STATE OF SOUTH DAKOTA
)
IN CIRCUIT COURT
)
COUNTY OF ________________________ )
______________ JUDICIAL COURT
IN RE ESTATE OF _____________________________ )
South Dakota Inheritance Tax Report
)
and
___________________________________, Deceased )
Information for Judicial Determination of Inhertitance Tax
1. Decedent’ s Name: ______________________________ Date of Birth (DOB): ________ Date of Death (DOD): _________
Last Residence: ___________________________________ Spouse’ s name (and DOD, if applicable): ___________________
2.
Estate Representative or Applicant: _______________________________________________________________________
3.
Attorney of Record’ s Name: ___________________________ Street Address: ____________________________________
City: _______________________ State: _________ Zip + 4: __________ Phone Number: __________________________
YES
NO
4. Is this an Amended Report? If yes, insert DOR# from previous Receipt of IT Report: _________________
____
____
5. Does any property pass by Will or Trust? If yes, please attach copy.
____
____
6. Are any life estates involved? If yes, name and DOB of life tenant(s): ____________________________
____
____
7. Is a disclaimer or power of appointment involved? If yes, please attach appropriate document.
____
____
8. Did South Dakota decedent own any out-of-state property? If yes, please attach schedule with values.
____
____
9. Did decedent file a United States Gift Tax Return or Returns? If yes and DOD was before July 1, 1989,
____
____
attach copies of all returns. If yes and DOD was after June 30, 1989, attach returns for the last two years of life.
File the copy or copies of the 709 with the Department of Revenue only.
10. Did decedent’ s estate file a United States Estate (and Generation Skipping Transfer) Tax Return?
____
____
If yes, file a copy of the 706 with the Department of Revenue only.
(a) Amount of gross estate....................................................................................... $ __________________________
(b) Amount of state death tax credit allowable...................................................... $ __________________________
(c) Amount of death taxes imposed by other states............................................. $ __________________________
11. RECAPITULATION
(a) Schedule A............................................................................................................ $ __________________________
(b) Schedule B - 1/2 of subtotal (1).......................................................................... $ __________________________
(c) Schedule B - subtotal (2)..................................................................................... $ __________________________
(d) Schedule C............................................................................................................ $ __________________________
(e) Schedule C - 1 subtotal (1)................................................................................. $ __________________________
(f) Total of items 11(a), 11(b), 11(c), 11(d) and 11(e).............................................. $ __________________________
(g) Less Schedule D................................................................................................... $ __________________________
(h) Net value of decedent’ s taxable estate.............................................................. $ __________________________
Under penalty of Perjury, I swear that this Report is, to the best
Name of Preparer: __________________________________
of my knowledge and belief, true, correct and complete.
_________________________________________________
Signature: _________________________ Date: _________
Estate Representative or Applicant
Date
Subscribed and Sworn to before me this _____ day of ________
_________________________________________________
______________________ ____________.
FOR DEPARTMENT OF REVENUE USE
__________________________________________________
Notary Public Signature and Seal
My commission expires:
1
Updated January 1998