20-EXT EXTENSION PAYMENT COUPON 2003
• Please read the instructions carefully. Note to fiscal year taxpayers: File Form 20-EXT by the regular due date of your return.
Name of Oregon filer Federal Employer Identification Number Oregon Business Identification Number
Complete the tax payment coupon below if you owe Oregon tax
• Mail your completed coupon and payment by the regular return due date to avoid late payment penalties.
• Remember: When you file your return, mark the box “An extension is attached” on the front of the return.
An extension of time to file your return is not an extension of time to pay your tax. If you do not pay 100 percent of your
total tax liability by the due date, a 5 percent late payment penalty, plus interest, may be added to your tax due.
How to complete the coupon (Please use blue or black ink to fill out your coupon and check. Do not use gel pens or red ink.)
1. Oregon Business Identification Number (BIN). Enter the BIN for the corporation that will file the Oregon tax return.
Each corporation doing business in Oregon is assigned a BIN by the department. If this is your first filing year, a BIN will
be assigned when your payment is received. If you do not know your BIN, an officer of the corporation may contact us
by telephone at 503-378-4988 or e-mail at corp.help.dor.state.or.us.
2. Federal Employer Identification Number (FEIN). Enter the FEIN for the corporation that will file the Oregon tax return.
3. Name, Address, and Telephone Number. When you file your return, check the box on the front of the return if the
name or address has changed. Extension payments must be made in the name of the corporation that will be
shown on the tax return when filed.
4. Make check payable to: Oregon Department of Revenue. To ensure proper credit to your account, write the tax return
filer’s Oregon BIN and FEIN on your check.
5. Detach coupon, keep a copy for your records, and mail with your payment to: Oregon Department of Revenue
PO Box 14780
Salem OR 97309-0469
Cut Here Cut Here
FORM For Tax Year
OREGON CORPORATION EXTENSION Department Use Only
20-EXT PAYMENT COUPON 2003 Date received
Tax Year (check one):
Read this Tax Return Type (check one):
Calendar Year—Payment due April 15 (200) Excise (Form 20, 20-S, or 20-INS) Payment Amount
Fiscal Year—Payment due 15th day of the 4th month (202) Income (Form 20-I or 20-S)
after end of tax year $ 0 0
Oregon Business Identification Number
Date Fiscal Date Fiscal
Year Begins Year Ends 0
Federal Employer Identification Number
Name of corporation that will file the Oregon return
City State ZIP Code Telephone Number
( ) Check if new address
150-102-165 (Rev. 1-04) Web