in the current tax year may be carried forward to the next tax year. The number of years that a credit can be carried forward varies according to the car­ ryforward rules of that credit. When we process your return, we’ll apply your credits against your tax in the order in which they’re listed on the schedule. If you’re claiming more than one type of carryfor­ ward credit and the total you can use is more than your tax liability for the year, enter your credits in the order in which they expire. Start with credits that expire earlier, followed by credits that expire later. List all credits you have avail­ able even if you can’t use them this year. See Example 4. For detailed information, see “Carryforward credits” in Publication OR-17. For each credit with a code between 835 and 871, you’ll enter three amounts: • Amount from prior year: This is the amount, if any, that was available in a prior year but wasn’t used because it was more than your tax liability. See Example 3. • Amount awarded this year: The amount awarded is the amount of credit that is available for you to claim for the first time in 2019. For some credits, the full amount is awarded all at once (see Example 2), but for others, only a portion is awarded each year for a number of years (see Example 5). Report only the amount of the credit that is awarded for this year. Note for Schedule OR-ASC-NP filers: Some credits must be prorated using your Oregon percentage for the year they’re awarded. Prorated credits are signified by “PR” in Publication OR-CODES. To prorate a credit, mul­ tiply this year’s Oregon percentage (line 35 of Form OR­ 40-N or Form OR-40-P) times the amount of the credit that’s available for the first time this year. Enter the result on Schedule OR-ASC-NP as the amount awarded this year. • Total used this year: The amount carried forward from a prior year plus the amount awarded this year, up to your 2019 tax liability, is your total amount of credit used this year. Note: The total of all carryforward cred­ its used can’t be more than your 2019 tax liability. If the total is more than your tax liability, you’ll need to reduce the amount of one or more credits that you’re using. See Example 6. Note: If an annual limit applies to the amount of a credit that can be used in one year, the total used for that credit can’t exceed the limit, even if the credit amount you can use is less than your tax liability for the year. Step 1: Enter the carryforward codes in the order that you would like to claim each credit. Combine amounts if you’re claiming more than one amount per credit code. Use each code only once. Step 2: In the “Amount from prior year” column, enter the total amount of the credit that was available but couldn’t be used in a prior year and was car­ ried forward to tax year 2019. If no amount of the credit was carried forward to 2019, enter -0-. Don’t enter amounts used in 2018; only enter unused amounts. Step 3: In the “Amount awarded this year” column, enter the credit amount that is available for you to use for the first time in 2019. Schedule OR-ASC-NP filers: Follow the instructions above if a credit must be prorated. Step 4: In the “Total used this year” column, enter the credit amount you’re using this year. This amount can’t be more than the combined total of the “Amount from prior year” and the “Amount awarded this year” for that credit. If 2019 isn’t the last year for a carryforward to be claimed, any excess credit not used this year may be carried forward to tax year 2020. 150-101-063-1 (Rev. 02-20-20) 5

Step 5: Add up the carryforward credits you’re using this year. Enter the total on Form OR-40, line 28; Form OR-40-N, line 53; or Form OR-40-P, line 52. The total of all carryforward credits can’t be more than your tax on Form OR-40, line 27; Form OR-40-N, line 52; or Form OR-40-P, line 51. If your carryfor­ ward credits total more than your tax, reduce one or more of the carryforward credits you’re using this year. Example 2. In 2019, Neil and David received a $25,000 credit for contributing to the Child Care Fund. For 2019, their tax reported on Form OR-40-P, line 51 is $16,500. This credit is not multiplied by the Oregon percentage. Here’s how they enter their credit information on Schedule OR-ASC-NP: Code Amount