1 1
1 2 2 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 IMPORTANT! THIS FORM MUST BE FILED ELECTRONICALLY. Form All layers With grid &2 data 84 85
3 4 82 83
3 A PRINTABLE COPY MAY BE PROVIDED FOR THE 3
4 CUSTOMER'S RECORDS ONLY. 4
5 Oregon Department of Revenue 5
2022 Schedule OR-21-AP
6 Oregon Pass-through Entity Elective Tax Apportionment of Income 6
7 7
8 8
9 Page 1 of 1 • Use UPPERCASE letters. • Use blue or black ink. • Print actual size (100%). • Don’t submit photocopies or use staples. 9
10 PTE legal name Federal employer identification number (FEIN) 10
11 11
12 12
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 99-9999999
13 13
14 Any PTE with income from business activity that is taxable by Oregon and one or more other states must apportion its income according to Oregon’s 14
15 Uniform Division of Income for Tax Purposes Act, ORS 314.605 to 314.675, unless the PTE is a financial institution or public utility. In that case, the 15
16 PTE must apportion its income using the provisions of ORS 314.280. See instructions for more information. 16
17 17
18 Oregon sales 18
19 19
20 1. Shipped from outside Oregon ..........................................................................1. , 999,999,999.00, 0 0 20
21 21
22 22
23 2. Shipped from inside Oregon (but not to the U.S. government or purchasers 23
24 where the PTE isn’t taxable) .............................................................................2. , 999,999,999.00, 0 0 24
25 25
26 26
27 3. Shipped from inside Oregon to the U.S. government ......................................3. , 999,999,999.00, 0 0 27
28 28
29 29
30 4. Shipped from inside Oregon to purchasers where the PTE isn’t taxable ........4. , 999,999,999.00, 0 0 30
31 31
32 32
33 5. Partnership sales ..............................................................................................5. , 999,999,999.00, 0 0 33
34 34
35 35
36 6. Other business receipts ....................................................................................6. , 999,999,999.00, 0 0 36
37 37
38 38
39 7. Direct premiums (insurance only) ..................................................................... 7. , 999,999,999.00, 0 0 39
40 40
41 41
42 8. Annuity considerations (insurance only) ...........................................................8. , 999,999,999.00, 0 0 42
43 43
44 44
45 9. Finance and service charges (insurance only) .................................................9. , 999,999,999.00, 0 0 45
46 46
47 47
48 10. Total Oregon sales. Add lines 1 through 9 .....................................................10. , 999,999,999.00, 0 0 48
49 49
50 50
51 Sales everywhere 51
52 11. Total sales everywhere ................................................................................... 11. , 999,999,999.00, 0 0 52
53 53
54 Oregon apportionment percentage 54
55 12. Oregon apportionment percentage. Line 10 divided by line 11. Round to 55
56 four decimal places. Enter on Form OR-21, line 19 ........................................12. 999.9999 % 56
57 57
58 58
59 —Include this schedule when you file Form OR-21— 59
60 60
61 61
62 62
150-107-111
63 (Rev. 09-13-22, ver. 01) 22342201010000 63
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66 66