The Oregon Statement Form, officially known as Form OR-SFC (Statement of Financial Condition), is a comprehensive document designed to provide a detailed overview of an individual's or business's financial situation. This form is necessary for individuals seeking adjustments like suspended collection status or wage garnishment modifications in Oregon. Completing every section accurately is crucial, as failure to do so may result in continued collection efforts, potentially leading to garnishment, liens, or the involvement of a private collection agency.
Facing financial challenges can be a stressful experience, but understanding the tools available to navigate these hurdles is essential. One such tool for Oregon residents is the Form OR-SFC, Statement of Financial Condition. This document is a comprehensive form designed to provide the Oregon Department of Revenue with a detailed overview of an individual's or a business's financial situation. By completing all sections of the form, which includes personal information, employment details, information on bank accounts, pay stubs, profit and loss statements for businesses, and details on assets and liabilities, applicants can provide a clear picture of their financial health. Failure to complete the form in its entirety could result in the continuation of collection activities by the department, such as garnishment, lien, or the debt being forwarded to a private collection agency. Additionally, the form allows individuals to apply for suspended collection status or wage garnishment modification, offering a potential lifeline for those struggling under the weight of financial obligations. It's a crucial step for individuals and businesses in Oregon seeking to address their fiscal responsibilities and navigate towards a more stable financial future.
Form OR-SFC
Statement of Financial Condition
Return by:
Complete all sections of this form. If you don’t complete all sections of this form, we can- not process it, which will continue collection activity. This may result in garnishment, lien, or assignment of debt to a private collection agency.
Three months of current bank statements—personal and business (if applicable). Three months of current pay stubs (if applicable).
Three months of profit and loss statements (for businesses only).
•All household income.
Additional sheets, as needed, for additional information.
Check here if applying for suspended collection status. For suspended collection status qualifications, visit www.oregon.gov/dor and search for “Suspended collection.”
Check here if applying for a wage garnishment modification.
Revenue use only
Date received
Revenue agent
Section 1. Personal information
Your irst name
MI
Last name
Your Social Security number
– –
Your date of birth
Other names or aliases used
Spouse/RDP’s irst
Spouse/RDP’s Social Security number
Spouse/RDP’s date of birth
name
–
Spouse/RDP’s other names or aliases used
Your cell phone
Your driver license number
State
Spouse/RDP’s cell phone
Spouse/RDP’s driver license no.
(
)
Your email
Spouse/RDP’s email
Dependent’s name (living with you)
Date of birth
Social Security number
Relationship
Your current physical address
City
ZIP code
County
Your home phone
()
Your mailing address (if different from above)
Name of your tax representative (CPA, attorney, enrolled agent)
Fax number
Phone
Address of your tax representative
Section 2. Employment information (personal and business)
Your employer or business name
Business phone
Payroll fax
Address
Date hired:____________________
Occupation: _______________________________
Wage earner
Sole proprietor
Partner
Owner oficer
Paid:
Weekly
Every other week
Monthly
Twice a month
Number of allowances claimed on Form W-4:____________________
150-101-159 (Rev. 01-17)
Form OR-SFC, Financial Statement—Page 1
Section 2. (continued) Employment information (personal and business)
Spouse/RDP’s employer or business name
If self-employed: List all responsible owner(s), partner(s), oficer(s), major shareholder(s), etc.
Identify the major responsibilities of each by circling the codes that apply: 1 = Files returns; 2 = Pays taxes; 3 = Prefers creditors; 4 = Hires and ires
Name and title
Effective date
Home address
Home phone
SSN
Code
1
2
3
4
Section 3. General inancial information (personal and business)
Bank accounts. Include IRA and retirement plans certiicates of deposit, etc. For all accounts, attach copies of your last three bank statements. Attach additional pages as needed.
Name of institution
Type
Date opened
Account number
Balance
Total. Enter this amount on line 2, Section 4 (asset and liability analysis)........................
$
Safe deposit boxes (rented or accessed). Include location, box number, and contents. Attach additional pages as needed.
