Form 504 - Maryland Fiduciary Income Tax Return - 2009 Page 3
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32009
Form
MARYLAND
FIDUCIARY
504
MODIFIED SCHEDULE K-1
09504K049
Schedule K-1
BENEFICIARY’S INFORMATION
OR FISCAL YEAR BEgINNINg
, 2009, ENDINg
Complete A Separate Form For Each Beneficiary
INFORMATION ABOUT THE ESTATE OR TRUST
Name of estate or trust
Federal employer identification numberr
Name and title of fiduciary
Fiduciary’s address
INFORMATION ABOUT THE BENEFICIARY
A. Name of beneficiary
B. Beneficiary’s identification number
C. Address, city, state and ZIP code
£ £ £
£ £
.
%
D. Beneficiary’s percentage of distribution at the estate’s or trust’s year end
£
£
E. What type of entity is this beneficiary? Check box if:
(1)
Individual
(2)
Fiduciary (trust or estate)
£
£
(3)
Qualified federal tax-exempt organization
(4)
Other__________________
F. Resident status of beneficiary, if beneficiary is an individual or fiduciary of
G. State of Domicile if Nonresident
another estate or trust.
£
£
Check box if:
Resident
Nonresident
DISTRIBUTED NET TAXABLE INCOME, MARYLAND MODIFICATIONS AND NONRESIDENT TAX PAID BY PASS-
THROUGH ENTITY (PTE)
1 Beneficiary’s share of net taxable income distributed from estate or trust
2 Beneficiary’s share of Maryland-source income distributed from estate or
trust (Complete only if beneficiary is a nonresident. (See below))**
$
$
_ _ _ _ _ _ _ _ _ _____ _______ __________ ____ _
_ __ _ __ _ __ _ __ _ _ __ _ __ _ __ _ __ _ __ _ _ __ _ __ _
3 Beneficiary’s share of Maryland addition modifications from estate or trust
4 Beneficiary’s share of Maryland subtraction modifications from estate or
(Specify applicable modifications and amounts.)
trust (Specify applicable modifications and amounts.)
(a) _________________
$ _________________
(a) _________________
$ _________________
(b) _________________
$ _________________
(b) _________________
$ _________________
(c) _________________
$ _________________
(c) _________________
$ _________________
5 Beneficiary’s share of nonresident tax paid by PTE(s)
FEIN of PTE(s)
Name of PTE(s):
(a) _________________
(a) _________________________________
(a) _________________________________
(b) _________________
(b) _________________________________
(b) _________________________________
(c) _________________
(c) _________________________________
(c) _________________________________
If additional space is needed for any item, attach a separate schedule.
Maryland Source Income for a Nonresident Beneficiary
**A nonresident is subject to tax on income from Maryland sources, which includes any income derived from real property or
tangible personal property located in Maryland; income derived from a business wholly or partially carried on in Maryland and
in which the trust or estate is a member of a pass-through entity; income from an occupation, profession or trade carried on
wholly or partially in Maryland; and income from wagering in Maryland.
COM/RAD-320
09-49
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