Form OR-40-N (150-101-048) "Oregon Individual Income Tax Return for Nonresidents" - Oregon

What Is Form OR-40-N (150-101-048)?

This is a legal form that was released by the Oregon Department of Revenue - a government authority operating within Oregon. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on February 20, 2020;
  • The latest edition provided by the Oregon Department of Revenue;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form OR-40-N (150-101-048) by clicking the link below or browse more documents and templates provided by the Oregon Department of Revenue.

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Download Form OR-40-N (150-101-048) "Oregon Individual Income Tax Return for Nonresidents" - Oregon

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Congress extended several tax provisions by passing Public Law 116-94.
Clear form
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As a result, line 22 on this form was updated on January 19, 2020.
2019 Form OR-40-N
Office use only
00541901010000
Page 1 of 5, 150-101-048
Oregon Department of Revenue
(Rev. 02-20-20 ver. 01)
Oregon Individual Income Tax Return for Nonresidents
Submit original form—do not submit photocopy
/
/
Space for 2-D barcode—do not write in box below
Fiscal year ending:
Amended return. If amending for an NOL,
tax year the NOL was generated:
Calculated using “as if” federal return.
Federal disaster relief.
Short-year tax election.
Federal Form 8886.
Extension filed.
Employment exception.
Form OR-24.
Military.
First name
Initial
Last name
Social Security no. (SSN)
First time using
Applied
this SSN (see
for ITIN
Deceased
instructions)
Spouse’s first name
Initial
Spouse’s last name
Spouse’s SSN
Applied
First time using
this SSN (see
for ITIN
Deceased
instructions)
Current mailing address
Date of birth
Spouse’s date of birth
(mm/dd/yyyy)
/
/
/
/
Phone
City
State
ZIP code
Country
)
(
Filing status
(check only one box)
Total
Exemptions
1.
Single.
6a. Credits for yourself:
Regular
Severely disabled .... 6a.
2.
Married filing jointly.
Check box if someone else can claim you as a dependent.
3.
Married filing separately (enter spouse’s information above).
6b. Credits for spouse:
Regular
Severely disabled .... 6b.
4.
Head of household (with qualifying dependent).
Check box if someone else can claim your spouse as a dependent.
5.
Qualifying widow(er) with dependent child.
Dependents.
List your dependents in order from youngest to oldest. If more than four, check this box
and include Schedule OR-ADD-DEP
with your return.
Dependent’s date
Check if child with
First name
Last name
Code*
Dependent’s SSN
of birth (mm/dd/yyyy)
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.
Congress extended several tax provisions by passing Public Law 116-94.
Clear form
Clear this page
As a result, line 22 on this form was updated on January 19, 2020.
2019 Form OR-40-N
Office use only
00541901010000
Page 1 of 5, 150-101-048
Oregon Department of Revenue
(Rev. 02-20-20 ver. 01)
Oregon Individual Income Tax Return for Nonresidents
Submit original form—do not submit photocopy
/
/
Space for 2-D barcode—do not write in box below
Fiscal year ending:
Amended return. If amending for an NOL,
tax year the NOL was generated:
Calculated using “as if” federal return.
Federal disaster relief.
Short-year tax election.
Federal Form 8886.
Extension filed.
Employment exception.
Form OR-24.
Military.
First name
Initial
Last name
Social Security no. (SSN)
First time using
Applied
this SSN (see
for ITIN
Deceased
instructions)
Spouse’s first name
Initial
Spouse’s last name
Spouse’s SSN
Applied
First time using
this SSN (see
for ITIN
Deceased
instructions)
Current mailing address
Date of birth
Spouse’s date of birth
(mm/dd/yyyy)
/
/
/
/
Phone
City
State
ZIP code
Country
)
(
Filing status
(check only one box)
Total
Exemptions
1.
Single.
6a. Credits for yourself:
Regular
Severely disabled .... 6a.
2.
Married filing jointly.
Check box if someone else can claim you as a dependent.
3.
Married filing separately (enter spouse’s information above).
6b. Credits for spouse:
Regular
Severely disabled .... 6b.
4.
Head of household (with qualifying dependent).
Check box if someone else can claim your spouse as a dependent.
5.
Qualifying widow(er) with dependent child.
Dependents.
List your dependents in order from youngest to oldest. If more than four, check this box
and include Schedule OR-ADD-DEP
with your return.
Dependent’s date
Check if child with
First name
Last name
Code*
Dependent’s SSN
of birth (mm/dd/yyyy)
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.
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2019 Form OR-40-N
00541901020000
Page 2 of 5, 150-101-048
Oregon Department of Revenue
(Rev. 02-20-20 ver. 01)
Name
SSN
Note: Reprint page 1 if you make changes to this page.