Box identiication
Current value of assets
Total. Enter this amount on line 3, Section 4 (asset and liability analysis)........................
Vehicles. Attach supporting documentation of current payoff. Attach additional pages as needed, and vehicles paid in full.
Year, make, model, license number
Lender/lien holder
Current market value
Current payoff
Available equity
(cannot be less than -0-)
Total. Enter this amount on line 4, section 4 (asset and liability analysis) ........................
Form OR-SFC, Financial Statement—Page 2
Section 3. (continued) General inancial information (personal and business)
Personal property. Include water craft, RVs, air craft, business equipment, and/or machinery. Attach additional pages as needed.
Total. Enter this amount on line 6, section 4 (asset and liability analysis) ........................
Life insurance. Attach additional pages as needed.
Name of insurance company
Agent’s name and phone
Policy number
Face amount
Loan/cash
surrender value
Total. Enter this amount on line 7, section 4 (asset and liability analysis) ........................
Securities. Include stocks, bonds, mutual funds, money market funds, securities, 401(k), etc. Attach additional pages as needed.
Where located
Owner of record
Quantity or denomination
Current value
Total. Enter this amount on line 8, section 4 (asset and liability analysis) ........................
Real property. Include a copy of the deed and a copy of homeowners/rental insurance policy with riders and supporting documentation of loan balance. Attach additional pages as needed.
A. Physical address
(single- or multi-family dwelling,
lot, rental, etc.)
Mortgage lender’s name and address
Parcel number:_______________
How is title held:______________________________________ Purchase price: _________________ Purchase date: __________________
Current market value: _______________________Mortgage balance: ___________________________ Equity: ___________________________
B. Physical address
C. Physical address
Form OR-SFC, Financial Statement—Page 3
D. Physical address
Total Equity. Enter this amount on line 9, Section 4 (asset and liability analysis) . . . . . . . . .
Credit cards and lines of credit. Credit cards and unsecured lines of credit may only be allowed with three months of statements showing they are used for living expenses.
Type of account
Name and address of creditor
Monthly payment
Credit limit
Credit available
Amount owed
Total $
Total. Enter this amount on line 28, Section 4 (asset and liability analysis)
Other inancial information. Please provide the following information relating to your inancial conditions. If you check “Yes” in any box, provide dates, an explanation, and documentation. Attach additional pages as needed.
Court proceedings
No
Yes _______________________________________________________________________________
Repossessions
Anticipated increase in income
Bankruptcies/receiverships
Recent transfer of assets
Beneiciary to trust, estate, proit sharing, etc. ...
Last Oregon income tax return iled
Year:_______ _______________________________________________________________________________
Total number of exemptions claimed
___________ ________________________________________________________________________________
Adjusted gross income from return
$__________ ________________________________________________________________________________
List any vehicles, equipment, or property sold, given away, or repossessed during the past three years. Attach additional pages as needed.
Year, make, model of vehicle, or property address
Who took possession
Value
Form OR-SFC, Financial Statement—Page 4
Section 4. Assets and liability analysis
Immediate assets.
Totals
1.Cash
2.Bank accounts / balance (from section 3)
3.Safe deposit box value of contents (from section 3)
4.Enter vehicles equity (from section 3)
5.Vehicle equity formula (line 4 - $3000, if less than -0-, enter -0-) This line for use on form 150-101-157, Settlement Offer Application only.
6.Personal property (from section 3)
7.Loan / cash surrender value for life insurance (from section 3)
8.Securities (from section 3)
9.Current real estate equity (from section 3)
10.Notes
11.Accounts receivable
12.Judgements / settlements received or pending
13. Interest in trusts
14. Interest in estates
15. Partnership interests
16. Major machinery / equipment, etc.
17. Business inventory
18. Other assets: (specify): (Example: $1,000 guns / $200 jewelry / $800 gold)
19. Other assets (specify):
20. Total assests
Real property equity. From Section 3. Liens or cost of sale don’t reduce equity (can’t be less than -0-).
Address or location
RMV from property tax statement
Mortgage payoff amount
Equity
21.
Property 1:
22.
Property 2:
23.
