Form D-41 - Fiduciary Income Tax Return - 2002 Page 2

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*0 20410 120000*
D-41 PAGE 2
Enter your last name.
Your social security number
Tax and payments
.
13 Tax on fiduciary income
.00
If line 12 is $10,000 or less
If line 12 is $10,001 – $30,000
If line 12 is over $30,000
Amount from line 12
Amount from line 12
Amount from line 12
Multiply by 0.05.
Subtract 10,000.
Subtract 30,000.
Enter on line 13.
Multiply by 0.075.
Multiply by 0.093.
Add 500.
Add 2,000.
Enter on line 13.
Enter on line 13.
Round all amounts to the nearest dollar.
If amount is zero, leave the line blank.
$
.00
$
.00
13
$
14 Credit for taxes paid to other states
.00
See instructions, page 8. Attach a copy of federal Form 1041
$
.00
.00
14
$
15 2002 estimated income tax payments
.00
.00
.00
$
15
.00
16 Payments made with an extension of time to file
$
$
.00
.00
From D.C. FR-127, line 7.
16
.00
$
.00
17 If amended return, payments made with previous 2002 D-41
17
$
.00
0 0
.00
.00
18 Total payments
$
.00
$
Add lines 14 through 17.
18
Complete if line 18 is more than line 13.
Complete if line 18 is less than line 13.
19 Your refund
$
.
00
20 Amount you owe
$
.00
Subtract line 13 from line 18.
Subtract line 18 from line 13.
Payment
Attach check or money order payable to
DC Treasurer. Write your social security
number, federal employer identification
number and “2002 D-41” on your payment.
Signature
Under penalties of law, I declare that I have examined this return and to the best of my knowledge it is correct.
Declaration of paid preparer other than taxpayer is based on all information available to the preparer.
Signature of fiduciary or officer representing fiduciary
Date
Signature of preparer
Preparer’s Federal ID, SSN, or PTIN
Preparer’s address (number and street)
City
State
Zip
Additional documentation
You must file a copy of the will or trust agreement and a statement explaining the tax liability of each
of the following: the estate or trust, the beneficiaries, and the grantor.
You do not need to refile these documents unless they have been amended.
You have filed these documents in a previous year. Date filed
Year of return
Fill in if:
Send your signed and completed original return to
Office of Tax and Revenue
P .O. Box 441
Washington, DC 20044-0441
D-41 P2
Fiduciary Income Tax Return

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