OREGON m x»m* STATF UBrtAHT Elderly Rental Assistance Oregon Department of Revenue JR R. 8EL2 1991 ERA program NOT FOR LOAN
Elderly Rental Assistance (ERA) Program The Homeowner and Renter Refund Program (HARRP) has not been funded for 1991. However, the Elderly Rental Assistance (ERA) program has been expanded. Elderly Rental Assistance is for low-income senior citizens who rent. You must file Form 90R to receive an ERA renter refund. Form 90R is on pages 7-10 of this booklet. The ERA refund is based on your income and the amount of rent, fuel, and utilities you paid. To qualify for the refund: You or your spouse must be age 58 or older on December 31, 1991. Your household income must be less than $10,000. You pay more than 20 percent of your household income for rent, fuel, and utilities. f you and your spouse are under 65, the value of your household assets must not exceed $25,000. You rented an Oregon residence in 1991. Your rented Oregon residence was subject to property tax. You lived in Oregon on December 31, 1991. You didn t own your residence on December 31, 1991. But you didn t have to be renting on that date to qualify for a 1991 rent refund. Household income includes all taxable and nontaxable income of both spouses in the same household. This includes income you received before you became an Oregon resident. See pages 4-6 for how to figure your household income. Fuel and utilities include the amount you paid in 1991 for lights, water, garbage, sewer, and heating. Household assets include the assets of both spouses in the same household, as shown on the Household Assets Checklist, pages 8 and 10. This requirement doesn t apply if you or your spouse are age 65 or older. See pages 6, 8, and 10 for how to figure the value of your household assets. Special rules apply to some types of households. W hen should file Form 90R? File by April 15, 1992. W here do send Form 90R? Mail Form 90R with your 1991 Oregon income tax return. But don t staple Form 90R to your tax return. f you don t file an Oregon income tax return, mail your Form 90R to: REFUND PO B ox 14700 Salem OR 97309-0930 When will g e t m y check? The Oregon Department of Revenue will send out checks in late October 1992. Fraudulent claim s Filing a fraudulent claim is against the law. f you file a fraudulent Form 90R, you could be charged with a class C felony. You could be fined up to $100,000, serve a jail sentence, or both. n addition, you would have to pay back twice the amount of the claim, plus interest. Special cases Roomm ates. Each eligible renter in a household must file a separate Elderly Rental Assistance refund Form 90R and complete a Household Assets Checklist. Each renter s refund must be based on his or her own household income. Complete the rent schedule on Form 90R. Show in column 7 the total rent paid for the shared address(es) while you lived there and the total rent you actually paid in column 5. You must report all the rent you paid during the year. List the name(s) of the other renter(s) on the rent schedule. Don t list roommates who didn t contribute to the rent. Ju st m arried? Did you marry during 1991? f so, you must file Form 90R and complete the Household Assets Checklist with your spouse. Your household income includes both incomes for the entire year. nclude the total rent you and your spouse paid during 1991 on the rent schedule. This includes rent for places you rented separately and places you rented together. Filing for deceased persons. You can t file Form 90R for a deceased person. Clergy. Members of the clergy who live in housing provided by the church may be eligible for a refund. You may claim a refund if (1) you paid rent for the use of the housing, and (2) the property was subject to Oregon property tax. Your minister s rental allowance must be included in household income even though excluded from federal gross income. A partm ent m anagers. On the rent schedule on Form 90R, include only the rent you actually paid. Don t include the value of rent provided by your employer. Special living places Your Elderly Rental Assistance refund may depend on the kind of housing you live in. Q ualifications for ERA refund/3
