Form 10 - Underpayment Of Oregon Estimated Tax - 2011
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2Clear Form
2011
Underpayment of
For Office Use Only
FORM
10
Date received
Oregon Estimated Tax
File with your 2011 Oregon individual income tax return
Name
Social Security number
–
–
EXCEPTION TO PAYING INTEREST
1. I am claiming an exception to the imposition of estimated payment interest because I qualified
for relief under ORS 316.573 or 316.587. Write in the exception number you are claiming here
and on Form 40, box 51a; or Form 40N or Form 40P, box 69a ........................................................................ 1
Exception No._______
PART A—Figure your required annual payment
.00
2. 2011 net income tax from Form 40, line 41; or Form 40N or Form 40P, line 58 ............................................... 2
3. 2011 refundable tax credit amounts you claimed on Form 40, lines 44–46; or
.00
Form 40N or Form 40P, lines 62–64 .........................................................................................................................3
.00
4. Line 2 minus line 3 ............................................................................................................................................. 4
.00
5. Multiply line 4 by 90% (0.90) ............................................................................................5
.00
6. 2011 Oregon income tax withheld from income ................................................................................................ 6
.00
7. Line 4 minus line 6. If less than $1,000, stop here! You do not owe underpayment interest .......................... 7
.00
8. Enter your 2010 Oregon tax after all credits (include refundable). You must have filed an Oregon return ........ 8
.00
9. Required annual payment. Enter the smaller of line 5 or line 8 (line 5 if 2010 return not timely filed) ............. 9
Note: If line 6 is equal to or more than line 9, stop here! You do not owe underpayment interest. Attach this form to your return.
PART B—Figure your required installment payment
A
B
C
D
10. Payment period due date ............................................................ 10
April 18, 2011
June 15, 2011
Sept. 15, 2011
Jan. 17, 2012
11. Divide the amount on line 9 by four and enter the amount
in each column, or if you use the Annualized Income
Worksheet on the back of this form, enter the amounts
from line 31 here (see instructions), and check box 51b on
Form 40 or 69b on Form 40N or 40P .......................................... 11
PART C — Figure your interest (
See page 3 of the instructions)
No. of
Monthly
No. of
Daily
Interest
Date
Event
Amount
Running balance
months
rate
days
rate
due
4/18/11
Req. Pymt.
.
.
12.
.
.
.
13. 4/18/11
Withholding
0.004167
0.000137
14.
Payment
.
.
0.004167
0.000137
.
15.
Payment
.
.
0.004167
0.000137
.
.
.
.
16.
Payment
0.004167
0.000137
17. 6/15/11
Req. Pymt.
.
.
.
.
.
18. 6/15/11
Withholding
0.004167
0.000137
19.
Payment
.
.
0.004167
0.000137
.
20.
Payment
.
.
0.004167
0.000137
.
.
.
.
21.
Payment
0.004167
0.000137
22. 9/15/11
Req. Pymt.
.
.
23. 9/15/11
Withholding
.
.
0.004167
0.000137
.
.
.
.
24.
Payment
0.004167
0.000137
25.
Payment
.
.
0.004167
0.000137
.
26.
Payment
.
.
0.004167
0.000137
.
27. 1/17/12
Rate Chg.
.
28. 1/17/12
Req. Pymt.
.
.
.
.
.
29. 1/17/12
Withholding
0.004167
0.000137
30.
Payment
.
.
0.004167
0.000137
.
31.
Payment
.
.
0.004167
0.000137
.
.
.
.
32.
Payment
0.004167
0.000137
33. 4/17/12
— Do not calculate interest after April 17, 2012 —
34. Total interest due. Add the amounts in the interest column. Round to the nearest
.00
whole dollar and enter here and on Form 40, line 51; or Form 40N or Form 40P, line 69 .............................. 34
150-101-031 (Rev. 12-11)
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