from prior year Amount awarded this year Total used this year 841 $0.00 $25,000.00 $16,500.00 .00 .00 .00 .00 .00 .00 Neil and David will carry forward $8,500 ($25,000–$16,500) to tax year 2020. Example 3. Use the same facts as Example 2, except that Neil and David also contributed to the Child Care Fund in 2018. Their 2018 credit was $10,000. They were able to use $3,000 and carried forward $7,000 to 2019. Here’s how they enter the information for the 2018 and 2019 credits on the same line: Code Amount from prior year Amount awarded this year Total used this year 841 $7,000.00 $25,000.00 $16,500.00 .00 .00 .00 .00 .00 .00 When we process their return, we’ll apply $7,000 carried forward from 2018 to their tax first, and they’ll carry for­ ward $15,500 [($7,000+$25,000)–$16,500] of their 2019 credit to tax year 2020. Example 4. Valerie and Tony received a $6,000 credit for contributing to a university venture development fund after moving to Oregon in 2019. This credit must be pro­ rated using their Oregon percentage. Their 2019 Oregon percentage reported on Form OR-40-P, line 35 is 70 percent, so their amount awarded this year is $4,200 ($6,000 x 0.70). Their 2019 tax on Form OR-40-P, line 51 is $0. Here’s how they enter their credit information: Code Amount from prior year Amount awarded this year Total used this year 864 $0.00 $4,200.00 $0.00 .00 .00 .00 .00 .00 .00 They enter the credit information even though they can’t use it this year, and carry forward $4,200 to tax year 2020. Example 5. Senait installed a solar heating system for her backyard swimming pool in 2017. She was awarded a $6,000 residential energy tax credit. The provisions of this credit limited the amount that can be used each year to $1,500, plus any amount carried forward from the previous year. Senait was “awarded” $1,500 for tax years 2017, 2018, 2019, and 2020. In 2017, Senait used $500 of the credit and carried $1,000 forward to 2018. In 2018, she used $900 of the amount carried forward from 2017, and didn’t use any of the amount awarded for 2018. She carried forward a total of $1,600 ($100 from 2017 plus $1,500 from 2018) to the 2019 tax year. Senait was also awarded a $500 credit for making a dona­ tion to the Oregon IDA Initiative Fund in 2019. The tax on Senait’s 2019 Form OR-40, line 27, is $3,400. Here’s how she enters her credit information on Schedule OR-ASC: Code Amount from prior year Amount awarded this year Total used this year 861 $1,600.00 $1,500.00 $3,100.00 852 $0.00 $500.00 $300.00 .00 .00 .00 Because Senait’s tax is $3,400, she is able to use the entire $1,600 residential energy credit carried forward plus the $1,500 available this year. She also uses $300 of the $500 credit for her donation to the Oregon IDA Initiative Fund, and carries the remaining $200 forward to tax year 2020. Example 6. Chad and Jolene have $3,200 of unused child and dependent care credit originally awarded in 2015 that they’ve carried forward to 2019. They qualified for a $4,000 residential energy credit in 2017, with $1,500 awarded for 2017, $1,500 awarded for 2018, and the remaining $1,000 awarded for 2019. Both types of credits may be carried forward for five years after the year they were first awarded. The child and depen­ dent care credit carryforward expires in 2020. Any residen­ tial energy credit carryforwards expire in 2022, 2023, and 2024, respectively. In 2017, Chad and Jolene used $400 of the $1,500 residential energy credit awarded that year, with $1,100 carried forward to 2018. In 2018, they used another $700 of their 2017 credit, with the remaining $400 carried forward to 2019 along with the $1,500 awarded for 2018. Chad and Jolene moved out of Oregon in 2019, and are filing Form OR-40-P. Their 2019 Oregon percentage on line 35 of their return is 80 percent, and their tax on line 51 is $4,500. Because it expires soonest, Chad and Jolene use all $3,200 of their child and dependent care credit carryforward first. After that, they’ll use $1,300 of their residential energy credit. Their prior-year amount is $1,900 ($400 from 2017 plus $1,500 from 2018). The $400 carried forward from 2017 will be used first, followed by $900 carried forward from 2018. Here’s how they enter their information on Schedule OR-ASC-NP: 150-101-063-1 (Rev. 02-20-20) 6

