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                                                                                                      Oregon Department of Revenue
5                Form OR-18-WC-V                                                                                                                                          5
6                Nonresident Real Property Conveyance Payment Voucher                                                                                                     6
7                                                                                                                                                                         7
8                Page 1 of 1        • Use UPPERCASE letters.  • Use blue or black ink.  • Print actual size (100%).  • Don’t submit photocopies or use staples.           8
9           Tax year begins (MM/DD/YYYY)                  Tax year ends (MM/DD/YYYY)                                                                                      9
10                                                                                                                                                                        10
11          99/99/9999/           /                       99/99/9999/   /                                                                                                 11
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13          Transferor first name                                         Initial                                                                                         13
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            XXXXXXXXXXXXXXXX                                              X
16          Transferor last name                                                                                                                                          16
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            XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
19          Social Security number (SSN)                                                                                                                                  19
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            999-99-9999
22          Transferor C corporation legal name                                                                                                                           22
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            XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
25          Federal employer identification number (FEIN)                                                                                                                 25
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            99-9999999
28          Escrow agent address                                                                                                                                          28
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            XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
31          City                                                                                State ZIP code                                                            31
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33          XXXXXXXXXXXXXXXXXXXXXX                                                              XX    XXXXX-XXXX -                                                        33
34          Escrow agent contact phone                                                                                                                                    34
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            999-999-9999
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47          Want to make your payment online? Find options at www.oregon.gov/dor.                                                                                         47
48          Use this voucher only if you are sending a payment separate from a return. For                                                                                48
49          more information, see Form OR-18-WC-V Instructions. Make your check, money                                                                                    49
50          order, or cashier’s check payable to the Oregon Department of Revenue. Write                                                                                  50
51          “Form OR-18-WC-V,” your daytime phone, the transferor’s FEIN or the last four                                                                                 51
52          digits of their SSN or ITIN, and the tax year on the payment. Don’t mail cash. Mail                                                                           52
            the payment and voucher to:
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54          Oregon Department of Revenue                                                                                                                                  54
            PO Box 14950
55          Salem OR 97309-0950                                                                                                                                           55
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57                                                                                              Enter payment amount                                                      57
58                                                                                                                                                                        58
59                                              150-101-186                                                                                                               59
                                                (Rev. 05-10-22, ver. 03)
60                                                                      9999 99                 $     ,              99,999,999.00,                             0 0       60
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63                                                          XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX                                                            63
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