Form It-R - Schedule "B (1)" Recapitulation - All Other Personal Property Resident Decedent Page 4

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SCHEDULE B (1) - INVESTMENT BONDS
RESIDENT DECEDENT
_______________________________________________________
____________/____________/____________
Decedent’s Name
Decedent’s Social Security Number
(A) Provide name of company or entity holding bond and all terms of bond.
1) List all names registered on each bond.
(B) Report full date of death value of bonds.
1) Include accrued dividends as of date of death.
(C) List decedent’s equity in bond (If 100% , amount will be the same as (b)).
Note: U.S. Savings Bonds should be listed on Schedule B-1 “All Other Property”.
(A)
(B)
(C)
Bonds - Individually or Jointly Owned
Date of Death Value
Decedent’s Equity
Division Use Only
Insert this total on SCHEDULE B-1 Recapitulation, Line 3 . . . . . . . . . . . . . . . . . . . . . . . . . .
(If additional space is required, attach riders of the same size. All forms may be reproduced)

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