Code Amount from prior year Amount awarded this year Total used this year 840 $3,200.00 $0.00 $3,200.00 861 $1,900.00 $1,500.00 $1,300.00 .00 .00 .00 The remaining $600 ($1,500 – $900) of the residential energy credit awarded for 2018 will be carried forward, to be used no later than tax year 2023. The $1,000 credit awarded for 2019 must be prorated using their 2019 Oregon percentage. They’ll carry $800 ($1,000 x 0.80) of their 2019 credit forward, to be used no later than tax year 2024. Refundable credits (codes 890–895) Schedule OR-ASC: Section 5 Schedule OR-ASC-NP: Section 7 Like standard credits, refundable credits can be claimed only on the current year’s tax return, but any amount that is more than your tax will be refunded to you. For detailed information about other refundable credits, see “Refundable credits” in Publication OR-17. Note for Schedule OR-ASC-NP filers: Some Oregon credits must be multiplied by your Oregon percentage. Prorated credits are signified by “PR” in Publication OR-CODES. To prorate your credit, multiply the credit amount by your Oregon percentage. This is the amount you can claim on your Oregon return. Step 1: For credits with a code between 890-895, enter the code and the amount you’re claiming. Use each code only once. Note for Schedule OR-ASC-NP filers: For prorated credits, first multiply the credit amount by your Oregon percentage (Form OR-40-N or Form OR-40-P, line 35) , then enter the prorated amount on Schedule OR-ASC-NP, section 7. Step 2: Add up all of the refundable credits reported on the schedule. Enter the total on Form OR-40, line 35; Form OR-40-N, line 61; or Form OR-40-P, line 60. 150-101-063-1 (Rev. 02-20-20) 7

Congress extended several tax provisions by passing Public Law 116-94. As a result, this publication was updated to include subtraction code 308 on December 31, 2019. Publication OR-CODES Numeric Codes for Oregon Adjustments, Additions, Subtractions, Modifications, and Credits Effective for tax year 2019 Numeric codes are required when you are claiming or reporting an adjustment, addition, subtraction, modification, or credit on Schedule OR-ASC or OR-ASC-NP. If you have multiple items that use the same code, other than a credit for income taxes paid to another state, add them together and enter the total as a single item. Include Schedule OR-ASC or OR-ASC-NP when you file your return. (Note: For page numbers, see the item’s listing in the Publication OR-17 Index.) Adjustments—Schedule OR-ASC-NP, Section 1 only. OR-40 OR-40-N OR-40-P Code Certain business expenses of reservists, performing artists, and fee-basis government o˜cials–Form 1040, Schedule 1, Line 24 X X 002 Health savings account deduction—Form 1040, Schedule 1, Line 25 X X 003 Penalty on early withdrawal of savings—Form 1040, Schedule 1, Line 30 X X 004 Write-in adjustments on Form 1040, Schedule 1, Line 36, or Form 1040NR, Line 34 X X 005 Additions—Schedule OR-ASC, Section 1 or OR-ASC-NP, Section 2. OR-40 OR-40-N OR-40-P Code Claim of right income repayments X X X 103 Disposition of inherited Oregon farmland or forestland X X X 106 Federal election on interest and dividends of a minor child X X X 107 Federal income tax refunds X 109 Net operating loss—non-Oregon source X X X 116 Oregon College & MFS 529 Savings Plan nonqualiÿed withdrawal X X X 117 Oregon deferral of reinvested capital gain X X X 118 Partnership and S corporation modiÿcations for Oregon X X X 119 Business credit—unused X X X 122 Federal subsidies for employer prescription drug plans X X X 123 Federal law disconnect X X X 131 Accumulation distribution from certain domestic trusts X X X 132 Fiduciary adjustment from Oregon estates and trusts X X X 133 Gambling losses claimed as an itemized deduction X 134 Individual development account nonqualiÿed withdrawal X X X 137 Oregon IDA Initiative Fund donation credit add back X 138 Lump-sum distribution from a qualiÿed retirement plan X X X 139 Passive foreign investment company income X X X 140 Child Care Fund contributions X 142 Oregon Production Investment Fund contributions X 144 University Venture Development Fund contributions X 146 Income taxes paid to another state by a pass-through entity X X X 148 Basis of business assets transferred to Oregon X X X 150 Depletion in excess of property basis X X X 151 Depreciation di˛erence for Oregon X X X 152 Federal depreciation disconnect X X X 153 Gain or loss on sale of depreciable property with di˛erent basis for Oregon X X X 154 Passive activity losses X X X 155 150-101-432 (Rev. 12-31-19) 1 Publication OR-CODES

