Form 41-2001-Oregon Fiduciary Income Tax Return Page 2
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1
2Form 41 (2001) — page 2
Name of Estate or Trust
Federal Employer Identification Number
SCHEDULE 1 — OREGON CHANGES TO DISTRIBUTABLE NET INCOME (DNI) AND TAXABLE INCOME OF FIDUCIARY (TIF)
(refer to specific instructions)
(Column A)
(Column B)
DNI
TIF
20. Distributable net income (from federal Form 1041, Schedule B, line 7) ................... 20
21. Taxable income of fiduciary (from federal Form 1041, line 22) ......................................................................... 21
22. Changes in depreciation for Oregon ............................................................................ 22
22
23. Other changes. Identify ___________________________________ ......................... 23
23
24. Line 22 plus line 23 ...................................................................................................... 24
24
25. Revised distributable net income (Column A, line 20 plus line 24)
Enter here and on page 1, line 1 ................................................................................. 25
26. Total taxable income (Column B, line 21 plus line 24) ......................................................................................... 26
27. Changes included on Column A, line 24, that were distributed (see instructions) ............................................ 27
28. Revised taxable income of fiduciary (total or net of lines 26 and 27)
Enter here and on page 1, line 4 ......................................................................................................................... 28
SCHEDULE 2 — FIDUCIARY ADJUSTMENT
(refer to specific instructions)
Subtractions
29. 2001 federal income tax subtraction—limited to $3,000 (see instructions) ......................................................... 29
30. Interest on U.S. obligations included in income on federal Form 1041 $ _______________,
less allocation of administration and miscellaneous expenses $ _______________ (see instructions) ........... 30
31. Oregon income tax refund included as income on federal Form 1041 ................................................................ 31
32. Other subtractions (attach explanation) ............................................................................................................... 32
33. Add lines 29 through 32 ....................................................................................................................................... 33
Additions
34. Oregon income tax deducted on 2001 federal Form 1041 .................................................................................. 34
35. Interest on obligations of other states or their political subdivisions .................................................................... 35
36. Depletion in excess of adjusted basis .................................................................................................................. 36
37. Estate taxes on income in respect of a decedent not taxable by Oregon ............................................................ 37
38. Other additions (attach explanation) .................................................................................................................... 38
39. Add lines 34 through 38 ....................................................................................................................................... 39
40. Fiduciary adjustment (difference between lines 33 and 39) ................................................................................. 40
This fiduciary adjustment is to be
added or
subtracted on page 1, line 5.
2001 RATE SCHEDULE
Compute the Tax Using the Following Rates
If your taxable income is:
Your tax is:
Not over $2,500 ................................................................. 5% of taxable income
Over $2,500 but not over $6,300 ....................................... $125 plus 7% of the excess over $2,500
Over $6,300 ....................................................................... $391 plus 9% of the excess over $6,300
Signature of Preparer Other Than Fiduciary
Telephone Number
I declare under the penalties for false swearing that this return (and any
accompanying schedules and statements) has been examined by me and, to the
x
best of my knowledge and belief it is true, correct, and complete.
Signature of Fiduciary
Date
Street Address
x
Title
Telephone Number
City
State
ZIP Code
I hereby authorize the following individual(s) to receive and provide any confidential tax information relating to this return.
Name (please print or type)
Mailing Address
Title
Telephone Number
City
State
ZIP Code
150-101-041 back (Rev. 9-01)
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