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5           2022 Form OR-41                                                                                                                               Office use only                     5
6           Page 1 of 4, 150-101-041                           Oregon Department of Revenue                            00472201010000                Date received                            6
7           (Rev. 08-01-22, ver. 01)                                                                                                                 •                                        7
8           Oregon Fiduciary Income Tax Return                                                                                                       Payment                                  8
9                                                                                                                                                                                             9
10                                                                                                                                                   Penalty date                             10
11                                                                   Submit original form—do not submit photocopy                                                                             11
12                                            Fiscal year            Month Day   Year                                    Month  Day       Year       1                                        12
13          • X      Amended                beginning:•              99/99/9999/ /                            •Ending:   99/99/9999/ /               •                                        13
14                   return                                                                                       • Trust or estate federal employer identification number (FEIN)             14
15                •  If amending for a net operating loss (NOL),     Month Day   Year                             99-9999999–                        •   X   Check if new FEIN                15
16                   period end date the NOL was generated:                                                                                                                                   16
                                                                     99/99/9999/ /
17                                                                                                                                                                                            17
18          • Trust or estate name —print clearly or type                                                         •    X New name              •  X    Extension to file                      18
19                                                                                                                                                                                            19
            XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
20          • Executor or trustee name                                                                            •    X New name              •  X    Form OR-24 is                          20
21          XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX                                                                                                        included                               21
22          • Title (TTEE or PR)                                                                                                                                                              22
23                                                                                                                                                                                            23
            XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
24          • Street address or PO Box                                                                            •    X New address                                                          24
25                                                                                                                                                                                            25
26          •XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXCity                 •State         •ZIP code                                   Phone                                                         26

27          XXXXXXXXXXXXXXXXXXXXX                                    XX             XXXXX-XXXX                                  (999)( )     999-9999–                                        27
28                • A. Check only one box:                                          B. This is:                        • C. Check one box:           • D. If exempt organization,             28
29          X     An estate—date of death:   99/99/9999/         /                                                                                     check federal form filed:              29
30                Decedent SSN:        999-99-9999–  –                              • X                       A first     X  An Oregon resident                                               30
31                                                                                                            return                                   X  990-T—Specify                       31
32          X     A bankruptcy estate  X   A funeral trust           X     A trust                                        X  A nonresident                your due date:                      32
33                                                                                  • X                       A final                                     99/99/9999/             /           33
34          X     A trust filing as an estate. Include federal Form 8855.                                     return     X   A part-year trust (use    X  Other—Specify:                      34
35                Date of death: 99/99/9999/ /                                                                               Schedule OR-SCH-P            XXXXXXXXXXX                         35
36                Decedent SSN:        999-99-9999–  –                                                                       to compute the tax)                                              36
37          Complete this form by beginning with page 3, Schedules 1 and 2. Include a copy of federal Form 1041, Schedule                                                                     37
38          K-1s, applicable schedules, 1099s, and W-2s.                                                                                                                                      38
39                                                                                                                     Beneficiary column               Fiduciary column                      39
40            1.  Revised distributable net                                                                                                                                                   40
41              income from Form OR-41,                                                                                                                                                       41
42              Schedule 1, line 4 .................. •          1.  99,999,999,999.00.00                                                                                                     42
43            2.  Distribution deduction (see instructions) ................................. •               2.  99,999,999,999.00.00                                                        43
44              a.  Tax-exempt income                                                                                                                                                         44
45                   deducted in computing                                                                                                                                                    45
46                   line 2 .................................. • 2a. 99,999,999,999.00.00                                                                                                     46
47              b.  Add lines 2 and 2a ............ • 2b.            99,999,999,999.00.00                                                                                                     47
48            3.  Percentage (line 2b divided by line 1) ...............   •    3. 999.9999.                      %   (Round to four decimal places)                                          48
49            4.  Revised taxable income of fiduciary from Form OR-41, Schedule 1, line 7 .......................... •                         4. 99,999,999,999.00.00                        49
50            5.  Fiduciary adjustment from Form OR-41, Schedule 2,                                                                                                                           50
51              line 19 (enter as a positive, whole number).                                                                                                                                  51
52              Indicate whether it should be:                                                                                                                                                52
53                                                                                                                                                                                            53
54                •   X   Added  or        •  X                Subtracted ........................... •       5.  99,999,999,999.00.00                                                        54
55                                                                                                                                                                                            55
56              a.   Beneficiary’s share (line 5 × percent on line 3 —see                                                                                                                     56
57                   instructions) ........................................................................ • 5a. 99,999,999,999.00.00                                                        57
58              b.  Fiduciary’s share (line 5 minus line 5a) ............................................................................ •  5b.     99,999,999,999.00.00                     58
59            6.  Income to be reported by beneficiaries (Form 1041,                                                                                                                          59
60              Schedule K-1 included—see instructions; total or net of                                                                                                                       60
61              lines 2 and 5a) ......................................................................... •   6.  99,999,999,999.00.00                                                        61