Additions—Schedule OR-ASC, Section 1 or OR-ASC-NP, Section 2. (Continued from page 1) OR-40 OR-40-N OR-40-P Code Suspended losses X X X 156 Federal estate tax on income in respect of a decedent X 157 Interest on state and local government bonds outside of Oregon X X X 158 Federal subtraction for retirement savings rollover from individual development account X X X 159 Charitable donations not allowed for Oregon X 160 Nonresident capital loss carryovers X X X 161 WFHDC medical expenses X 163 ABLE account nonqualiÿed withdrawal X X X 164 College Opportunity Grant contributions X 165 Subtractions—Schedule OR-ASC, Section 2 or OR-ASC-NP, Section 3. OR-40 OR-40-N OR-40-P Code American Indian X X X 300 Artist's charitable contribution X 301 Construction worker and logger commuting expenses X X X 303 Federal gain previously taxed by Oregon X X X 306 Federal pension income X X X 307 Tuition and fees X X X 308 Federal income tax from a prior year X 309 Fiduciary adjustments from Oregon estates and trusts X X X 310 Foreign tax X 311 Individual development account contributions X X X 314 Interest and dividends on U.S. bonds and notes X X X 315 Land donation to educational institutions X X X 316 Interest from state and local government bonds X X X 317 Military active duty pay X X X 319 Mortgage interest credit X 320 Net operating loss for Oregon X X X 321 Oregon lottery winnings X X X 322 Partnership and S corporation modiÿcations for Oregon X X X 323 Oregon College & MFS 529 Savings Plan deposit X X X 324 Oregon income tax refund X X 325 Previously taxed employee retirement plans X X X 327 Public Safety Memorial Fund award X X X 329 Railroad Retirement Board beneÿts: tier 2, windfall/vested dual, supplemental, and railroad unemployment beneÿts X X X 330 U.S. government interest in IRA or Keogh distributions X X X 331 Scholarship awards used for housing expenses X X X 333 Legislative Assembly salary and expenses X X X 335 Film production labor rebate—Greenlight Oregon Labor Rebate Fund X X X 336 Mobile home park capital gain X X X 338 Capital Construction Fund (CCF) contributions X X X 339 Federal business and health coverage credits X X X 340 Income on a composite return X X 341 Oregon Investment Advantage X X X 342 Mobile home tenant payment X X X 344 150-101-432 (Rev. 12-31-19) 2 Publication OR-CODES

Subtractions—Schedule OR-ASC, Section 2 or OR-ASC-NP, Section 3. (Continued from page 2) OR-40 OR-40-N OR-40-P Code Taxable beneÿts for former RDPs X X X 347 Previously taxed IRA conversions X X X 348 Special Oregon medical X X X 351 DISC dividend payments X X X 352 Depreciation di˛erence for Oregon X X X 354 Gain or loss on sale of depreciable property with di˛erent basis for Oregon X X X 355 Passive activity losses X X X 356 Suspended losses X X X 357 Basis of business assets transferred to Oregon ˝ X X 358 Marijuana business expenses not allowed on the federal return X X X 359 ABLE account deposit X X X 360 First-time home buyer savings account contributions and earnings X X X 361 Modifcations—Schedule OR-ASC-NP, Section 4 only. OR-40 OR-40-N OR-40-P Code Artist’s charitable contribution X 600 Federal income tax refunds + X X 601 Federal tax from a prior year X X 602 Foreign tax X X 603 Gambling losses claimed as an itemized deduction + X X 604 Federal estate tax on income in respect of a decedent + X X 605 Federal mortgage interest credit X X 607 Federal business and health coverage credits X X 609 Child Care Fund contributions + X X 642 Oregon Production Investment Fund contributions + X X 644 University Venture Development Fund contributions + X X 646 Oregon IDA Initiative Fund donation credit add back + X X 648 Claim of right income repayment + X X 649 Charitable donations not allowed for Oregon + X X 650 WFHDC medical expenses + X X 651 College Opportunity Grant contributions + X X 652 + Must be entered as a negative number. Standard credits—Schedule OR-ASC, Section 3 or OR-ASC-NP, Section 5. OR-40 OR-40-N OR-40-P Code Income taxes paid to another state X X X 802 Mutually-taxed gain on the sale of residential property X X X 806 Oregon Cultural Trust contributions X PR PR 807 Oregon Veterans' Home physicians X PR PR 808 Political contributions X X 809 Reservation enterprise zone X PR PR 810 Retirement income X X X 811 Rural emergency medical technicians X PR PR 812 Rural health practitioners X PR PR 813 Pass-through income taxes paid to another state X X X 815 150-101-432 (Rev. 12-31-19) 3 Publication OR-CODES

