Form 41 - Oregon Fiduciary Income Tax Return - 2012 Page 2
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1
2Name of estate or trust
Federal employer identification number (FEIN)
SCHEDULE 1—OREGON CHANGES TO DISTRIBUTABLE NET INCOME (DNI) AND TAXABLE INCOME OF FIDUCIARY (TIF)
(refer to specific instructions)
(Column A)
(Column B)
DNI
TIF
22. Distributable net income (from federal Form 1041, Schedule B, line 7) ...................22
23. Taxable income of fiduciary (from federal Form 1041, line 22) ........................................................................ 23
24. Difference in depreciation for Oregon (see instructions) ...............................................24
24
25. Other changes. Identify ___________________________________ .................................25
25
26. Line 24 plus line 25 .......................................................................................................26
26
27. Revised distributable net income (Column A, line 22 plus line 26)
Enter here and on page 1, line 1 ...................................................................................27
28. Total taxable income (Column B, line 23 plus line 26) .......................................................................................... 28
29. Changes included on Column A, line 26, that were distributed ........................................................................ 29
30. Revised taxable income of fiduciary (total or net of lines 28 and 29)
Enter here and on page 1, line 4 .......................................................................................................................... 30
SCHEDULE 2—FIDUCIARY ADJUSTMENT
(refer to specific instructions)
Subtractions
31. 2012 federal income tax subtraction—limited to $6,100 ..................................................................................... 31
32. Interest on U.S. obligations included in income on federal Form 1041 $ _______________,
less allocation of administration and miscellaneous expenses $ _______________ .......................................... 32
33. Oregon income tax refund included as income on federal Form 1041 ................................................................ 33
34. Other subtractions (attach explanation) ............................................................................................................... 34
35. Add lines 31 through 34 ....................................................................................................................................... 35
Additions
36. Oregon income tax deducted on 2012 federal Form 1041 .................................................................................. 36
37. Interest on obligations of other states or their political subdivisions ................................................................... 37
38. Depletion in excess of adjusted basis.................................................................................................................. 38
39. Estate taxes on income in respect of a decedent not taxable by Oregon ........................................................... 39
40. Other additions (attach explanation) .................................................................................................................... 40
41. Add lines 36 through 40 ....................................................................................................................................... 41
42. Fiduciary adjustment (difference between lines 35 and 41) ................................................................................. 42
This adjustment is an
addition or
subtraction on page 1, line 5.
2012 RATE SCHEDULE—Compute the Tax Using the Following Rates. See instructions.
If your taxable income is:
Your tax is:
Not over $3,150
5% of taxable income
Over $3,150 but not over $7,950
$158 plus 7% of the excess over $3,150
Over $7,950 but not over $125,000 (see instructions)
$494 plus 9% of the excess over $7,950
Over $125,000
$11,028 plus 9.9% of the excess over $125,000
Under penalty of false swearing, I declare that the information in this return and any included forms or statements is true, correct, and complete.
Signature of fiduciary
Print name
Date
x
Title (if applicable)
Daytime telephone number
(
)
Check the box to authorize the preparer to receive and provide any confidential tax information relating to this return.
Signature of preparer other than fiduciary
Print name and title
Date
x
Mailing address of preparer
Daytime telephone number
(
)
150-101-041 (Rev. 10-12)
Form 41, page 2 of 2
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