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5           2022 Schedule OR-PTE-NR                                                                                                                Office use only        5
6           Page 1 of 2, 150-101-367                    Oregon Department of Revenue                            18142201010000                                            6
7           (Rev. 08-11-22, ver. 01)                                                                                                                                      7
8           Qualified Business Income Reduced                                                                                                                             8
9           Tax Rate Schedule for Oregon Nonresidents                                                                                                                     9
10                                                                                                                                                                        10
11                                                         Submit original form—do not submit photocopy                                                                   11
12          First name                          Initial    Last name                                                                    Social Security number (SSN)      12
13          XXXXXXXXXXXX                        X          XXXXXXXXXXXXXXXXXXXX                                                         999-99-9999– –                    13
14          Spouse first name (if joint return) Initial    Spouse last name                                                             Spouse SSN                        14
15                                              X          XXXXXXXXXXXXXXXXXXXX                                                         –    –                            15
            XXXXXXXXXXXX                                                                                                                999-99-9999
16          To qualify for the reduced tax rate, you must complete both sections and submit this form with your Oregon Form OR-40-N.                                      16
17                                                                                                                                                                        17
18          Section A—Qualifying business information                                                                                                                     18
19          Complete Section A to determine if you qualify for the reduced tax rate. List each qualifying sole proprietorship (SP), S corporation                         19
20          (SC), or partnership (P) along with the business code number (or NAICS code), Oregon PTE-E tax deducted, number of qualifying                                 20
21          employees, entity type, nonpassive income (or loss), and Section 179 expenses attributable to each qualifying business (for S                                 21
22          corporations and partnerships only). Only list businesses that qualify. See instructions for more information.                                                22
23                                                                                                                                                                        23
24          1. Qualifying business name                                                                    FEIN           Business code no.  No. of qualifying employees  24

25             XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 99-9999999–                                                            9999999999               999,999,999            25
26             Entity type:                                a. Nonpassive loss                              b. Section 179 expense            c. Nonpassive income         26
27             XX      (SP, SC, or P only)      99,999,999,999.00.00                                       99,999,999,999.00.00         99,999,999,999.00.00              27
28                                                                                                                                                                        28
29             d. Oregon PTE-E tax deducted                                                                                                                               29
30                                                                                                                                                                        30
               99,999,999,999.00.00
31                                                                                                                                                                        31
32          2. Qualifying business name                                                                    FEIN           Business code no.  No. of qualifying employees  32

33             XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 99-9999999–                                                            9999999999               999,999,999            33
34             Entity type:                                a. Nonpassive loss                              b. Section 179 expense            c. Nonpassive income         34
35             XX      (SP, SC, or P only)      99,999,999,999.00.00                                       99,999,999,999.00.00         99,999,999,999.00.00              35
36                                                                                                                                                                        36
37             d. Oregon PTE-E tax deducted                                                                                                                               37
38                                                                                                                                                                        38
               99,999,999,999.00.00
39                                                                                                                                                                        39
40          3. Qualifying business name                                                                    FEIN           Business code no.  No. of qualifying employees  40

