Request Form For A Closing Certificate For Fiduciaries Page 2

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Schedule CC
Page 2
PART II – Information Required When Requesting a Closing Certificate for Trusts
Legal Name
Federal EIN
1. Attach a copy of the trust instrument with amendments (will / codicils) and copies of annual court accountings for past three years.
2. a. Name(s) of grantor(s)
Social security number(s)
b. Name(s) of grantee(s)
Social security number(s)
3. On what date was the trust funded?
4. Was the trust contacted by the IRS and/or Wis. Dept. of Revenue in the last 3 years?
Yes
No
If Yes, explain:
5a. State reason for closing the trust
b. If death of beneficiary, provide name of beneficiary, social security number, last address, and date of death.
6. Have you petitioned the court to close the trust?
Yes
No
If Yes, attach a copy of the petition.
If No, explain why no petition has been filed
7. Has the trust made an annual accounting to a court?
Yes
No
If No, explain
8. Is a certificate required by the court?
Yes
No
See page 3 of the Form 2 instructions
9. Enter the total fair market value of each of the assets listed below that are held by the trust at the end of the year preceding the
final year of the trust. (NOTE Where any line is left blank and the appropriate schedule for that line is not filed with this return,
it will be deemed that NONE is the DECLARATION for that line by the person(s) signing Form 2.)
.
00
a. Real Estate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9a.
.
00
b. Stocks and Bonds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9b.
.
00
c. Mortgages, Notes, and Cash . . . . . . . . . . . . . . . . . . . . 9c.
.
00
d. Annuities and Life Insurance . . . . . . . . . . . . . . . . . . . . 9d.
.
00
e. Interest in Partnerships, LLCs, and S Corporations . . . 9e.
.
00
f. Other Miscellaneous Property . . . . . . . . . . . . . . . . . . .
9f.
.
00
g. Total Assets (add lines 9a through 9f) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9g.

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