It-R 9/11 - Resident Decedent - New Jersey
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1STATE OF NEW JERSEY
IT-R (9-11)
(67) For Division Use Only
Inheritance Tax Return
Transfer Inheritance Tax
RESIDENT DECEDENT
PO Box 249
Trenton, NJ 08695-0249
(Instructions on reverse side)
Decedent’s Name________________________________________________________ Decedent’s S.S. No. ____________/__________/____________
(Last)
(First)
(Middle)
Date of Death (mm/dd/yy) _________/_______/_________ County of Residence _______________________________
Testate
Intestate
Name _______________________________________________ Daytime Phone (
) _______________________
Authorized Representative
to receive all
Street ___________________________________________________________________________________________
correspondence
City _____________________________________________ State ________________ Zip Code _________________
1. Real Property . . . . . . . . . . . . . . . . Total carried forward from - Schedule A . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1.
2. Closely Held “Businesses” . . . . . . Total carried forward from - Schedule B . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2.
3. All Other Personal Property . . . . . Total carried forward from - Schedule B(1) Recapitulation . . . . . . . . . . . . . . .
3.
4. Transfers . . . . . . . . . . . . . . . . . . . . Total carried forward from - Schedule C . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4.
5. Gross Estate . . . . . . . . . . . . . . . . . Total Lines 1 thru 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5.
6. Deductions . . . . . . . . . . . . . . . . . . Total carried forward from - Schedule D . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6.
7. Net Estate . . . . . . . . . . . . . . . . . . . Total - Line 5, minus Line 6 (If less than zero enter “0”) . . . . . . . . . . . . . . . . .
7.
8. Contingent Amount Included in Line 7 (See explanation on reverse side) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8.
9. Balance of Estate (Line 7, minus Line 8) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9.
Number of
TAX
Class
Beneficiaries
Total
Exempt
Taxable
10. A (Spouse/Civil
Union Partner)_________
$________________/____ $________________/____ $________________/____
10.
11. A (Other)
__________ $________________/____ $________________/____ $________________/____
11.
12.
C
__________ $________________/____ $________________/____ $________________/____
12.
13.
D
__________ $________________/____ $________________/____ $________________/____
13.
14.
E
__________ $________________/____ $________________/____ $________________/____
14.
15. Compromise Tax Due on Line 8 Amount (See explanation on reverse side) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15.
16. Contingent Tax (See explanation on reverse side) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.
17. Total Tax Due (Total - Line 10 thru Line 16) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.
18. Interest Due (If applicable) (See explanation on reverse side) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18.
19. Total Amount Due (Line 17, Plus Line 18) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.
20. Payment on Account (If applicable) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20.
PAY THIS AMOUNT
21. If Line 20 (Payments) is LESS THAN Line 19, Enter BALANCE DUE -
21.
WITH FORM IT-PMT
22. If Line 20 (Payments) is MORE THAN Line 19, Enter REFUND AMOUNT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22.
23. Are any questions in Schedule “C” answered yes? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23.
Yes
No
24. Have or will you file or are you required to file a Federal Estate Tax Return? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24.
Yes
No
25. Has or will any disclaimer been filed? If so, attach copy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25.
Yes
No
26. If the decedent died after December 31, 2001, did the decedent’s taxable estate plus adjusted taxable gifts for
Federal estate tax purposes under the provision of the Internal Revenue Code in effect on December 31, 2001
exceed $675,000? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26.
Yes
No
If yes, by how much $ ______________________.
Indicate which letters were issued and where issued:
Letters of Administration
Letters Testamentary
State of __________
County of _____________________
SUBMIT A FULL COPY OF THE DECEDENT’S WILL, CODICILS, TRUSTS, AND A COPY OF
THE LAST FULL YEAR’S FEDERAL INCOME TAX RETURN.
Affiant says, under penalty of perjury, “I declare that I have examined this return and all accompanying schedules and to the best of my knowledge and belief, it is true, correct
and complete.” I hereby authorize the party(s) set forth above to act as the estate’s representative, to receive confidential information, and to make presentations on behalf
of the estate.
Signature: _____________________________________________________________________
Subscribed and sworn before me
(Executor - Administrator - Heir-at-law)
this _____________________ day of ____________________________, ______.
Print Name: _____________________________________________________________________
__________________________________________________________________
Address
_____________________________________________________________________
Official Title (Notarized)
_____________________________________________________________________
THIS FORM MAY BE REPRODUCED
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