41             XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 99-9999999–                                                            9999999999               999,999,999            41
42             Entity type:                                a. Nonpassive loss                                 b. Section 179 expense         c. Nonpassive income         42
43             XX      (SP, SC, or P only)      99,999,999,999.00.00                                       99,999,999,999.00.00         99,999,999,999.00.00              43
44                                                                                                                                                                        44
45             d. Oregon PTE-E tax deducted                                                                                                                               45
46                                                                                                                                                                        46
               99,999,999,999.00.00
47                                                                                                                                                                        47
48          4. Total for each column                    a. Nonpassive loss total                           b. Section 179 expense total   c. Nonpassive income total      48
49             (a), (b), (c), and (d):          99,999,999,999.00.00                                       99,999,999,999.00.00         99,999,999,999.00.00              49
50                                                                                                                                                                        50
51             d. Oregon PTE-E tax deducted                                                                                                                               51
52                                                                                                                                                                        52
               99,999,999,999.00.00
53                                                                                                                                                                        53
54          5.  Add lines 4c and 4d ................................................................ 5.    99,999,999,999.00.00                                           54
55                                                                                                                                                                        55
56          6.  Add lines 4a and 4b ................................................................ 6.    99,999,999,999.00.00                                           56
57                                                                                                                                                                        57
58          7.  Line 5 minus line 6 ................................................................... 7. 99,999,999,999.00.00                                           58
59                                                                                                                                                                        59
60          If line 7 is 0 or less, you can’t use the reduced tax rate. Return to the Form OR-40-N, line 46, and complete the rest of the form. If line                   60
61          7 is more than 0, enter this amount on line 2b of the Tax worksheet in Section B on page 2.                                                                   61
62                                                                                                                                                                        62
63                                              —You must include this schedule with your Oregon Form OR-40-N—                                                            63
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             2022 Schedule OR-PTE-NR
72           Page 2 of 2, 150-101-367              Oregon Department of Revenue                                    18142201020000                                                                             72
73           (Rev. 08-11-22, ver. 01)                                                                                                                                                                         73
74           Section B—Tax worksheet                                                                                                                                                                          74
75           Complete each applicable line to determine your tax. See the instructions for more information.                                                                                                  75
76                                                                                                                                                                                                            76
77             1.  Enter Oregon taxable income from Form OR-40-N, line 45 ........1a.                              99,999,999,999.00.00                                                                       77
78             2.  Enter the total qualifying income from Section A, line 7 .....................................................................................2b.                     99,999,999,999.00.00 78
79             3.  Line 1a minus line 2b. Don’t enter less than 0 .............................3a.                 99,999,999,999.00.00                                                                       79
80             4.  Enter the amount on lines 4a and 4b of the depreciation addition                                                                                                                           80
81               from Form OR-40-N, line 30S that is attributable to the qualifying                                                                                                                           81
82               businesses ...................................................................................4a. 99,999,999,999.00.00 4b.                                              99,999,999,999.00.00 82
83             5.  Line 3a minus line 4a. Don’t enter less than 0 .............................5a.                 99,999,999,999.00.00                                                                       83
84             6.  Line 2b plus line 4b .............................................................................................................................................6b. 99,999,999,999.00.00 84
85             7.  Enter the amount on lines 7a and 7b of the depreciation subtraction                                                                                                                        85
86               from Form OR-40-N, line 33S that is attributable to qualifying                                                                                                                               86
87               businesses ...................................................................................7a. 99,999,999,999.00.00 7b.                                              99,999,999,999.00.00 87
88             8.  Line 5a plus line 7a ......................................................................8a.  99,999,999,999.00.00                                                                       88
89             9.  Line 6b minus line 7b. Don’t enter less than 0 ...................................................................................................9b.                 99,999,999,999.00.00 89
90            10.  Tax for income on line 8a (see instructions).                                                                                                                                              90
91               This is your tax on nonqualifying income. .................................10a.                   99,999,999,999.00.00                                                                       91
92            11.  Tax for income on line 9b using Tax rate chart B in the instructions.                                                                                                                      92
93               This is your tax on qualifying income ...............................................................................................................11b.               99,999,999,999.00.00 93
94            12.  Line 10a plus line 11b.                                                                                                                                                                    94
95               This is your total tax with the reduced rate for                                                                                                                                             95
96               qualifying income .......................................................................12a.     99,999,999,999.00.00                                                                       96
97            13.  Tax for income on line 1a (see instructions)...............................13a.                 99,999,999,999.00.00                                                                       97
98            14.  Enter the lesser of line 12a or line 13a.......................................14a.             99,999,999,999.00.00                                                                       98
99                                                                                                                                                                                                            99
100          If line 12a is less than 13a, enter the amount from line 14a on Form OR-40-N, line 46, and check box 46c.                                                                                        100
101                                                                                                                                                                                                           101
102          If line 13a is less than 12a, it isn’t more beneficial for you to use the reduced tax rate. Enter the amount from line 14a on Form                                                               102
103          OR-40-N, line 46, and complete the rest of the return.                                                                                                                                           103
104                                                                                                                                                                                                           104
105          Note: You can’t amend to revoke or make the election after your original return is filed unless you file an amended return on or before                                                          105
106          the original due date of April 18, 2023, or if filing an extension, October 16, 2023. If you amend after the due date for the return,                                                            106
107          including extensions, you must use the tax on line 12a of the Tax worksheet even if line 13a is less.                                                                                            107
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109                                        —You must include this schedule with your Oregon Form OR-40-N—                                                                                                     109
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