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71           2022 Form OR-41                                                                                                                                                                                  71
72           Page 2 of 4, 150-101-041          Oregon Department of Revenue 00472201020000                                                                                                                    72
73           (Rev. 08-01-22, ver. 01)                                                                                                                                                                         73
74           Estate or trust name                                                                                                                                    FEIN                                     74
75                                                                                                                                                                                                            75
             XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX                                                                                                                     99-9999999–
76                                                                                                                                                                                                            76
77             7.  Oregon taxable income of fiduciary (total or net of lines 4 and 5b)   .................................... •                       7.             99,999,999,999.00.00                     77
78                                                                                                                                                                                                            78
79                                                                                                                                                                                                            79
80           Oregon tax                                                                                                                                                                                       80
81             8.  Tax using rate schedule on page 3, or from Schedule OR-SCH-P, line 11 .......................... •                                 8.             99,999,999,999.00.00                     81
82             9.  Reduced-rate tax amount and qualifying source(s)............................................................... •                  9.             99,999,999,999.00.00                     82
83                                                                                                                                                                                                            83
84                •  9a.   X      NLTCG •  9b.   X PTE                                                                                                                                                        84
85                                                                                                                                                                                                            85
86            10.  Total tax (add lines 8 and 9) .................................................................................................. • 10.            99,999,999,999.00.00                     86
87                                                                                                                                                                                                            87
88                                                                                                                                                                                                            88
89           Standard and carryforward credits                                                                                                                                                                89
90            11.  Total standard credits from Schedule OR-ASC-FID, Section 3 ............................................ •                          11.            99,999,999,999.00.00                     90
91            12. Tax minus standard credits (line 10 minus line 11; if line 11 is more than line 10, enter 0) .... •                                 12.            99,999,999,999.00.00                     91
92            13.  Total carryforward credits from Schedule OR-ASC-FID, Section 4 ...................................... •                            13.            99,999,999,999.00.00                     92
93            14.  Tax after standard and carryforward credits (line 12 minus line 13) ..................................... •                        14.            99,999,999,999.00.00                     93
94                                                                                                                                                                                                            94
95                                                                                                                                                                                                            95
96           Payments and refundable credits                                                                                                                                                                  96
97            15.  Oregon income tax withheld (include Forms 1099 or W-2) ................................................... •                       15.            99,999,999,999.00.00                     97
98            16. Payments with OR-18-WC or OR-19 (don’t include copies of Forms OR-18-WC or OR-19) ... •                                             16.            99,999,999,999.00.00                     98
99            17.  Payments prior to filing your return. Include any extension payment made ......................... •                               17.            99,999,999,999.00.00                     99
100           18.  Reserved ...................................................................................................................................  18.                                          100
101           19.  Total refundable credits from Schedule OR-ASC-FID, Section 5 ......................................... •                           19.            99,999,999,999.0099,999,999,999.00.00.00 101
102           20.  Total payments and refundable credits (add lines 15 through 19) ........................................ •                         20.            99,999,999,999.00.00                     102
103                                                                                                                                                                                                           103
104                                                                                                                                                                                                           104
105          Tax to pay or refund                                                                                                                                                                             105
106           21. Tax due. Is line 14 more than line 20? If so, line 14 minus line 20 ...................... Tax due               •                  21.            99,999,999,999.00.00                     106
107           22. Overpayment. Is line 20 more than line 14? If so, line 20 minus line 14 .... Overpayment                         •                  22.            99,999,999,999.00.00                     107
108           23.  Penalty for filing or paying late (see instructions) .................................................................. •          23.            99,999,999,999.00.00                     108
109           24.  Interest due with this return (see instructions) ....................................................................... •         24.            99,999,999,999.00.00                     109
110           25. Total due (line 21 plus lines 23 and 24) ............................................................. Total due •                  25.            99,999,999,999.00.00                     110
111           26. Refund (line 22 minus lines 23 and 24) (see instructions) ......................................       Refund    •                  26.            99,999,999,999.00.00                     111
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136                                                                                                                                                                             136
137          2022 Form OR-41                                                                                                                                                    137
138          Page 3 of 4, 150-101-041        Oregon Department of Revenue                          00472201030000                                                               138
139          (Rev. 08-01-22, ver. 01)                                                                                                                                           139
140          Estate or trust name                                                                                                                          FEIN                 140
141                                                                                                                                                                             141
             XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX                                                                                                           99-9999999–
142                                                                                                                                                                             142
143           Schedule 1  —Oregon changes to distributable net income (DNI) and taxable income of fiduciary (TIF)                                                               143
144                                                                                                (Column A)                                                   (Column B)      144
145                                                                                                DNI                                                          TIF             145
146                                                                                                                                                                             146
147            1.  Distributable net income (see instructions) ...... •                    1. 99,999,999,999.00.00                                                              147
148            2.  Taxable income of fiduciary (see instructions) ...................................................................... •             2.  99,999,999,999.00.00 148
