Washington State Estate And Transfer Tax Return Form - Washington Department Of Revenue Page 2
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3Estate of:
PART 3 – Elections by the Executor
Please check the “YES” or “NO” box for each question. (See instructions beginning on page 6)
Yes
No
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1.
Do you elect alternate valuation?...........................................................................................................................
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2.
Do you elect special use valuation? If “Yes,” you must complete and attach Schedule A-1. .................................
Do you elect to pay the taxes in installments as described in section 6166? If “Yes,” you must attach the
3.
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additional information described on page 10 of the instructions. ...........................................................................
Do you elect to postpone the part of the taxes attributable to a reversionary or remainder interest as described
4.
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in section 6163?.....................................................................................................................................................
PART 4 – General Information
(Note: Please attach the necessary supplemental documents. You must attach the death
certificate.)
! Married
1.
Marital status of the
! Widow or widower – Name of deceased spouse:
decedent at time of death:
Date of death:
! Legally separated
! Single
! Divorced – Date divorce decree became final:
Please check the “YES” or “NO” box for each question. (See instructions beginning on page 11)
Yes
No
2.
Does the gross estate contain any section 2044 property (qualified terminable interest property (QTIP) from a
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prior gift or estate). See page 11 of the instructions...............................................................................................
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3a. Have Federal gift tax returns ever been filed? .......................................................................................................
If “YES,” please attach copies of the returns, if available, and furnish the following information:
Period(s) covered
Internal Revenue Office(s) where filed
3b.
3c.
If you answer “YES” to any of questions 4-13, you must attach additional information as described in the instructions.
Yes
No
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4. Was there any insurance on the decedent’s life that is not included on the return as part of the gross estate?......
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5. Did the decedent own any insurance on the life of another that is not included in the gross estate? ......................
6. Did the decedent at the time of death own any property as a joint tenant with right of survivorship in which (a)
one or more of the other joint tenants was someone other than the decedent’s spouse, and (b) less than the full
value of the property is included on the return as part of the gross estate? If “Yes,” you must complete and
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attach Schedule E. ..................................................................................................................................................
7. Did the decedent, at the time of death, own any interest in a partnership or unincorporated business or any stock
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in an inactive or closely held corporation?...............................................................................................................
8. Did the decedent make any transfer described in section 2035, 2036, 2037, or 2038 (see the instructions for
Schedule G beginning on page 14 of the separate instructions)? If “Yes,” you must complete and attach
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Schedule G..............................................................................................................................................................
Were there in existence at the time of the decedent’s death:
9.
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Any trusts created by the decedent during his or her lifetime? .......................................................................
Any trusts not created by the decedent under which the decedent possessed any power, beneficial
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interest, or trusteeship? ..................................................................................................................................
10. Did the decedent ever possess, exercise or release any general power of appointment? If “Yes,” you must
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complete and attach Schedule H.............................................................................................................................
11. Was the marital deduction computed under the transitional rule of Public Law 97-34, section 403(e)(3)
(Economic Recovery Tax Act of 1981)? If “Yes,” attach a separate computation of the marital deduction, enter
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the amount on item 20 of the Recapitulation, and note on item 20 “computation attached.” ...................................
12. Was the decedent, immediately before death, receiving an annuity described in the “General” paragraph of the
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instructions for Schedule I? If “Yes,” you must complete and attach Schedule I .....................................................
13. Was the decedent ever the beneficiary of a trust for which a deduction was claimed by the estate of a pre-
deceased spouse under section 2056(b)(7) and which is not reported on this return? If “Yes,” attach an
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explanation ..............................................................................................................................................................
14. Surviving spouse’s name
15. Social Security Number
16. Amount received (see page 11 of the instructions)
17. Individuals (other than the surviving spouse), trusts, or other estates who receive benefits from the estate (do not include charitable
beneficiaries shown in Schedule O) (see instructions). For Privacy Act Notice (applicable to individual beneficiaries only), see the
instructions for Form 1040. (Attach separate sheet for additional names.)
Name of individual, trust, or estate receiving $5,000 or more
Identifying number
Relationship to decedent
Amount (see instructions)
18.
All unascertainable beneficiaries and those who receive less than $5,000.....................................................
18.
19.
TOTAL............................................................................................................................................................
19.
REV 85 0046 (6-03-03)
Page 2
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