Carryforward credits—Schedule OR-ASC, Section 4 or OR-ASC-NP, Section 6. OR-40 OR-40-N OR-40-P Code Agriculture workforce housing X PR PR 835 Biomass production/collection carryforward X PR PR 838 Business energy carryforward X X X 839 Child and dependent care carryforward X PR PR 840 Child Care Fund contributions X X X 841 Crop donation X PR PR 843 Electronic commerce zone investment X PR PR 845 Employer-provided dependent care assistance carryforward X X PR 846 Employer scholarship X PR PR 847 Energy conservation projects X X X 849 Fish screening devices X PR PR 850 Oregon IDA Initiative Fund donation X X X 852 Oregon Low Income Community Jobs Initiative/New Markets X X X 855 Oregon Production Investment Fund contributions X X X 856 Pollution control facilities carryforward X X X 857 Renewable Energy Development Fund contributions carryforward X X X 859 Renewable energy resource equipment manufacturing facility carryforward X X X 860 Residential energy X PR PR 861 Transportation projects X X X 863 University Venture Development Fund contributions X PR PR 864 Reforestation of underproductive forestlands X X X 867 Rural technology workforce development X PR PR 868 Bovine manure production/collection X PR PR 869 College Opportunity Grant contributions X X X 871 Carryforward credits available only to S corporation shareholders. Agriculture workforce housing loans (S corporation) X X X 836 Alternative qualiÿed research activities carryforward (S corporation) X X X 837 Lender’s credit: a˛ordable housing (S corporation) X X X 854 Lender’s credit: energy conservation carryforward (S corporation) X X X 848 Long-term enterprise zone facilities carryforward (S corporation) X X X 853 Qualiÿed research activities carryforward (S corporation) X X X 858 Refundable credits—Schedule OR-ASC, Section 5 or OR-ASC-NP, Section 7. OR-40 OR-40-N OR-40-P Code Claim of right X PR PR 890 Mobile home park closure X X X 891 Working family household and dependent care (WFHDC) X PR PR 895 PR indicates a credit that must be prorated. 150-101-432 (Rev. 12-31-19) 4 Publication OR-CODES

2019 Schedule OR-ADD-DEP Page 1 of 1, 150-101-187 Oregon Department of Revenue 18371901010000 (Rev. 08-26-19 ver. 01) Oregon Personal Income Tax Return Additional Dependents Submit original form—do not submit photocopy. Office use only FIRST NAME INITIAL LAST NAME SOCIAL SECURITY NUMBER (SSN) – – SPOUSE’S FIRST NAME INITIAL SPOUSE’S LAST NAME SPOUSE’S SSN – – Instructions. Use this schedule if you have more than four dependents. Complete all information for each additional dependent that is not listed on the ÿrst page of your Oregon return. List your dependents in order from youngest to oldest. FIRST NAME LAST NAME CODE* * DEPENDENT’S SSN DEPENDENT’S DATE OF BIRTH (MM/DD/YYYY) CHECK IF CHILD WITH QUALIFYING DISABILITY – – / / – – / / – – / / – – / / – – / / – – / / – – / / – – / / – – / / – – / / – – / / – – / / – – / / – – / / – – / / – – / / – – / / – – / / **DEPENDENT RELATIONSHIP CODE—PLEASE SEE INSTRUCTIONS TO DETERMINE THE APPROPRIATE CODE. *DEPENDENT RELATIONSHIP CODE—PLEASE SEE INSTRUCTIONS TO DETERMINE THE APPROPRIATE CODE. 1. Total number of additional dependents listed above. Enter the result here and include this number on line 6c of your Oregon return ........ 1. 2. Total number of additional dependent children with a qualifying disability listed above. Enter the result here and include this number on line 6d of your Oregon return........................................................................................................................................................ 2. —You must include this schedule with your Oregon income tax return—