Low incom e housing. You can claim a refund only on the rent you actually paid. Nursing hom e residents. f you lived in a nursing home, you may file for a renter s refund. Nursing home payments include medical care, however, not just rent. Generally, 20 percent of your total payment is considered rent, and 3 percent is considered fuel and utilities. We will accept a higher percentage only if you can show the higher percentage is correct. f you lived in a nursing home on December 31, 1991, while your spouse rented, each of you can file a separate Form 90R for a refund. You would file for a refund based on your nursing home rent. Your spouse would file a separate refund claim. You need only to show your own household income on the claim you file. f you lived in a nursing home on December 31, 1991 while your spouse owned a home, you would file for a refund based on your nursing home rent. Your spouse would not qualify for a refund. Room and board. Generally, 60 percent of your total payment is considered rent, and 10 percent is considered fuel and utilities. Retirem ent (re st) hom e o r cen ter. Generally, 60 percent of your total payment is considered rent, and 10 percent is considered fuel and utilities. Group hom es. Does your group home pay full property taxes? f so, usually you may claim 60 percent of your total room and board as rent, and 10 percent as fuel and utilities. s your group home exempt from property taxes? n that case, you can t file for Oregon s ERA refund program. Licensed trailers. f you lived in a licensed travel trailer that wasn t on the county property tax rolls, and you rented the land, you may claim the refund on the rent you actually paid. f you need help, see page 11 for numbers to call. You don t qualify for an ERA refund if you live in any of the following places: Cooperative housing corporation. Nonprofit home for the elderly. Mobile home you owned but you rented the land. Mobile home you rented but you owned the land. f you live in one of the above types of housing, you re considered a homeowner, not a renter. Form 90R instructions Address section Labels. f you received a label with this booklet, please use it on the ERA return you mail to the department. This will speed processing your return. Don t attach the label to your return until the return is completed. f som eone else p rep ares y o u r retu rn, ask them to use you r label. Make sure the label is correct. f it isn t, mark through the label and make corrections on it. f you don t have a label, print or type your name, address, and Social Security number on your return. Complete the address section even if Form 90R is being filed with an income tax form. f your address changes between the time you file and October 1992, please notify the Department of Revenue. See page 11 for numbers to call. Social Security number. The request for your Social Security number(s) is authorized by Section 405, Title 42, of the United States Code. You must give us this information. t will be used to establish your identity. Please send a copy of your Social Security card if your Social Security number or name has changed. Age. We need each spouse s age as of December 31, 1991, to check if you qualify for the Elderly Rental Assistance program and to see if you need to complete the Household Assets Checklist. Total household income Household incom e. Household income is the taxable and nontaxable income of husband and wife who live in the same household. t doesn t include your spouse s income if you were permanently living apart at the end of the year. t doesn t include income of your children, roommates, or any other person living with you other than your spouse. You can find some of your household income items on your federal return. Other amounts will come from your personal records. N onresidents and p art-year residents w ho lived in O regon in 1991- nclude all taxable and nontaxable income for the en tire year. nclude income from Oregon sources and income from sources outside of Oregon. Line instructions Note: nstructions are for lines not fully explained on the form. Work and investment income 1. W ages, salaries, and oth er pay for w ork. Fill in your total wages, salaries, commissions, tips, barter income, fees, and other pay for work. 2. nterest and dividends. Fill in your total taxable and nontaxable interest and dividends. Don t include return of capital dividends. Also don t include insurance policy (return of premium) dividends. 4/Living places, Form 90R instructions
