Clear Form
FORM
STATE OF HAWAII—DEPARTMENT OF TAXATION
THIS SPACE FOR DATE RECEIVED STAMP
P-70
PERMITTED TRANSFERS
IN TRUST TAX RETURN
(2010)
DPF101
Name of Transferor
Federal Employer I.D No. or Social Security No.
Address of Transferor (Number and Street)
City, State, and Postal/ZIP Code
Name of Trust
Name of Permitted Trustee
Date of Delivery
Cash ...................................................................................................................................
1.
1
Marketable securities ..........................................................................................................
2.
2
Life insurance contracts ......................................................................................................
3.
3
Non-private annuities ..........................................................................................................
4.
4
TOTAL AMOUNT (Add lines 1 through 4) ...........................................................................
5.
5
x
.01
6.
Tax Rate .............................................................................................................................
6
TOTAL TAX (Multiply line 5 by line 6) ..................................................................................
7.
7
DECLARATION: I declare, under the penalties set forth in section 231-36, HRS, that this return (including any accompanying schedules or
statements) has been examined by me and, to the best of my knowledge and belief, is a true, correct, and complete return, made in good faith,
pursuant to the provisions of the Hawaii Permitted Transfers in Trust Laws, and the rules issued thereunder. Declaration of preparer (other than
taxpayer) is based on all information of which preparer has any knowledge.
Signature of Transferor
Date
Date
Preparer’s identification no.
Preparer’s signature
Check if
self-employed
Print preparer’s name
Paid
Preparer’s
Firm’s name (or yours,
Information
Federal E.I. No.
if self-employed)
Address and Postal/
Phone No.
Zip Code
FORM P-70