Form 40 - Oregon Individual Income Tax Return - 2013 Page 2
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2Page 2 — 2013 Form 40
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32 Total tax before credits from front of form, line 31 .......................................................................................... 32
33 Exemption credit. If the amount on line 8 is less than $100,000, multiply your
NONREFUNDABLE
CREDITS
•
.00
total exemptions on line 6e by $188. Otherwise, see instructions on page 20 .......
33
.00
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34 Retirement income credit. See instructions, page 20 ..............................................
34
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.00
35 Child and dependent care credit. See instructions, page 21 ...................................
35
•
.00
ADD TOGETHER
36 Credit for the elderly or the disabled. See instructions, page 21 .............................
36
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.00
37 Political contribution credit. See limits, page 21 ......................................................
37
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.00
•
Include proof
38 Credit for income taxes paid to another state. State:
38y
38z ...
38
Schedule included
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•
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39y $
39 Other credits. Identify:
39x
39z
39
Schedule included
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40 Total non-refundable credits. Add lines 33 through 39 ................................................................................
40
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.00
41 Net income tax. Line 32 minus line 40. If line 40 is more than line 32, enter -0- .........................................
41
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.00
42 Oregon income tax withheld. Include Form(s) W-2 and 1099 ..............................
42
PAYMENTS AND
REFUNDABLE
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.00
43 Estimated tax payments for 2013 and payments made with your extension .............
43
CREDITS
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•
43a
Wolf depredation
43b
Claim of right
ADD TOGETHER
•
.00
44 Earned income credit. See instructions, page 23 ....................................................
44
Include Schedule
•
.00
45
Working family child care credit
from WFC, line 18 ..............................................
45
WFC if you claim
this credit
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46 Mobile home park closure credit. Include Schedule MPC .......................................
46
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.00
47 Total payments and refundable credits. Add lines 42 through 46 ................................................................
47
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.00
➛
48
Overpayment.
If line 41 is less than line 47, you overpaid. Line 47 minus line 41 ....
OVERPAYMENT
48
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.00
➛
TAX TO PAY
49
49
Tax to pay.
If line 41 is more than line 47, you have tax to pay. Line 41 minus line 47 ....
.00
50 Penalty and interest for filing or paying late. See instructions, page 23 ..................... 50
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.00
51 Interest on underpayment of estimated tax. Include Form 10 and check box
51
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Exception # from Form 10, line 1
51a
Check box if you annualized
51b
.00
52 Total penalty and interest due. Add lines 50 and 51 ....................................................................................... 52
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53
Amount you owe.
Line 49 plus line 52 ...............................................................
AMOUNT YOU OWE
53
➛
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.00
REFUND
54
Refund.
Is line 48 more than line 52? If so, line 48 minus line 52 ..........................................
54
•
.00
Estimated tax.
Fill in the part of line 54 you want applied to 2014 estimated tax ...
55
55
.00
.00
•
•
CHARITABLE
56
57
American Diabetes Assoc.
Oregon Coast Aquarium
CHECKOFF
.00
.00
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•
58
59
SMART
SOLV
DONATIONS,
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.00
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PAGE 27
60
61
The Nature Conservancy
St. Vincent DePaul Soc. of OR
These will
.00
.00
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I want to donate
reduce
62
63
Oregon Humane Society
The Salvation Army
part of my tax
your refund
.00
.00
•
•
64
65
Doernbecher Children’s Hosp.
Oregon Veteran’s Home
refund to the
.00
.00
•
•
•
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following fund(s)
66a
66b
67a
67b
Charity code
Charity code
.00
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68
68a
68b
........
68
See instructions
Political party $3 checkoff. Party code:
You
Spouse/RDP
.00
•
69 Total Oregon 529 College Savings Plan deposits. See instructions, page 26 ..........
69
.00
•
70 Total. Add lines 55 through 69. Total can’t be more than your refund on line 54 .........................................
70
➛
.00
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71
NET REFUND.
Line 54 minus line 70. This is your net refund .....................................
NET REFUND
71
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72 For direct deposit of your refund, see instructions, page 27.
Type of account:
Checking or
Savings
DIRECT
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DEPOSIT
Routing No.
Account No.
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Will this refund go to an account outside the United States?
Yes
Important: Include a copy of your federal Form 1040, 1040A, 1040EZ, 1040NR, or 1040NR-EZ.
Under penalty for false swearing, I declare that the information in this return is true, correct, and complete.
•
Preparer license no.
Your signature
Date
Signature of preparer other than taxpayer
X
X
Address
Telephone no.
Spouse’s/RDP’s signature (if filing jointly, BOTH must sign)
Date
X
If you owe, make your check or money order payable to the
Oregon Department of Revenue.
Write your daytime telephone number and “2013 Oregon Form 40” on your check or money order.
Include your payment, along with the payment voucher
on page 23, with this return.
Mail
REFUND
Oregon Department of Revenue
Mail
returns
REFUND
TAX-TO-PAY
PO Box 14555
and
NO-TAX-DUE
PO Box 14700
returns to
Salem OR 97309-0940
returns to
Salem OR 97309-0930
150-101-040 (Rev. 12-13)
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