3. Business n et incom e.* Fill in your net profit. Net profit is the combined income and losses on all your business schedules. This includes business partnerships and S corporations. Did you have a net business loss? f so, you can subtract up to $1,000 of the loss in figuring household income. Net operating loss carryovers and carrybacks can t be used to reduce household income. Refigure your Oregon income using Oregon depreciation, if necessary. 4. Farm n et incom e.* Fill in your net farm profit. Net farm profit is the combined income and losses on all your farm schedules. This includes farm partnerships and S corporations. f you had a net farm loss, you can subtract up to $1,000 of the loss in figuring household income. Net operating loss carryovers and carrybacks can t be used to reduce household income. Refigure your Oregon income using Oregon depreciation, if necessary. 5. Total gain on p rop erty sales. Fill in your total gain from any property sales: stocks, bonds, land, or other property. f you had a net loss, you can subtract up to $1,000 in figuring household income. Don t include any gain you deferred or excluded from the sale of your house. Did you sell property you placed in service after December 31, 1980, and before January 1, 1985? f so, you may need to refigure your gain for Oregon. Did you take the federal investment tax credit? f so, you may have a difference between Oregon basis and federal basis. You will need to refigure your gain or loss for the assets, using the Oregon basis. See page 11 for help. 6. Rental n et incom e.* Fill in your rental net income. Rental net income is the combined income or losses from all your rentals. This includes rental partnerships and S corporations. f you had a net loss, you can subtract up to $1,000 in figuring household income. Refigure your Oregon income using Oregon depreciation, if necessary. * Note for lines 3, 4, and 6: Does the combined total of your depreciation, depletion, and amortization deductions from all businesses exceed $5,000? f so, you must refigure these items, limiting your total deduction to $5,000. Exam ple: Manuel has a business which had gross income of $26,000 in 1991. He had a $9,000 depreciation deduction and other business expenses of $20,000. He reported a business loss for federal purposes of $3,000. The loss is limited to $1,000 for ERA purposes. nstead of adding the $4,000 excess depreciation back to his $1,000 ERA loss, he recomputes his business income for ERA. With a depreciation deduction of $5,000, the business income he reports for ERA purposes is $1,000 ($26,000 - ($20,000 + $5,000) = $1,000). 7. O ther ncom e from you r federal retu rn. Fill in any other taxable income you received in 1991 that is on your federal return. This includes: Alimony received (Form 1040, line 11). Bonuses, prizes, lottery winnings (including Oregon lottery winnings), and other income from federal Form 1040, line 22. dentify the other income. Don t include your: State income tax refund. Oregon property tax refund. Unemployment benefits. Your unemployment benefits go on line 13- Retirement income 9. Social Security, Supplem ental Security ncom e (SS), and Railroad R etirem ent. Fill in the total Social Security (taxable and nontaxable), SS, and Railroad Retirement you got in 1991. nclude Medicare premiums for 1991. Don t include reimbursed medical expenses. nclude any amounts you received in your name from Social Security for the benefit of a minor child. 1 0. Pensions and annuities. Fill in the total pension and annuity income you got in 1991. Don t include your contribution to the plan. You should have a statement (1099-R) from the payer that shows your contribution. Other income 1 2. Adult and Fam ily Services (w elfare). Fill in the total amount of welfare you received. nclude aid to the blind and disabled and old age assistance. Also include Aid to Dependent Children (but not the Special Shelter Allowance). You should have received a notice from Adult and Family Services that shows the amount you received. Don t include: Amounts for food stamps or surplus foods. Payments for medical care, drugs, medical supplies, and services related to medical care for which you received no direct payment. n-home services approved by the Department of Human Resources. Reimbursement of expenses from participating in work or training programs. 