Form 105 - Colorado Fiduciary Income Tax Return - 2012 Page 2

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Form 105 Schedule
Note: If any Income Distribution Deduction was claimed for Federal Tax purposes, this page must be complete.
Schedule A — Names and Addresses of Beneficiaries — Use lines (a) through (f) for resident beneficiaries
(a)
(b)
(c)
(d)
(e)
(f)
— Use lines (g) through (l) for nonresident beneficiaries
(g)
(h)
(i)
(j)
(k)
(l)
Schedule B
— Computation of the shares of the Colorado
Schedule C
— Computation of the percentage of federal distributable net income
fiduciary adjustment. The Colorado fiduciary adjustment is to be
from Colorado sources for use in Schedule D, columns 7 and 8, in determining the
allocated among the beneficiaries and the fiduciary in proportion
modified federal income reportable to Colorado by nonresident beneficiaries.
to their share of the federal distributable net income.
Beneficiary
1. Per Federal
2. From Colorado
Share of federal distributable net income
Sources
as per
Form 1041
schedule A
Amount
Percent
1. Dividends ...................................
$
$ XXXXXXXXXX XX
(a)
$
% 2. Interest (Include exempt interest)
XXXXXXXXXX XX
(b)
% 3. Partnership/Fiduciary income ....
(c)
% 4. Net rents and royalties...............
(d)
% 5. Net profit (loss) business ...........
(e)
% 6. Other income .............................
(f)
% 7. Total lines 1 through 6 ...............
$
$
(g)
% 8. Expenses ...................................
(h)
% 9. Federal distributable net income .
$
$
(i)
%
(j)
%
(k)
%
(l)
%
Subtotal
$
% 10. Percent of federal distributable net income from Colorado sources:
Fiduciary
%
Total
$
100% (Line 9, column 2 divided by line 9, column 1) ____________________________ %
Schedule D—Beneficiaries Social Security Numbers, Income, Modifications and Withholding
1. Resident Beneficiary’s Social
2. Federal Fiduciary Income
3. Schedule B Percentage
4. Fiduciary Adjustment
Security Number
$
% $
(a)
$
% $
(b)
$
% $
(c)
$
% $
(d)
$
% $
(e)
$
% $
(f)
5. Nonresident Beneficiary’s Social
6. Federal Distributable Net
8. Income Reportable to
9. Colo. Withholding
7. Schedule C Percentage
Security Number
Income
Colorado
Required 4.63% of Column 8
$
% $
$
00
(g)
$
% $
$
00
(h)
$
% $
$
00
(i)
$
% $
$
00
(j)
$
% $
$
00
(k)
$
% $
$
00
(l)

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