2019 Schedule OR-529 Page 1 of 1, 150-101-068 Oregon Department of Revenue 17651901010000 (Rev. 10-08-19 ver. 01) Oregon College Savings Plan Direct Deposit for Personal Income Tax Filers Submit original form—do not submit photocopy. Office use only FIRST NAME INITIAL LAST NAME SOCIAL SECURITY NUMBER (SSN) – – SPOUSE’S FIRST NAME INITIAL SPOUSE’S LAST NAME SPOUSE’S SSN – – Would you like to deposit all or a portion of your refund into an Oregon College Savings Plan or MFS 529 Savings Plan account? If so, follow the instructions below. Requirements • To make this choice, you must have an open Oregon College Savings Plan or MFS 529 Savings Plan account. See the contact information at the bottom of the page for account and portfolio options. • Deposits must be a minimum of $25 per account. • If your refund is used to pay a debt you owe or the amount you elect to deposit exceeds your available refund, your deposit will be cancelled. Any remaining refund will be refunded by check or direct deposit. Instructions You may deposit all or a portion of your refund in up to four accounts. Complete all the fields below for each account. • Select the account manager—Oregon College Savings Plan or MFS 529 Savings Plan; • Enter the investment option’s portfolio number —see each plan’s website for portfolio numbers; • Enter the account number—11 digits for MFS 529 Savings Plan or 13 digits for Oregon College Savings Plan; • Enter the amount to be deposited into each account; and • Total the amounts to be deposited. 1. Check one: 1a. Oregon College Savings Plan; or 1b. MFS 529 Savings Plan 1c. Portfolio no. 1d. Account no. 1e. Amount $ .00 2. Check one: 2a. Oregon College Savings Plan; or 2b. MFS 529 Savings Plan 2c. Portfolio no. 2d. Account no. 2e. Amount $ .00 3. Check one: 3a. Oregon College Savings Plan; or 3b. MFS 529 Savings Plan 3c. Portfolio no. 3d. Account no. 3e. Amount $ .00 Oregon College Savings Plan; or 4b. MFS 529 Savings Plan 4. Check one: 4a. 4c. Portfolio no. 4d. Account no. 4e. Amount $ .00 Total. Add lines 1e–4e. Enter this amount on your return ........................................................................................... Total $ Contact information Oregon Savings Network Oregon College Savings Plan MFS 529 Savings Plan www.oregonsavingsnetwork.com www.oregoncollegesavings.com www.mfs.com Phone: (503) 373-1903 Phone: 1 (866) 772-8464 Phone: 1 (866) 529-1637 Email: college.savings@ost.state.or.us —You must include this schedule with your Oregon income tax return to have your refund applied— .00

2019 Schedule OR-DONATE Page 1 of 1, 150-101-058 Oregon Department of Revenue 18161901010000 (Rev. 09-26-19 ver. 01) Oregon Charitable Checkoff Donations Submit original form—do not submit photocopy. Office use only FIRST NAME INITIAL LAST NAME SOCIAL SECURITY NUMBER (SSN) – – SPOUSE’S FIRST NAME INITIAL SPOUSE’S LAST NAME SPOUSE’S SSN – – Instructions: Use this form to donate some or all of your refund to the charities listed below. If your refund is used to pay a debt you owe or the amount you elect to donate exceeds your available refund, your donation will be prorated based upon the amount of your available refund. Organization name Charity code number • Amount of refund donated 1. Oregon Coast Aquarium .................................................................. 4 ................................................................... 1. 2. SOLVE.............................................................................................. 6 ................................................................... 2. 3. The Nature Conservancy ................................................................. 8 ................................................................... 3. 4. St. Vincent DePaul Society of Oregon ............................................. 7 ................................................................... 4. 5. Oregon Humane Society ................................................................. 10 ................................................................... 5. 6. The Salvation Army ......................................................................... 11 ................................................................... 6. 7. Doernbecher Children’s Hospital ..................................................... 9 ................................................................... 