Form E2a - Vermont Estate Tax Information And Application For Tax Clearances
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1VERMONT ESTATE TAX INFORMATION
AND APPLICATION FOR TAX CLEARANCES
Name of Decedent and Address of Residence (domicile) at Time of Death
Decedent’s Social
Security Number
Spouse’s/CU
Partner’s Social
Name and Address of Administrator/Executor/Trustee
Security Number
Employer ID
Number (if any)
Name and Address of Attorney (if any)
Date of Death
Age at Death
c
c
Section A
VERMONT INCOME TAX
(See instructions on reverse side)
c
c
Section B
VERMONT FIDUCIARY TAX
(See instructions on reverse side)
c
c
c
Date
Section C
VERMONT ESTATE TAX
(See instructions on reverse side)
c
c
I certify that the information contained herein is true, correct, and complete to the best of my knowledge.
Signature of Administrator/Executor/Trustee
Date
Form E2A
Keep a copy for your records.
(Rev. 10/03)
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