Form 706-A - United States Additional Estate Tax Return Page 4
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Form 706-A (Rev. 9-2013)
Page
Schedule C. Dispositions to Family Members of the Qualified Heir
Each transferee must enter into an agreement to be personally liable for any additional taxes imposed by section 2032A(c) and
the agreement must be attached to this Form 706-A. (see instructions)
Last name
First name
Middle initial
Transferee #1:
Social security number
Relationship to the qualified heir
Description of property transferred
A
B
C
Item
Description of specially valued property and schedule and item
Date of
number
number where reported on the decedent’s Form 706
disposition
1
Form 706, Schedule
, Item
Description:
First name
Middle initial
Last name
Transferee #2:
Social security number
Relationship to the qualified heir
Description of property transferred
A
B
C
Item
Description of specially valued property and schedule and item
Date of
number
number where reported on the decedent’s Form 706
disposition
1
Form 706, Schedule
, Item
Description:
706-A
If there are more than two transferees, attach additional sheets using the same format.
Form
(Rev. 9-2013)
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