Form 40P Fillable Part-Year Resident Individual Income Tax Return
(all forms fillable on Windows, Mac, Android tablets, and iPad using Adobe Reader XI)

00 00 00 00 00 00 00 00 00 00 1 Single 60a Wolf depredation 60b Claim of right Account No Carry this Preparer license no Routing No Type of account: (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (see instructions) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (W 2s 10 Dividend income from federal Form 1040 line 9a 10F 10S 1099s) 11 State and local income tax refunds from federal Form 1040 line 10 11F 11S 12 Alimony received from federal Form 1040 line 11 12F 12S 13 Business income or loss from federal Form 1040 line 12 13F 13S 14 Capital gain or loss from federal Form 1040 line 13 14F 14S 15 Other gains or losses from federal Form 1040 line 14 15F 15S 150 101 055 (Rev 12 13) 150 101 055 (Rev 12 13) NOW GO TO THE BACK OF THE FORM 16 IRA distributions from federal Form 1040 line 15b 16F 16S 17 Pensions and annuities from federal Form 1040 line 16b 17F 17S 18 Rents royalties partnerships etc from federal Form 1040 line 17 18F 18S 19 Farm income or loss from federal Form 1040 line 18 19F 19S 20 Unemployment and other income from federal Form 1040 lines 19 through 21 20F 20S 21 Total income Add lines 8 through 20 21F 21S 22 IRA or SEP and SIMPLE contributions federal Form 1040 lines 28 and 32 22F 22S 23 Education deductions from federal Form 1040 lines 23 33 and 34 23F 23S 24 Moving expenses from federal Form 1040 line 26 24F 24S 25 Deduction for self employment tax from federal Form 1040 line 27 25F 25S 26 Self employed health insurance deduction from federal Form 1040 line 29 26F 26S 27 Alimony paid from federal Form 1040 line 31a 27F 27S 28 Other adjustments to income Identify: 28x 28y $ Schedule28z 28F 28S 29 Total adjustments to income Add lines 22 through 28 29F 29S 2a Married filing jointly 2b Registered domestic partners (RDP) filing jointly 30 Income after adjustments Line 21 minus line 29 30F 30S 31 Interest on state and local government bonds outside of Oregon 31F 31S 32 Federal election on interest and dividends of a minor child 32F 32S 33 Other additions Identify: 33x 33y $ Schedule included 33z 33F 33S 34 Total additions Add lines 31 through 33 34F 34S 35 Income after additions Add lines 30 and 34 35F 35S 36 Social Security and tier 1 Railroad Retirement Board benefits included on line 20F 36F 37 Other subtractions Identify: 37x 37y $ Schedule included 37z 37F 37S 38 Income after subtractions Line 35 minus lines 36 and 37 38F 38S 39 Oregon percentage Line 38S line 38F (not more than 100 0%) 39 3a Married filing separately: 3b Registered domestic partner filing separately: 4 Head of household: Person who qualifies you 40 Amount from front of form line 38F (federal amount) 40 41 Itemized deductions from federal Schedule A line 29 41 42 State income tax claimed as itemized deduction 42 43 Net Oregon itemized deductions Line 41 minus line 42 43 44 Standard deduction from page 26 44 45 2013 federal tax liability ($0 $6 250; see instructions for the correct amount) 45 46 Other deductions and modifications Identify: 46x 46y $ Schedule 46z 46 47 Add lines 43 45 and 46 if itemizing Otherwise add lines 44 45 and 46 47 48 Taxable income Line 40 minus line 47 48 5 Qualifying widow(er) with dependent child 51 Interest on certain installment sales 51 52 Total tax before credits Add lines 50 and 51 OREGON TAX 52 53 Exemption credit See instructions page 30 53 54 Child and dependent care credit See instructions page 30 54 55 Credit for income taxes paid to another state State: 55y Schedule 55z 55 56 Other credits Identify: 56x 56y $ Schedule included 56z 56 57 Total non refundable credits Add lines 53 through 56 57 58 Net income tax Line 52 minus line 57 If line 57 is more than line 52 enter 0 58 59 Oregon income tax withheld from