Property 3:
24. Total equity from properties listed on additional sheet (if applicable)
25.
Total of all real property equity (add the Equity column from lines 21 thru 24)
26. Enter dollar amount from line 20
27. Total value of all immediate assets and real property equity (line 25 plus line 26)
Current liabilities. Include judgements, notes, and other charge accounts. Do not include vehicle or home loans.
28.Amount owed to credit cards and lines of credit (from Section 3)
29.Taxes owed to IRS (provide a copy of recent notices)
30.Other liabilities (specify):
31.Other liabilities (specify):
32.Other liabilities (specify):
33. Total liabilities
Form OR-SFC, Financial Statement—Page 5
Section 5. Monthly income and expense analysis
Income. Attach copies of all income sources that contribute to household expenses (minimum three months).
List Net Income
34.
Wages / salaries / tips (yours)
35. Social Security income (yours)
36.
Pension / annuities (yours)
pension
annuities
both
37.
Disability (yours)
38. Wages / salaries / tips (spouse/RDP’s)
39.Social Security income (spouse/RDP’s)
40.Pension / annuities (spouse/RDP’s) pension annuities both
41.Disability (spouse/RDP’s)
42.Interest / dividends / royalties (average monthly)
43.Payments from trust / partnerships / entities
44.Unemployment
45.Other income (specify)
46.Other income (specify)
47.Other income (specify)
List Gross Income
48. Business income (yours)
49.Business income (spouse/RDP’s)
50.Rental income
51.Child support
52.Alimony
53.Seller carried contracts / sales
54. Total income
Personal expenses (actually paid). (May be limited by federal standards.)
55. Rent / mortgage / real estate secured line(s) of credit
If renting—name, address, and phone number of landlord
Amount
56.
Real estate taxes
(Is this included in your mortgage payment?
Yes)
57. Personal home owners / renters insurance: (
) Assoc. fees: (
58. Personal utilities:
Electric: (
Natural gas / oil: (
Phone, internet, & cable: (
Garbage: (
Water / sewer: (
59.
Food / clothing / other Items: No. of people: (
Their ages: (
60. Auto payments / lease
61.
Auto insurance
62. Auto maintenance / fuel / other transportation
63.Medical payments (not covered by insurance) (provide proof)
64.Estimated tax payments (provide proof)
65.Court ordered payments (alimony, child support, restitution, not deducted from your paycheck)
Form OR-SFC, Financial Statement—Page 6
Section 5. (continued) Monthly income and expense analysis
Personal expenses (actually paid). (continued) (May be limited by federal standards.)
66.Garnishments (specify)
67.Delinquent tax payments (other than Oregon state taxes, IRS, etc.)
68.Work related child care expenses
69. Other expenses (do not include unsecured debt) (specify)
70. Total personal expenses
Business expenses (actually paid). Provide current general ledger and proit / loss.
71. Materials purchased (specify)
72.
Supplies (specify)
73. Installment payments (specify)
74.
Monthly payments (specify)
75. Rent / mortgage
76.
Insurance
77. Business utilities: Electric: (
78.
Net wages and salaries paid to employees
79. Current taxes (payroll / business)
80. Other: Specify: (do not include unsecured debt)
81.
Total business expenses
82. Net disposable income (line 54 minus lines 70 and 81)........................................................................................................
Section 6. Additional information
Please provide any additional information not already included. Attach additional pages as needed. All household income must be included.
Form OR-SFC, Financial Statement—Page 7
Section 6. (continued) Additional information
Your proposed monthly payment.....................................................................................................................
Your proposed payment date...........................................................................................................................................
Section 7. Authorization to disclose
Under penalties of perjury, I declare that I have examined this statement of assets, liabilities, and other information, and to the best of my knowledge and belief, it is true, correct, and complete. I (we) authorize the Oregon Department of Revenue to verify any information on this inancial statement which may include credit reports.
