S
R
I
P
P
TATE OF
HODE
SLAND AND
ROVIDENCE
LANTATIONS
D
T
- E
T
S
IVISION OF
AXATION
STATE
AX
ECTION
FORM RI-100
FILING FEE $50.00
DEATH CERTIFICATE REQUIRED
E
T
C
T
STATE
AX
REDIT
RANSMITTAL
Estate of
Date of death
Address
Social security number
City, state and ZIP code
Probate case number and location
Name of personal representative
Relationship - Personal Representative is:
Spouse
Child
Sibling
Parent
Other
Address
Person in
Capacity:
Possession
Executor
Administrator
Other
of Property
City, state and ZIP code
Telephone
Name of attorney
Telephone
Address
City, state and ZIP code
A Federal return is not required to be filed, but a Certificate of No Tax Due is requested.
A Federal return is attached, but no Rhode Island tax is due. A Certificate of No Tax Due is required.
A Federal return is attached. A Notice of Estate Taxes Assessed is requested.
Payment of Rhode Island estate taxes is enclosed in the amount of $________________.
The Federal return is attached showing computation of the total credit. Apportionment is as shown in section II below.
An extension of time to file the Federal return has been approved.
Extension Date:
(A true copy attached.)
An extension of time to pay the Federal Tax has been approved.
Extension Date:
(A true copy attached.)
SECTION I:
SECTION II:
REAL ESTATE REQUIRING DISCHARGE OF LIEN
:
$
RHODE ISLAND ASSETS
Did the decedent have any interest in real estate located in Rhode Island
requiring a discharge of estate tax lien?
NON-RHODE ISLAND ASSETS:
$
Yes
No
0.00
Please include a typed Form T-77 in triplicate for each property to be
TOTAL:
$
.
discharged
If a Federal Estate tax return is required, enter the total gross
SECURITY REQUIRING ESTATE TAX WAIVER
value for Federal Estate and Generation Skipping Tax purposes.
Did the decedent have any interest in a security of a Rhode Island incorporated
business requiring an estate tax waiver?
If no Federal Estate tax return is required, enter the total gross
No
Yes
value of the decedent’s estate. Gross value means the total
Please include a typed Form T-79 in duplicate for each security.
value of the assets before any deductions.
Under penalties of perjury, I declare that I have examined this return including accompanying schedules and to the best of my knowledge and belief,
it is true, correct and complete
Signature of personal representative
Date
Signature of preparer
Date
Ø
Ø
Name, address and telephone number of preparer (please print or type)
Telephone number
Revised 01/10/2014