1 3. Unem ploym ent benefits. Fill in your total unemployment benefits for 1991. 1 4. V eteran s and m ilitary benefits. Fill in your veteran s benefits, G Bill benefits, family allowances, and educational allowances. 1 5. Gifts and gran ts. Add together all of your gifts, grants, and scholarships. Fill in the total in excess of $500. This also includes gifts and grants from a foreign country. Don t include federal grants to improve your home. ERA line instructions/5
Exam ple: You receive a $600 gift and a $300 state grant during the year. You must include $400 in your household income: Gift $600 Grant 300 Total received $900 Less - 500 nclude in household income $400 16. O ther sou rces. Fill in amounts from any other sources of household income, including: Child support. Minister s rental allowance. Foreign earned income. Disability pay. Life insurance proceeds. Personal injury damages. Strike benefits. Workers compensation. Accident and health insurance payments. Total inheritances. Anything that changed owners because of death. t may be cash or the value of property. Figure the value as the amount you d get if the property were sold on the date of death. Don t include property you received because of the death of your spouse. 19. Adjustments to incom e. Did you file federal Form 1040? f so, fill in the amount from line 30. f you filed federal Form 1040A, fill in the amount from line 15c. f you filed federal Form 1040EZ, fill in -0-. Total household assets 2 1. Household assets. f you and your spouse are both under age 65, you must meet the household assets test. The total value of the household assets of both you and your spouse must not exceed $25,000 to qualify for an ERA refund. This is true even if you meet the household income test. You m ust com plete the Household Assets Checklist on th e back o f your Form 90R. Household assets defined Household assets include the fair market value (as of December 31, 1991) of the following items: Real property. Tangible p erson al p rop erty used in a trade or business in which you are an owner. Examples are an automobile used in your business or your office equipment. Examples of tangible personal property to be included on the others line are inventory and your percentage of partnership assets. ntangible personal property, such as money on hand, shares of stock, money owed to you by others, and funds on deposit. Don t include the value of retirement plans. f the total fair market value of these assets as of December 31, 1991, exceeds $25,000, you don t qualify for an ERA refund. However, if you or your spouse are age 65 or older, you aren t required to meet the household assets test. Qualifying rent 2 2. Total Oregon ren t you paid for 1991. Complete the rent schedule on the form. Fill in the Oregon rent you paid in 1991. nclude all rent you paid for each residence rented in 1991. Rent doesn t include advance rent or deposits for keys, cleaning, or security. f you are a mobile home renter, claim rent actually paid for both your mobile home and space. 23. Total O regon ren t paid by the household for 1991. Fill in the total household rent. nclude rent for each residence rented in 1991. Rent doesn t include advance rent or deposits for keys, cleaning, or security. 24. Special Shelter Allowance (ADC). Did you get a Special Shelter Allowance from Adult and Family Services (welfare)? f you did, you ll get a card showing the amount of your Special Shelter Allowance. Fill in the amount from the card on this line. This allowance is the ERA refund amount you ve already received as welfare. 