Sign here
X
Your signatureDate
Spouse’s signature (if applying jointly, both must sign even if only one had income)
Date
Return your completed form to: Oregon Department of Revenue
PO Box 14725
Salem OR 97309-5018
Form OR-SFC, Financial Statement—Page 8
Filling out the Oregon Statement of Financial Condition form is an essential step for individuals needing to disclose their financial status, especially when there are ongoing collection activities. This form is comprehensive, covering personal and business finances, assets, liabilities, and income. It must be completed with accuracy to ensure a thorough review by the Oregon Department of Revenue. Below are step-by-step instructions to aid you in filling out this form correctly. Remember, incomplete information may lead to continued collection efforts such as garnishment or liens.
Once the form is complete, double-check for accuracy to avoid delays in processing. Submit the form along with all required attachments to the Oregon Department of Revenue by the specified return date to avoid further collection activity. Accuracy and completeness are key to ensuring a smooth review process.
The Form OR-SFC, or the Statement of Financial Condition, is a document required by the Oregon Department of Revenue. Its primary purpose is to provide a comprehensive overview of an individual's or business's financial situation. This includes assets, liabilities, income, and expenses. The form must be completed in full to prevent ongoing collection activities by the state, which could include garnishment, liens, or the assignment of debt to a private collection agency.
This form needs to be filled out by any individual or business that is requested by the Oregon Department of Revenue, particularly when there is an ongoing collection activity or when applying for suspended collection status or a wage garnishment modification. It is crucial for those facing financial scrutiny from the state, allowing the Department of Revenue to assess an equitable solution based on the financial information provided.
To properly fill out the Form OR-SFC, several supporting documents are required, including:
These documents help provide a full picture of your financial health and are critical for the Oregon Department of Revenue's assessment.
To apply for suspended collection status or request a modification to a wage garnishment through the Form OR-SFC, applicants should:
If the Form OR-SFC is not entirely filled out, the Oregon Department of Revenue will not be able to process it. Incomplete forms lead to continued collection activity, which may result in garnishment of wages, liens on property, or the assignment of the debt to a private collection agency. It is therefore crucial to ensure that all sections of the form are filled out accurately and that all necessary supporting documents are provided.
When filling out the Oregon Statement of Financial Condition form, individuals commonly encounter several pitfalls that can complicate their financial situation further or delay the processing of their form. Awareness of these mistakes can significantly streamline the process, ensuring that all information is accurately represented, and thus, avoiding potential repercussions such as continued collection activity. Here are seven common errors to avoid:
To ensure a smooth process when dealing with the Oregon Department of Revenue, it's advisable to approach the form with careful attention to detail, ensuring that all required information and documents are provided fully and accurately.
When individuals in Oregon find themselves navigating the complexities of financial declarations related to tax situations, the Oregon Statement of Financial Condition (Form OR-SFC) becomes a pivotal document. This comprehensive form requires thorough documentation of an individual's or business's financial status to prevent or resolve collection activities initiated by the state. To support and supplement the information provided in the Oregon Statement form, several other forms and documents are often required or recommended for a complete financial overview. These additional documents ensure that the individual's financial picture is accurately represented to the Oregon Department of Revenue.
In conclusion, the Oregon Statement of Financial Condition form is just the starting point for those seeking to accurately declare their financial status to the Oregon Department of Revenue. The accompanying documents work synergistically to paint a complete picture of an individual's or business's financial health. Together, they provide the Department of Revenue with the detailed insights needed to make informed decisions regarding collection activities, suspended collection status qualifications, or wage garnishment modifications.
The Oregon Statement form closely mirrors a traditional personal financial statement that individuals might use to demonstrate their financial health to lenders or investors. Just like the Oregon Statement, a personal financial statement encompasses a detailed layout of an individual’s assets and liabilities, including bank accounts, real property, vehicles, and personal property. It aims to provide a snapshot of the financial standing of an individual, detailing the resources they hold and the debts they owe, a critical consideration for financial institutions when deciding on lending or the extension of credit.
Similar to bankruptcy schedules, the Oregon Statement form necessitates a comprehensive listing of an individual's financial status. Bankruptcy schedules, required during the filing for bankruptcy, demand meticulous documentation of the filer's assets, liabilities, income, and expenses, closely paralleling the structure of the Oregon Statement form. Both documents are pivotal for assessing the financial position of an individual or entity, albeit for different legal proceedings. However, they serve the similar essential function of providing a thorough financial overview to interested parties.