149            3. • Other changes. Identify:                                                                                                                                    149
150               XXXXXXXXXXXXXXXXXXXXXXX _____________________________________ •          3. 99,999,999,999.00.00               •                     3.  99,999,999,999.00.00 150
151            4.  Revised distributable net income (column A,                                                                                                                  151
152             line 1 plus line 3); enter here and on page 1,                                                                                                                  152
153             line 1 ................................................................. • 4. 99,999,999,999.00.00                                                              153
154            5.  Total taxable income (column B, line 2 plus line 3) ............................................................... •               5.  99,999,999,999.00.00 154
155            6.  Changes included on column A, line 3, that were distributed ............................................... •                       6.  99,999,999,999.00.00 155
156            7.  Revised taxable income of fiduciary (line 5 minus 6); enter here and on page 1, line 4 ........ •                                   7.  99,999,999,999.00.00 156
157                                                                                                                                                                             157
158                                                                                                                                                                             158
159                                          Schedule 2  —Fiduciary adjustment (see instructions)                                                                               159
160           Subtractions                                                                                                                                                      160
161            8.  2022 federal income tax subtraction  (see instructions, 0 to $7,250)..................................... •                         8.  99,999,999,999.00.00 161
162            9.  Interest on U.S. obligations included in income on federal Form 1041 net of                                                                                  162
163             allocable administration and miscellaneous expenses ......................................................... •                        9.  99,999,999,999.00.00 163
164           10.  Oregon income tax refund included as income on federal Form 1041 ................................. •                                10. 99,999,999,999.00.00 164
165           11.  Total other subtractions from Schedule OR-ASC-FID, Section 2 ......................................... •                            11. 99,999,999,999.00.00 165
166           12.  Add lines 8 through 11 .......................................................................................................... • 12. 99,999,999,999.00.00 166
167                                                                                                                                                                             167
168                                                                                                                                                                             168
169           Additions                                                                                                                                                         169
170           13.  Oregon income tax deducted on 2022 federal Form 1041 ................................................... •                          13. 99,999,999,999.00.00 170
171           14.  Interest on obligations of other states or their political subdivisions .................................... •                      14. 99,999,999,999.00.00 171
172           15.  Depletion in excess of adjusted basis ................................................................................... •         15. 99,999,999,999.00.00 172
173           16.  Estate taxes on income in respect to a decedent not taxable by Oregon ............................ •                                16. 99,999,999,999.00.00 173
174           17.  Total other additions from Schedule OR-ASC-FID, Section 1 .............................................. •                          17. 99,999,999,999.00.00 174
175           18.  Add lines 13 through 17 ........................................................................................................ •  18. 99,999,999,999.00.00 175
176           19.  Fiduciary adjustment (difference between lines 12 and 18; enter as a positive, whole                                                                         176
177             number). Indicate whether it should be: ................................................................................ •             19. 99,999,999,999.00.00 177
178                                                                                                                                                                             178
179               •  X     Added  or  •  X   Subtracted. Enter amount on page 1, line 5.                                                                                        179
180                                                                                                                                                                             180
181                                                                                                                                                             Go to page 1    181
182                                                                                                                                                                             182
183                                                                                                                                                                             183
184                                   2022 rate schedule—compute the tax using the following rates (see instructions)                                                           184
185                               If your taxable income is: ......................................Your tax is:                                                                 185
186                               Not over $3,750 .......................................................4.75% of taxable income                                                186
187                               Over $3,750 but not over $9,450 .............................$178 plus 6.75% of the excess over $3,750                                        187
188                               Over $9,450 but not over $125,000 .........................$563 plus 8.75% of the excess over $9,450                                          188
189                               Over $125,000 .........................................................$10,674 plus 9.9% of the excess over $125,000                          189
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202                                                                                                                                                              202
203          2022 Form OR-41                                                                                                                                     203
204          Page 4 of 4, 150-101-041       Oregon Department of Revenue            00472201040000                                                               204
205          (Rev. 08-01-22, ver. 01)                                                                                                                            205
206          Estate or trust name                                                                  FEIN                                                          206
207                                                                                                                                                              207
             XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX                                                   99-9999999–
208                                                                                                                                                              208
209          Under penalty of false swearing, I declare that the information in this return and any included forms or statements is true, correct, and complete. 209
210          Executor or trustee signature                               Print name                                                                              210
211          X                                                           XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX                                                     211
212          Title (if applicable)                                                  Phone               Date                                                     212
213                                                                                                                                                              213
             XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX                                    ((999))999-9999–    99/99/9999/ /
214                                                                                                                                                              214
215          • X Check the box to authorize the following individual(s) to receive and provide confidential tax information relating to this return.             215
216                                                                                                                                                              216
217          Preparer name (print)                                       Title                       •  Preparer license number                                  217
218                                                                                                                                                              218
219          XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXPreparer mailing address XXXXXXXXXXXXXXXXXXCity      XXXXXXXXXXState ZIP code                                    219
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221          XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXPreparer signature       XXXXXXXXXXXXXXXXXXXXX Phone XX Date XXXXX-XXXX                                          221

222          X                                                                      ((999))999-9999–    99/99/9999/ /                                            222
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224                                         See instructions for mailing addresses.                                                                              224
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