Federal column (F)
Oregon column (S)
Income
7. Wages, salaries, and other pay for work from federal Form 1040 or
. 00
. 00
1040-SR, line 1. Include all Forms W-2. .................................................. 7F.
7S.
. 00
. 00
8. Interest income from Form 1040 or 1040-SR, line 2b. .............................. 8F.
8S.
. 00
. 00
9. Dividend income from Form 1040 or 1040-SR, line 3b. ............................ 9F.
9S.
. 00
. 00
10. State and local income tax refunds from federal Schedule 1, line 1. ........ 10F.
10S.
. 00
. 00
11. Alimony received from federal Schedule 1, line 2a. .................................. 11F.
11S.
. 00
. 00
12. Business income or loss from federal Schedule 1, line 3.. ........................ 12F.
12S.
. 00
. 00
13. Capital gain or loss from Form 1040 or 1040-SR, line 6. .......................... 13F.
13S.
. 00
. 00
14. Other gains or losses from federal Schedule 1, line 4. .............................. 14F.
14S.
. 00
. 00
15. IRA distributions from Form 1040 or 1040-SR, line 4b. ............................ 15F.
15S.
. 00
. 00
16. Pensions and annuities from Form 1040 or 1040-SR, line 4d. .................. 16F.
16S.
. 00
. 00
17. Schedule E income or loss from federal Schedule 1, line 5. ..................... 17F.
17S.
. 00
. 00
18. Farm income or loss from federal Schedule 1, line 6 ................................ 18F.
18S.
19. Social Security benefits from Form 1040 or 1040-SR, line 5b and unem-
. 00
. 00
ployment and other income from federal Schedule 1, lines 7 and 8. ........ 19F.
19S.
. 00
. 00
20. Total income. Add lines 7 through 19. ........................................................ 20F.
20S.
Adjustments
21. IRA or SEP and SIMPLE contributions, federal Schedule 1,
. 00
. 00
lines 15 and 19. ......................................................................................... 21F.
21S.
. 00
. 00
22. Education deductions from federal Schedule 1, lines 10, 20, and 21. ...... 22F.
22S.
. 00
. 00
23. Moving expenses from federal Schedule 1, line 13. ................................. 23F.
23S.
. 00
. 00
24. Deduction for self-employment tax from federal Schedule 1, line 14. ...... 24F.
24S.
25. Self-employed health insurance deduction from federal
. 00
. 00
Schedule 1, line 16. ................................................................................... 25F.
25S.
. 00
. 00
26. Alimony paid from federal Schedule 1, line 18a. ....................................... 26F.
26S.
. 00
. 00
27. Total adjustments from Schedule OR-ASC-NP, section 1. ........................ 27F.
27S.
. 00
. 00
28. Total adjustments. Add lines 21 through 27. ............................................. 28F.
28S.
. 00
. 00
29. Income after adjustments. Line 20 minus line 28. ...................................... 29F.
29S.
Additions
. 00
. 00
30. Total additions from Schedule OR-ASC-NP, section 2. ............................. 30F.
30S.
. 00
. 00
31. Income after additions. Add lines 29 and 30. .............................................31F.
31S.
Subtractions
32. Social Security and tier 1 Railroad Retirement Board benefits included
. 00
on line 19F. ................................................................................................. 32F.
. 00
. 00
33. Total subtractions from Schedule OR-ASC-NP, section 3. ........................ 33F.
33S.
. 00
. 00
34. Income after subtractions. Line 31 minus lines 32 and 33. ....................... 34F.
34S.
.
%
35. Oregon percentage (see instructions) (not more than 100.0%). .............. 35.
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2019 Form OR-40-N
00541901030000
Page 3 of 5, 150-101-048
Oregon Department of Revenue
(Rev. 02-20-20 ver. 01)
Name
SSN
Note: Reprint page 1 if you make changes to this page.
Deductions and modifications
. 00
36. Amount from line 34S. .............................................................................................................................................. 36.
37. Oregon itemized deductions. Enter your Oregon itemized deductions from Schedule OR-A, line 23. If you
. 00
are not itemizing your deductions, enter -0-. ........................................................................................................... 37.
. 00
38. Standard deduction. Enter your standard deduction (see instructions). ................................................................ 38.
You were: 38a.
Your spouse was: 38c.
65 or older 38b.
Blind
65 or older
38d.
Blind
. 00
39. Enter the larger of line 37 or 38. ............................................................................................................................... 39.
. 00
40. 2019 federal tax liability. See instructions for the correct amount: $0-$6,800. ................................................... 40.
. 00
41. Total modifications from Schedule OR-ASC-NP, section 4. ..................................................................................... 41.
. 00
42. Deductions and modifications multiplied by the Oregon percentage (see instructions). ......................................... 42.
. 00
43. Charitable art donation (see instructions). ................................................................................................................ 43.