7. 8. The Oregon Veterans’ Homes ......................................................... 12 ................................................................... 8. 9. ALS Association .............................................................................. 29 ................................................................... 9. 10. Planned Parenthood of Oregon ....................................................... 13 ................................................................... 10. 11. Oregon Lions Sight & Hearing Foundation ...................................... 14 ................................................................... 11. 12. Shriners Hospitals for Children ........................................................ 15 ................................................................... 12. 13. Special Olympics Oregon ................................................................ 16 ................................................................... 13. 14. Susan G. Komen ............................................................................. 17 ................................................................... 14. 15. Oregon Military Assistance Program ............................................... 24 ................................................................... 15. 16. Oregon Historical Society ................................................................ 18 ................................................................... 16. 17. Oregon Food Bank .......................................................................... 25 ................................................................... 17. 18. Albertina Kerr Kid’s Crisis Care ....................................................... 26 ................................................................... 18. 19. American Red Cross........................................................................ 27 ................................................................... 19. 20. Cascade AIDS Project ..................................................................... 28 ................................................................... 20. 21. Veterans Suicide Prevention ............................................................ 23 ................................................................... 21. 22. Oregon Nongame Wildlife ............................................................... 19 ................................................................... 22. 23. Prevent Child Abuse ........................................................................ 20 ................................................................... 23. 24. Alzheimer’s Disease Research ........................................................ 21 ................................................................... 24. 25. Stop Domestic and Sexual Violence ............................................... 22 ................................................................... 25. 26. Habitat for Humanity ....................................................................... 1 ................................................................... 26. 27. Oregon Head Start Association ....................................................... 2 ................................................................... 27. 28. American Diabetes Association ....................................................... 3 ................................................................... 28. 29. SMART ............................................................................................ 5 ................................................................... 29. .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 30. Total charitable checkoff donations. Add lines 1 through 29. .............................................................................. 30. Enter total on line 45 of Form OR-40; line 71 of Form OR-40-N; or line 70 of Form OR-40-P. This amount can’t reduce your net refund below zero. For more information about the charities listed above, visit www.oregon.gov/dor and search for “charitable checkoffs” or the name of a charity. —You must include this schedule with your Oregon income tax return to have your refund applied— .00