The form mirrors the content seen in forms for loan applications, where detailed financial information is critical. Just like loan application processes, the Oregon Statement gathers extensive data on an applicant's financial situation, including employment, income, assets, and liabilities, to evaluate their ability to adhere to financial commitments. Both types of documents are utilized to assess financial viability and risk, serving as tools in decision-making processes for financial assistance or relief.
Comparable to a means test form utilized in bankruptcy cases, the Oregon Statement elucidates the financial capacity of an individual or business. A means test is designed to determine eligibility for certain types of bankruptcy filings, requiring detailed financial disclosures akin to those found in the Oregon Statement. This similarity underscores their collective aim to evaluate financial status and the ability to meet financial obligations or qualifications for financial relief or restructuring.
The Oregon Statement shares aspects with income statement reports of businesses. These reports, focusing on profit and loss statements, provide insight into the financial performance of an entity over a specific period. Though oriented towards different end uses — one for tax and debt purposes, the other for business evaluation — both documents compile detailed income and expense information to paint a picture of financial health.
It also aligns with garnishment modification applications, which require in-depth financial disclosures to assess an individual's ability to withstand wage garnishment. Similar to these applications, the Oregon Statement form collects detailed income information and existing financial obligations to evaluate whether modifications to garnishment, or other collections efforts, are warranted. These documents ensure that debt collection efforts do not excessively burden individuals' financial resources.
Asset declaration forms in divorce proceedings also bear resemblance to the Oregon Statement form. In divorce cases, each party must fully disclose assets and liabilities to ensure fair distribution. The Oregon Statement's comprehensive financial inventory — encompassing assets, debts, income, and expenditures — serves a similar purpose in providing a transparent and complete account of an individual’s financial standing, critical for equitable resolutions.
Loan modification application forms, designed to assess someone's ability to meet modified loan terms, share commonalities with the Oregon Statement form. Both require detailed financial information to determine whether an individual's financial circumstance warrants adjustment to financial agreements, whether it be for a home mortgage modification or for managing tax liabilities.
The Oregon Statement has parallels with financial affidavit forms used in legal contexts, such as child support determinations. These affidavits require detailed disclosures of income, expenses, assets, and liabilities to gauge an individual's financial capacity to meet obligations. This comprehensive financial scrutiny is mirrored in the Oregon Statement’s thorough documentation requirements, highlighting their shared objective of facilitating fair and informed financial assessments.
Lastly, the Oregon Statement resembles taxpayer disclosure forms that entities or individuals might submit for tax compliance or audit purposes. Both types of documents demand full transparency regarding income, expenses, assets, and liabilities. The goal is to provide tax authorities with a complete view of the taxpayer's financial situation, ensuring accurate tax obligations are assessed and met.
When completing the Oregon Statement of Financial Condition Form, it is crucial to approach the task with thoroughness and accuracy. Here are some do's and don'ts to guide you through the process.
Accuracy, transparency, and completing all required sections are key to properly filling out the Oregon Statement of Financial Condition Form. By following these guidelines, you can help ensure that your financial situation is presented accurately to the Department of Revenue, aiding in the swift processing of your form.
Understanding the complexities and nuances of tax forms is crucial for responsibly managing one's financial obligations. Below are some common misconceptions about the Oregon Statement of Financial Condition (Form OR-SFC) that need clarification:
Understanding these misconceptions can empower individuals to approach their financial obligations with the Oregon Department of Revenue more effectively, helping to avoid unnecessary stress and complications in managing their finances.
Understanding the Oregon Statement of Financial Condition form is crucial for residents navigating financial assessments by the state. Here are six key takeaways to ensure correct completion and utilization:
Understanding and accurately completing the Oregon Statement of Financial Condition is vital for transparent communication with the Department of Revenue. It not only aids in accurately assessing one's financial condition but also opens pathways to potential relief options for those in financial distress.
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