Form 1041me - Income Tax Return For Resident And Nonresident Trusts And Estates - 2001

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INCOME TAX RETURN

FOR RESIDENT AND NONRESIDENT TRUSTS AND ESTATES

For calendar year 2001 or tax year beginning in 2001

01

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010910000

Tax period

Amended Return

FORM 1041ME

NAME OF ESTATE OR TRUST

ESTATE/TRUST EIN

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NAME AND TITLE OF FIDUCIARY OR TRUSTEE

FIDUCIARY SSN OR EIN

ADDRESS OF FIDUCIARY (NUMBER AND STREET)

CONTACT PERSON

TELEPHONE NUMBER

CITY

STATE

ZIP CODE

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Type of entity:

Decedent’s estate

Complex Trust

Bankruptcy estate — (Chapter 7)

Pooled income fund

(check one box)

Simple Trust

Grantor Trust

Bankruptcy estate — (Chapter 11)

Qualified funeral trust

Check the boxes that apply:

Resident estate or trust

Nonresident estate or trust

Initial return

Final return

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1. Federal taxable income (if nonresident trust or estate, skip to line 3) .............................................. 1

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2. Trust/estate’s share of fiduciary adjustment (from Schedule 1, line 3) ............................................ 2

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3. Maine taxable income

(resident trust or estate — line 1 plus or minus line 2)

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(nonresident trust or estate — page 2, Schedule 2, line (f), Column 6) ... 3

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4. Maine income tax (from tax table on page 3 of instructions) ................................................................. 4

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5. Adjustments to tax (from Schedule A, line 24) ...................................................................................... 5

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6. Adjusted Maine income tax (line 4 plus or minus line 5) ........................................................................ 6

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7. Tax payments:

a. Maine income tax withheld (attach Form W-2, W-2G, or 1099-R) ....................... 7a

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b. 2001 Estimated tax payments (include real estate withholding tax payments) ... 7b

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c. Total Payments (add lines 7a and 7b) .................................................................. 7c

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8. a. If line 6 is greater than line 7c, enter TAX BALANCE DUE .............................................................. 8a

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b. Enter PENALTY for underpayment of estimated tax (attach Form 2210ME)

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(Check here if you used the annualized income installment method)

.................................................. 8b

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c. TOTAL AMOUNT DUE (add lines 8a and 8b) ................................................................................ 8c

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9. If line 7c is greater than line 6, enter OVERPAYMENT .......................................................................... 9

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10. Overpayment to be:

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a. CREDITED to next year’s estimated tax 10a

b. REFUNDED 10b

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Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements and to the best of my knowledge and belief they are true, correct, and complete. Declaration of preparer (other than

taxpayer) is based on all information of which preparer has any knowledge.

Make check payable to:

DATE

X

TREASURER, STATE OF MAINE

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SIGNATURE OF FIDUCIARY OR OFFICER REPRESENTING FIDUCIARY

WRITE THE EMPLOYER IDENTIFICATION

DATE

NUMBER OF THE ESTATE OR TRUST ON THE

X

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CHECK —

DO NOT SEND CASH

SIGNATURE OF PREPARER OTHER THAN FIDUCIARY

FIRM’S NAME

PREPARER’S PHONE NUMBER

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PREPARER’S SSN OR PTIN

STREET NUMBER AND NAME

CITY

STATE

ZIP CODE

Office Use Only

File return with: Maine Revenue Services, PO Box 9108, Augusta, Maine 04332-9108