25. Fuel and utilities. nclude the amount you paid in 1991 for lights, water, garbage, sewer, and heating. Don t include telephone or cable television as utilities. Nursing hom e, retirem ent hom e, o r group hom e. f you paid rent to a nursing home, retirement (rest) home, or group home, check the box that applies. Generally, a nursing home provides medical care. Retirement and group homes don t. Refund w orksheet. The Oregon Department of Revenue will figure your refund for you. We ve included an ERA refund worksheet if you want to figure what your refund will be. The worksheet is on page 11. Your refund will be on line 9 of the worksheet. Sign the form Be sure to sign and date Form 90R on the back. Both spouses must sign the form when a joint claim is filed. Remember... to g e t your refund You or your spouse must be age 58 or older on December 31, 1991. You m ust completely fill in the rent schedule. f you and your spouse are both under age 65, you m ust also complete the Household Assets Checklist. Always fill in your age and your spouse s age at the top of the form. f your return is incomplete, it will be sent back to you. 6/H ousehold assets
FORM 90R OREGON RENTAL USE LA B E L Last name r ELDERLY ASSSTANCE First name and initial 1991 n For o ffice use only Date received Social Security number (SSN) Your age Spouse s last name if different Spouse s first name and initial Spouse's Social Security number Spouse s age Otherwise, please print or type. Mailing address Check here if this address is different from the one shown on your 1990 HARRP return. city _ State ZP Code Telephone number For office use only 1 2 3 WORK AND NVESTMENT NCOME --------------------- ------- 1 Wages, salaries, and other pay for work... 1 ----------------------------- 2 nterest and dividends (total taxable and nontaxable)... 2 ----------------------------- 3 Business net income (loss limited to $ 1,0 0 0 )... 3 ----------------------------- 4 Farm net income (loss limited to $ 1,0 0 0 )... 4 ----------------------------- 5 Total gain on property sales (loss limited to $1,000)... 5 ----------------------------- 6 Rental net income (loss limited to $ 1,0 0 0 )... 6 ----------------------------- 7 Other income from your federal return. d e n tify 7 ----------------------------- 8 Add lines 1 through 7...... 8 RETREMENT NCOME 9 Social Security, Supplemental Security ncome (SS), Railroad Retirement (total for 1 9 9 1 )... 9 10 Pensions and annuities (total taxable and nontaxable received during 1991)... 10 11 Add lines 9 and 1 0... OTHER NCOME 12 Adult and Family Services (w e lfa re )... 13 Unemployment benefits... 14 Veteran's and military benefits... 15 Gifts and grants: Total amount m inus $500... 16 Other sources: dentify...... 17 Add lines 12 through 1 6... 18 Add lines 8,11, and 1 7... 19 Adjustments to income from federal Form 1040, line 30 or federal Form 1040A, line 1 5 c... 20 YOUR TOTAL HOUSEHOLD NCOME. Line 18 minus line 19. f your household income is $10,000 or more, STOP HERE! You don t qualify for an ERA refund... 21 YOUR TOTAL HOUSEHOLD ASSETS. See checklist on the back of this form. f your household assets exceed $25,000, and you are under age 65, STOP HERE! You don t qualify for an ERA refund... 19 21 20 QUALFYNG RENT 22 Total Oregon rent you paid for 1991, from column 5 of rent schedule (see back of fo rm )... 23 Total Oregon rent paid by the household, from column 7 of rent schedule (see back of form).. 24 Special Shelter Allowance (Aid to Dependent Children)...* 25 Total fuel and utilities only (not telephone). DON T NCLUDE RENT HERE... 22 23 24 25 Check the box if you paid rent to a: CD nursing home [H retirement (rest) home CD group home RENT SCHEDULE List the places vou rented in Oregon and the rent you paid for 1991. Attach additional schedules if necessary. Your address: Street, City, State, ZP code A (1) First and last name of each roommate at this address (2) Landlord s name, address, and telephone B 150-545-001 (9-91) NOW GO TO THE BACK OF THE FORM