income Include Forms W 2 and 1099 59 60 Estimated tax payments for 2013 and payments made with your extension 60 61 Tax payments from pass through entity and real estate transactions 61 62 Earned income credit See instructions page 32 62 63 Working family child care credit from WFC N/P line 21 63 64 Mobile home park closure credit Include Schedule MPC 64 65 Total payments and refundable credits Add lines 59 through 64 65 66 Overpayment Is line 58 less than line 65? If so line 65 minus line 58 OVERPAYMENT 66 67 Tax to pay Is line 58 more than line 65? If so line 58 minus line 65 TAX TO PAY 67 68 Penalty and interest for filing or paying late See instructions page 33 68 69 Interest on underpayment of estimated tax Include Form 10 and check box 6a Yourself Regular Severely disabled 6a 6b Spouse/RDP Regular Severely disabled b 6c All dependents First names c 6d Disabled First names d 70 Total penalty and interest due Add lines 68 and 69 70 71 Amount you owe Line 67 plus line 70 AMOUNT YOU OWE 71 72 Refund Is line 66 more than line 70? If so line 66 minus line 70 REFUND 72 73 Estimated tax Fill in the part of line 72 you want applied to 2014 estimated tax 73 7b You 7c You have 7d You filed 8 Wages salaries and other pay for work Include all Forms W 2 8F 8S 86 Total Oregon 529 College Savings Plan deposits See instructions page 34 86 87 Total Add lines 73 through 86 Total can t be more than your refund on line 72 87 88 NET REFUND Line 72 minus line 87 This is your net refund NET REFUND 88 9 Taxable interest income from federal Form 1040 line 8a 9F 9S ADD TOGETHER ADD TOGETHER 00 ADDITIONS Address Telephone no ADJUSTMENTS Amended Return 2013Form 40P American Diabetes Assoc 74 amount to line 40 and payment CHARITABLE Charity code 84a 84b Charity code 85a 85b Check Check all that apply Check box if you annualized 69b Check if tax is from: 50a Checking or CHECKOFF children only claim this credit Country CREDITS Current mailing address Date of birth (mm/dd/yyyy) Deceased DEDUCTIONS DEPOSIT DIRECT 89 For direct deposit of your refund see instructions page 34 Doernbecher Children s Hosp 82 DONATIONS EITHER Exception # from Form 10 line 1 69a Exemptions extension federal Federal column (F) Oregon column (S) filed an Filing First name and initial Fiscal year ending following fund(s) For office use only FOR PART YEAR RESIDENTS Form 24 Form 8886 Form FIA 40P or 50b From To I want to donate If you filed a return last year and your Important: Include a copy of your federal Form 1040 1040A 1040EZ or 1040NR Include Include Schedule INCOME Individual Income Tax Return K F P J HW Last name mm dd yyyy mm dd yyyy MODIFICATIONS name or address is different check here NONREFUNDABLE NOT BOTH Oregon OREGON 49 Tax from tax charts 49a Oregon Coast Aquarium 75 Oregon Humane Society 80 Oregon income tax Line 49 X Oregon percentage from line 39 or 50 Oregon resident: Oregon Veteran s Home 83 Page 2 2013 Form 40P PAGE 34 part of my tax Partner s name Partner s SSN payment PAYMENTS AND proof of reduce refund to the REFUNDABLE Savings See instructions page 29 49 Signature of preparer other than taxpayer SMART 76 Social Security No (SSN) SOLV 77 Spouse s name Spouse s SSN Spouse s/RDP s first name and initial if joint return Spouse s/RDP s last name if joint return Spouse s/RDP s SSN if joint return Spouse s/RDP's signature (if filing jointly BOTH must sign) Date Spouse/RDP was: 65 or older Blind St Vincent DePaul Soc of OR 79 State Status SUBTRACTIONS Telephone number The Nature Conservancy 78 The Salvation Army 81 These will TO INCOME Total Total 6e Under penalty for false swearing I declare that the information in this return is true correct and complete voucher WFC N/P if you Will this refund go to an account outside the United States? withholding Worksheet FCG You were: 65 or older Blind your refund Your signature Date ZIP code