Form 40-V - Oregon Income Tax Payment Voucher
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1Where to mail
Oregon Income Tax Payment Voucher, Form 40-V
If you filed your return:
Mail to:
On paper
PO Box 14555
Salem OR 97309-0940
With a 2-D barcode or
PO Box 14720
electronically
Salem OR 97309-0463
Don’t use Form 40-V if you are using an electronic payment option.
Use the voucher only if you are paying by check or money order.
Complete the form below using your computer.
After you have printed it, cut along the dotted line and
mail to the Department of Revenue at the addresses shown above.
Note:
If, when typing, you see a solid box instead of letters or numbers,
adjust the view size to 100 percent. If the letters or numbers still are not visible,
press the tab key.
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OREGON INCOME TAX PAYMENT VOUCHER
FORM
Department of Revenue Use Only
40-V
150-101-172 (Rev. 12-13)
•
Fiscal Year Ending
•
Payment Type (check only one):
2013 Return
Check if:
First time Oregon filer
Amended—Tax Year:
Prior Tax Year:
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
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