Page 2 - Form 90R 1991 RENT SCHEDULE (Continued from Page 1) (3) 1991 Rental period for each (4) (5) (6) (7) address listed on page 1 Rent you paid per month Total rent you paid Household rent per month Total rent paid by household A From / To B From / To TOTAL RENT FOR 1991. Fill in the total here.. (5)......... (7) 1991 HOUSEHOLD ASSETS CHECKLST Complete this checklist if you and your spouse are both under age 65. Use Fair Market Value as of December 31,1991. *12345 A. Real property B. Tangible personal property used in a trade or business in which you or your spouse have an ownership in te re s t... ] 1 1 t A t ti y c tl F h F C. ntangible personal property. ncludes but isn t limited to: 1. Money owed to you: a. personal or business notes receivable...... b. others (identify) 2. Funds on deposit: a. funds accruing due to death of the insured where withdrawal is at your o p tio n... b. funds accruing due to original maturity of a policy contract where withdrawal is at your option 3. Money on deposit: a. checking or savings account... b. certificates of d e p o s it... c. others (identify) 4. Money on hand: a. currency and bills of exchange... b. others (identify) 5. Shares of stock: a. capital, common, and preferred... b. shares in mutual funds and investment trusts... c. others (identify) TOTAL HOUSEHOLD ASSETS (add together all boxes) Enter here and on line 21 Under penalties for false swearing, declare that have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief it is true, correct and complete. f prepared by a person other than taxpayer, this declaration is based on all information of which the preparer has any knowledge. SGN HERE Your signature Date Signature of preparer other than taxpayer License No. Spouse's signature (f filing jointly, BOTH must sign) Address 6 Mail your 90R to : REFUND, PO BOX 14700, Salem, OR 97309-0930 REFUNDS WLL BE MALED N OCTOBER 1992
FORM 90R OREGON RENTAL USE LA B E L Last name T ELDERLY ASSSTANCE First name and initial 1991 n For o ffice use only Date received Social Security number (SSN) Your age Spouse s last name if different Spouse s first name and initial Spouse s Social Security number Spouse's age ) j Otherwise, please print or type. Mailing address " Check here if this address is different from the one shown on your 1990 HARRP return. Q ] C ity L State ZP Code j Telephone number For office use only WORK AND NVESTMENT NCOME 1 Wages, salaries, and other pay for work... 2 nterest and dividends (total taxable and nontaxable) 3 Business net income (loss limited to $ 1,0 0 0 )... 4 Farm net income (loss limited to $ 1,0 0 0 )... 5 Total gain on property sales (loss limited to $1,000) 6 Rental net income (loss limited to $ 1,0 0 0 )... 7 Other income from your federal return. dentify 8 Add lines 1 through 7...... 1 2 3 RETREMENT NCOME 9 Social Security, Supplemental Security ncome (SS), Railroad Retirement (total for 1991)...» 9 10 Pensions and annuities (total taxable and nontaxable received during 1991)... 1 0 11 Add lines 9 and 1 0... 11 OTHER NCOME 12 Adult and Family Services (w e lfa re )... 1 2 13 Unemployment benefits... 1 3 14 Veteran's and military benefits... 1 4 15 Gifts and grants: Total amount m inus $500... 15 16 Other sources: dentify...... 16 17 Add lines 12 through 1 6... :...... 17 18 Add lines 8,11, and 1 7... 18 19 Adjustments to income from federal Form 1040, line 30 or federal Form 1040A, line 1 5 c... 1 9 20 YOUR TOTAL HOUSEHOLD NCOME. Line 18 minus line 19. f your household income is $10,000 or more, STOP HERE! You don t qualify for an ERA refund... 9... 20 21 YOUR TOTAL HOUSEHOLD ASSETS. See checklist on the back of this form. f your household assets exceed $25,000, and you are under age 65, STOP HERE! You don t qualify for an ERA refund... 2 1 QUALFYNG RENT 22 Total Oregon rent you paid for 1991, from column 5 of rent schedule (see back of fo rm )... 23 Total Oregon rent paid by the household, from column 7 of rent schedule (see back of form).. 24 Special Shelter Allowance (Aid to Dependent Children)...9. 25 Total fuel and utilities only (not telephone). DON T NCLUDE RENT HERE.... 22 23 24 25 Check the box if you paid rent to a: EH nursing home d l retirement (rest) home CH group home RENT SCHEDULE List the places you rented in Oregon and the rent you paid for 1991. Attach additional schedules if necessary. Your address: Street, City, State, ZP code A (1) First and last name of each roommate at this address (2) Landlord s name, address, and telephone B 150-545-001 (9-91) NOW GO TO THE BACK OF THE FORM
