Delaware Form 400 - Fiduciary Income Tax Return

Delaware Form 400 - Fiduciary Income Tax Return - 2011 Page 3

DELAWARE

DE 400

Tax Year

SCHEDULE K-1

2011

BENEFICIARY’S INFORMATION

Fiscal year

beginning

and ending

Amended K-1

Name of Estate or Trust

Percentage of Distributive Share

Final K-1

Non-resident

Beneficiary’s ID Number

Employer ID Number

Name and Address of Beneficiary

Fiduciary’s Name and Address

(a) Allocable share item

(b) Amount

1. Beneficiary’s Federal Distributable Net Income....................

Form 200-01, Line 31 or 200-02 Line 19

2. Beneficiary’s share of additions..........................................

Form 200-01, Line 36 or 200-2 Line 25

3. Beneficiary’s share of subtractions.....................................

NON-RESIDENT BENEFICIARY INFORMATION

Form 200-02, Line 6

4. Net business income allocable to Delaware..........................

Form 200-02, Line 7a

5. Capital gain (loss) allocable to Delaware.............................

Form 200-02, Line 7b

6. Other gain (loss) allocable to Delaware...............................

Form 200-02, Line 10

7. Net partnership income allocable to Delaware......................

Form 200-02, Line 10

8. Net estate and trust income allocable to Delaware...............

Form 200-02, Line 10

9. Net rent and royalty income allocable to Delaware...............

Form 200-02, Line 10

10. Net S-Corporation income allocable to Delaware..................

Form 200-02, Line 11

11. Net farm income allocable to Delaware................................

(Revised 12/21/11)

Delaware Form 400 - Fiduciary Income Tax Return - 2011 Page 3