. 00
44. Total deductions and modifications. Add lines 42 and 43. ...................................................................................... 44.
. 00
. 00
45. Oregon taxable income. Line 36 minus line 44. If line 44 is more than line 36, enter -0-. ....................................... 45.
Oregon tax
. 00
46. Tax. Check the appropriate box if you’re using an alternative method to calculate your tax (see instructions). ..... 46.
46a.
Schedule OR-FIA-40-N
46b.
Worksheet OR-FCG
46c.
Schedule OR-PTE-NR
. 00
47. Interest on certain installment sales. ........................................................................................................................ 47.
. 00
48. Total tax before credits. Add lines 46 and 47. ......................................................................................................... 48.
Standard and carryforward credits
. 00
49. Exemption credit (see instructions). ......................................................................................................................... 49.
. 00
50. Total standard credits from Schedule OR-ASC-NP, section 5. ................................................................................ 50.
. 00
51. Total standard credits. Add lines 49 and 50. ............................................................................................................ 51.
. 00
52. Tax minus standard credits. Line 48 minus line 51. If line 51 is more than line 48, enter -0-. .................................. 52.
53. Total carryforward credits claimed this year from Schedule OR-ASC-NP, section 6. Line 53 can’t be more
. 00
than line 52 (see Schedule OR-ASC-NP instructions). ............................................................................................. 53.
. 00
54. Tax after standard and carryforward credits. Line 52 minus line 53. ........................................................................ 54.
Payments and refundable credits
. 00
55. Oregon income tax withheld. Include a copy of Forms W-2 and 1099. ................................................................ 55.
. 00
56. Amount applied from your prior year’s tax refund. ................................................................................................... 56.
57. Estimated tax payments for 2019. Include all payments you made prior to the filing date of this return,
. 00
including real estate transactions. Do not include the amount you already reported on line 56. ............................ 57.
. 00
58. Tax payments from a pass-through entity. ............................................................................................................... 58.
. 00
59. Earned income credit (see instructions). .................................................................................................................. 59.
60. Kicker (Oregon surplus credit). Enter your kicker credit amount (see instructions).
. 00
If you elect to donate your kicker to the State School Fund, enter -0- and see line 76. ................................. 60.
. 00
61. Total refundable credits from Schedule OR-ASC-NP, section 7. .............................................................................. 61.
. 00
62. Total payments and refundable credits. Add lines 55 through 61. ........................................................................... 62.
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2019 Form OR-40-N
00541901040000
Page 4 of 5, 150-101-048
Oregon Department of Revenue
(Rev. 02-20-20 ver. 01)
Name
SSN
Note: Reprint page 1 if you make changes to this page.
Tax to pay or refund
. 00
63. Overpayment of tax. If line 54 is less than line 62, you overpaid. Line 62 minus line 54. ...................................... 63.
. 00
64. Net tax. If line 54 is more than line 62, you have tax to pay. Line 54 minus line 62. ............................................... 64.
. 00
65. Penalty and interest for filing or paying late (see instructions). ................................................................................ 65.
. 00
66. Interest on underpayment of estimated tax. Include Form OR-10. ........................................................................ 66.
Exception number from Form OR-10, line 1:
66a.
Check box if you annualized:
66b.
. 00
67. Total penalty and interest due. Add lines 65 and 66. ............................................................................................... 67.
. 00
68. Net tax including penalty and interest. Line 64 plus line 67. ............................... This is the amount you owe. 68.
. 00
69. Overpayment less penalty and interest. Line 63 minus line 67 .......................................... This is your refund. 69.
. 00
70. Estimated tax. Fill in the portion of line 69 you want applied to your open estimated tax account........................ 70.
. 00
71. Charitable checkoff donations from Schedule OR-DONATE, line 30. ..................................................................... 71.
. 00
72. Oregon 529 college savings plan deposits from Schedule OR-529 (see instructions). .......................................... 72.
. 00
73. Total. Add lines 70 through 72. Total can’t be more than your refund on line 69. ................................................... 73.
. 00
74. Net refund. Line 69 minus line 73. ..................................................................................This is your net refund. 74.
Direct deposit
75. 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
76. Kicker donation. If you elect to donate your kicker to the State School Fund, check this box:
76a.
Complete the kicker worksheet, located in the instructions, and enter the amount here.
. 00
This election is irrevocable. .................................................................................................................................76b.
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2019 Form OR-40-N
00541901050000
Page 5 of 5, 150-101-048
Oregon Department of Revenue
(Rev. 02-20-20 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
Date
/
/
X
Date
Spouse’s signature (if filing jointly, both must sign)
/
/
X
Signature of preparer other than taxpayer
Preparer phone
Preparer license number, if professionally prepared
(
)
X
Preparer address
State
ZIP code
City
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 68)
• 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-N”
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.
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