Page 2 - Form90R 1991 RENT SCHEDULE (Continued from Page 1) (3)1991 Rental period for each (4) (5) (6) (7) address listed on page 1 Rent you paid per month Total rent you paid Household rent per month Total rent paid by household A From / To B From / To TOTAL RENT FOR 1991. Fill in the total here ^ (5) (7) 1991 HOUSEHOLD ASSETS CHECKLST Complete this checklist if you and your spouse are both under age 65. Use Fair Market Value as of December 31,1991. *12345 A. Real property... B. Tangible personal property used in a trade or business in which you or your spouse have an ownership in te re s t... C. ntangible personal property. ncludes but isn t limited to: 1. Money owed to you: a. personal or business notes receivable... b. others (identify) 2. Funds on deposit: a. funds accruing due to death of the insured where withdrawal is at your o p tio n... b. funds accruing due to original maturity of a policy contract where withdrawal is at your option 3. Money on deposit: a. checking or savings account... b. certificates of d e p o s it... 4... c. others (identify) 4. Money on hand: a. currency and bills of exchange...... b. others (identify) 5. Shares of stock: a. capital, common, and preferred... b. shares in mutual funds and investment trusts... c. others (identify) TOTAL HOUSEHOLD ASSETS (add together all boxes) Enter here and on line 21 Under penalties for false swearing, declare that have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief it is true, correct and complete. f prepared by a person other than taxpayer, this declaration is based on all information of which the preparer has any knowledge. SGN HERE Your signature Date Signature of preparer other than taxpayer License No. Spouse's signature (f filing jointly, BOTH must sign) Address Mail your 90R to : REFUND, PO BOX 14700, Salem, OR 97309-0930 REFUNDS WLL BE MALED N OCTOBER 1992
ERA Refund Worksheet 1. Rent. 2. Fuel and utilities. 3. Total. Add lines 1 and 2. 4. Limit. 2,100 5. Lesser of line 3 or 4. 6. Household income. 7. Percentage. 20% 8. Multiply line 6 by line 7. Enter here. 9- ERA refund. Line 5 minus line 8. Taxpayer assistance The Oregon Department of Revenue will provide you with forms. But we can t fill out your forms for you. To get forms, write to: Forms, Oregon Department of Revenue, PO Box 14999, Salem OR 97309-0990. Addresses Oregon Department of Revenue offices that provide forms and answer questions: Main Office, Salem* Revenue Building First floor, Room 135 955 Center St. NE Salem OR 97310 Portland** Federal Building Lobby 1220 SW Third Ave. Portland OR 97204 8 a.m. - 4:45 p.m. Monday-Friday, except holidays. "W e ll provide walk-in help on the same schedule as the nternal Revenue Service. January 2-April 15 only. Printed inform ation (free) (Check individual boxes to order. Clip on the dotted line, then mail in the entire list with your return address.) Art Contribution Subtraction Computing nterest: Tax You Owe Credit for ncome Taxes Paid to Other States Crop Gleaning Credit and Oregon Seafood Credit Estimated Tax Health nsurance Home Care for the Elderly Credit Married Persons Filing Separate Returns Military Personnel Filing nformation Oregon ncome Tax Withholding: Some Special Cases 150-101-642 150-800-691 150-101-646 150-101-686 150-101-648 150-101-698 150-101-653 150-101-656 150-101-657 150-206-643 Telephone numbers H ours: 8 a.m. - 4 :4 5 p.m. Monday-Friday, except 9 a.m. - 4:45 p.m. Wednesday. Closed on holidays. Questions? For assistance, call the Oregon Department of Revenue. These numbers are toll-free from January 2, 1992, to April 30, 1992. From Portland numbers 243-2833 From Salem numbers 378-4988 From elsewhere in Oregon 1-800-356-4222 After April 30, call Salem 1-378-4988. There will be no toll-free number after April 30. From outside o f O regon, call Salem (503) 378-4988 at all times (not toll-free). H earing o r speech im paired? We have a separate number, (503) 373-1826, that you may use if you have a TDD. This number is answered only by machine and is not for voice use. n Political Contributions (limit 100) 150-101-662 Retirement ncome 150-101-673 Your Rights as an Oregon Taxpayer 150-800-406 Send to: Please print Your name Address City State Form s O regon D epartm ent o f Revenue PO B ox 14999 Salem OR 97309-0990 ZP 150-545-002 (12-91) ERA refund w o rksh eet/11
O regon D epartm ent of Revenue 955 Center St. NE Salem OR 97310 BULK RATE U.S. POSTAGE PAD SALEM. OREGON PERMT NO. 55 Contains Recycled Material