Schedule OR-21-MD-PT Instructions                                           2022
                               Pass Through of Distributive Share of Proceeds,
                                                   Addition, and Credit

Purpose of Schedule OR-21-MD-PT                                   Part C: Member information

Upper-tier members of pass-through entities (PTEs) elect-         For each member, enter their name, current address, phone, 
ing to pay the PTE elective tax (PTE-E tax) use Schedule          and Social Security number (SSN).
OR-21-MD-PT to report the items passing through to the            Ownership percentage.   Enter the member’s ownership 
upper-tier PTE’s members from the lower-tier entity. The          percentage as of the close of the tax year. If the member 
addition and credit reported to the upper-tier PTE by the         disposed of all or part of an ownership interest during the 
electing lower-tier entity can’t be claimed on an entity-level    year, enter the member’s ownership percentage before the 
return and must be passed through to the upper-tier PTE’s         disposition.
members. Schedule OR-21-MD-PT     must be included with           Form OR-OC. Mark this box if the member is a nonresident 
Form OR-21 when the return is filed. Complete a separate          who elects to be included in a composite filing for this tax 
Schedule OR-21-MD-PT for each electing lower-tier entity of       year.
which the upper-tier PTE is a member.
                                                                  Column l: Member’s distributive proceeds. Enter the mem-
Use additional pages for each schedule, as needed.                ber’s share of the distributive proceeds that you entered on 
                                                                  line 2.
Part A: Electing lower-tier entity                                Column m: Member’s addition for tax deducted at federal 
                                                                  level.
information                                                              Enter the member’s share of the addition for tax 
                                                                  deducted by the lower-tier entity on a federal return that 
Entity type. Check the box that matches the lower-tier enti-      you entered on line 3. 
ty’s organization type. If the entity is an LLC that is treated   Column n: Member’s credit for PTE-E tax paid. Enter the 
as a partnership or an S corporation for tax purposes, check      member’s share of the credit for PTE-E tax paid by the lower-
the applicable box.                                               tier entity that you entered on line 4.
Entity information. The legal name must be entered even if        Compare all totals. After you have entered the information 
the lower-tier entity does business under an assumed name.        for all members, make sure that the totals for each column 
Enter the entity’s federal employer identification number         match the total amount reported to you by the electing PTE 
                                                                  on Schedule OR-21-K-1.
(FEIN) and current address.
                                                                  • The total distributive proceeds in column l must match the 
                                                                  amount on line 2.
Part B: Distributive share of proceeds, 
                                                                  • The total additions in column m must match the amount 
addition, and credit from electing lower- 
                                                                  on line 3.
            Sole proprietorship
tier entity
                                                                  • The total credit for PTE-E tax paid in column n must match 
Line 2: Distributive proceeds. Enter your distributive share      the amount on line 4.
of proceeds from the lower-tier entity reported to you on         Include the completed schedule(s), including any additional 
Schedule OR-21-K-1, line 1.                                       pages, when filing Form OR-21.

Line 3: Addition for tax deducted at federal level. Enter your 
                                                                  Do you have questions or need help?
share of the Oregon addition for tax deducted by the lower-
tier entity on its federal return, reported to you on Schedule      www.oregon.gov/dor
OR-21-K-1, line 2.                                                503-378-4988 or 800-356-4222
Line 4: Credit for PTE-E tax paid. Enter your share of the        questions.dor@dor.oregon.gov

credit for PTE-E tax paid by the lower-tier entity, reported      Contact us for ADA accommodations or assistance in other 
to you on Schedule OR-21-K-1, line 3.                             languages.

150-107-110-1 (Rev. 09-13-22)                                   1                        2022 Schedule OR-21-MD-PT Instructions