Application for Automatic
FORM
2013
40-EXT
Extension of Time to File Oregon
Individual Income Tax Return
Note to fiscal year taxpayers: File Form 40-EXT by the regular due date of your return.
Use Form 40-EXT to apply for an automatic six-month exten-
An extension of time to file your return isn’t an extension of
sion of time to file your Oregon return. We will honor all fed-
time to pay your tax. If you don’t pay all of the tax due when
eral extensions of time to file individual income tax returns as
you apply for your extension, you will owe interest on the
valid Oregon extensions. If you received a federal automatic
unpaid balance from April 15, 2014 until the date you pay it
six-month extension (federal Form 4868), don’t use Oregon
in full. The 2014 interest rate is 4 percent. You may also owe a
Form 40-EXT unless you owe Oregon tax for 2013. Complete
late payment penalty. See “Penalties and interest” on page 2.
Oregon Form 40-EXT only if you:
• Owe Oregon tax for 2013, cannot file your 2013 Oregon
To apply for an automatic six-month Oregon extension, file
return by April 15, 2014, and will be making a payment;
Form 40-EXT by April 15, 2014. If you are a fiscal year tax-
or
payer, file Form 40-EXT by the regular due date of your return.
• Are filing an extension for Oregon only.
Enter your name(s), Social Security number(s), and address
Complete the tax payment worksheet below to determine
on Form 40-EXT below. Detach and mail Form 40-EXT to us.
if you owe Oregon tax for 2013. If you owe Oregon tax, you
Instructions and mailing address are on page 2.
must pay it by April 15, 2014.
TAX PAYMENT WORKSHEET
1. Total income tax liability for 2013. This is the amount you expect to enter
00
on Form 40, line 41; Form 40N or Form 40P, line 58 .................................................................... 1
2. Total income tax payments (withholding, estimated payments) and refundable credits
for 2013. This is the amount you expect to enter on Form 40, line 47; Form 40N or
00
Form 40P, line 65 .......................................................................................................................... 2
If the amount on line 2 is more than the amount on line 1, you don’t owe Oregon tax.
If the amount on line 1 is more than the amount on line 2, continue to line 3.
3. Tax to pay with extension. Line 1 minus line 2. Enter the result here
00
and in the “Enter Payment Amount” box on Form 40-EXT below ................................................ 3
150-101-165 (Rev. 12-13)
Keep your completed tax payment worksheet with your records. Do not mail the worksheet to the department.
Detach Here
Detach Here
Application for Automatic
FORM
Department of Revenue Use Only
For Tax Year
40-EXT
Extension of Time to File Oregon
2013
•
Individual Income Tax Return
150-101-165 (Rev. 12-13)
or Fiscal Year Ending
First time Oregon filer
Check if:
Mail your payment to: Extension Clerk, Oregon Dept. of Revenue, PO Box 14950, Salem OR 97309-0950
New name or address
Daytime Telephone Number
Enter Payment Amount
Last name
First name and initial
SSN
$
0 0
.
Spouse’s/RDP’s last name (if joint payment)
Spouse’s/RDP’s first name and initial
Spouse’s/RDP’s SSN (
if joint payment)
Current mailing address
City
State
ZIP code