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Enter the smaller of line 5 or line 8 150-101-031 (Rev. 12-13) 7 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 2013 FORM 10 Underpayment of Oregon Estimated Tax File with your 2013 Oregon individual income tax return Name Social Security number – – Exception No._______ 2. 2013 net income tax from Form 40, line 41; or Form 40N or Form 40P, line 58 ............................................... 2 3. 2013 refundable tax credit amounts you claimed on Form 40, lines 44–46; or Form 40N or Form 40P, lines 62–64 ......................................................................................................................... 3 4. Line 2 minus line 3 ............................................................................................................................... .............. 4 5. Multiply line 4 by 90% (0.90) ............................................................................................ 5 6. 2013 Oregon income tax withheld from income ................................................................................................ 6 7. Line 4 minus line 6. If less than $1,000, stop here! You do not owe underpayment interest .......................... 7 8. Enter your 2012 Oregon tax after all credits (include refundable). You must have filed an Oregon return ........ 8 9. Required annual payment. 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. .00 .00 .00 .00 .00 .00 .00 .00 A April 15, 2013 B June 17, 2013 C Sept. 16, 2013 D Jan. 15, 2014 10. Payment period due date ............................................................ 10 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 No. of Monthly No. of Daily Interest Date Event Amount Running balance months rate days rate due 12. 4/15/13 Req. Pymt. 13. 4/15/ 13 Withholding 0.003333 0.000110 14. Payment 0.003333 0.000110 15. Payment 0.003333 0.000110 16. Payment 0.003333 0.000110 17. 6/17/ 13 Req. Pymt. 18. 6/17/ 13 Withholding 0.003333 0.000110 19. Payment 0.003333 0.000110 20. Payment 0.003333 0.000110 21. Payment 0.003333 0.000110 22. 9/16/ 13 Req. Pymt. 23. 9/16/ 13 Withholding 0.003333 0.000110 24. Payment 0.003333 0.000110 25. Payment 0.003333 0.000110 26. Payment 0.003333 0.000110 27. 1/15/ 14 Rate Chg. 28. 1/ 15 / 14 Req. Pymt. 29. 1/ 15 / 14 Withholding 0.003333 0.000110 30. Payment 0.003333 0.000110 31. Payment 0.003333 0.000110 32. Payment 0.003333 0.000110 33. 4/ 15 / 14 34. Total interest due. Add the amounts in the interest column. Round to the nearest whole dollar and enter here and on Form 40, line 51; or Form 40N or Form 40P, line 69 .............................. 34 .00 (See page 3 of the instructions) — PART A — Figure your required annual payment PART B — Figure your required installment payment PART C — Figure your interest — Do not calculate interest after April 15, 2014 — ................................................................................................ ----------------Page (0) Break---------------- 150-101-031 (Rev. 12-13) 8 1. (see instructions) .......................................................................... 1 2. Oregon additions for each period (see instructions) .................... 2 3. Add lines 1 and 2 .......................................................................... 3 4. Annualization multiplier ................................................................ 4 5. Annualized Oregon income. Multiply line 3 by line 4 .................... 5 6. Oregon subtractions for each period (except federal tax) ............ 6 7. Annualization multiplier ................................................................ 7 8 Annualized Oregon subtractions. Multiply line 6 by line 7 ............ 8 9. Federal tax from the worksheet on page 5 of the instructions ..... 9 10. Total subtractions. Add lines 8 and 9 ......................................... 10 11. Enter your net Oregon itemized deductions for each period. If you do not itemize, enter -0- and skip to line 14 (see instructions) ........................................................................ 11 12. Annualization multiplier .............................................................. 12 13. Annualized net Oregon itemized deductions. Multiply line 11 by line 12 ........................................................... 13 14. In each column, enter the full amount of your Oregon standard deduction .................................................................... 14 15. Enter line 13 or 14, whichever is larger ...................................... 15 16. Total deductions. Add lines 10 and 15 ....................................... 16 17. Annualized Oregon taxable income. Line 5 minus line 16 .......... 17 18. Oregon tax for the amount on line 17 (see tax tables or tax rate chart in the 2013 tax booklet) ........................................ 18 19. Exemption credit (not annualized) from Form 40, line 33; Form 40N, line 54; or Form 40P, line 53 ..................................... 19 20. Enter the credits for each period. Do not include exemption credits (see instructions) ........................................... 20 21. Total credits. Add lines 19 and 20 .............................................. 21 22. Net annualized income tax. Line 18 minus line 21 ..................... 22 23. Percentage that applies for each period .................................... 23 24. Multiply line 22 by line 23 ........................................................... 24 25. Enter the sum of all amounts from the prior columns of line 31 below (i.e., column A, line 31 amount goes in column B, line 25) ....................................................................... 25 26. Line 24 minus line 25. If less than zero, enter -0- ...................... 26 27. ... 27 28. Enter the amount from the previous column of line 30 below (i.e., column A, line 30 amount goes in column B, line 28) ......... 28 29. Add lines 27 and 28 .................................................................... 29 30. If line 29 is more than line 26, line 29 minus line 26. If line 29 is less than line 26, enter -0- ....................................... 30 31. Enter the smaller of line 26 or line 29 here and on Part B, line 11 (see front of the form). Go to line 1 in next column ........ 31 4 2.4 1.5 1 4 2.4 1.5 1 ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) 22.5% 45% 67.5% 90% 2013 Form 10 Page 2 Annualized Income Worksheet Read the instructions on page 5 before completing this worksheet. Note: Start with column A. Work down the column, and complete lines 1 through 31 before going on to columns B, C, and D. File this form with your 2013 Oregon Individual Income Tax Return Have questions? See page 6 of the instructions for numbers to call. * If you are a part-year filer, divide by the number of periods you resided in Oregon, if less than 4. (See instructions for Part B, line 11.) ( ) ( ) ( ) 1 4 2.4 1.5 A 1/1/13 to 3/31/13 B 1/1/13 to 5/31/13 C 1/1/13 to 8/31/13 D 1/1/13 to 12/31/13 Enter your adjusted gross income for each period *Divide line 9, Part A, by four and enter results in each column ----------------Page (1) Break----------------