Form Sc1041 - Fiduciary Income Tax Return - 2012 Page 4

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TAX WITHHELD FOR NONRESIDENT BENEFICIARIES
(Rev. 7/25/12)
Under South Carolina law the executor, administrator or other fiduciary of an estate or trust is required to withhold 7% of the amount of South
Carolina taxable income distributable to each nonresident beneficiary. The amount withheld from each beneficiary will be reflected on column F,
Part IV, page 3 of SC1041. Complete an SC41 for each beneficiary from whom an amount is withheld. Be sure to insert current year in space.
Copy - to the beneficiary from whom the tax is withheld so that the beneficiary may attach it to his or her South Carolina income tax return.
Copy - to the beneficiary for his records.
Copy - to be retained by the fiduciary.
The amount of tax withheld by the fiduciary should be claimed as SOUTH CAROLINA INCOME TAX WITHHELD on the SC Income Tax Return.
Note: Any estimated income tax payments assigned to beneficiaries must be reported to them on SC41, along with instructions to
enter this amount as tax withheld on their South Carolina income tax return. SC41 must be attached to the beneficiary's return to
claim this payment.
STATE OF SOUTH CAROLINA - INCOME TAX
20
SC41
FIDUCIARY REPORT OF NONRESIDENT BENEFICIARY TAX WITHHELD
ENDING DATE OF ESTATE'S OR TRUST'S TAX YEAR
Nonresident Beneficiary's Name
Social Security No.
NAME OF ESTATE OR TRUST
FEIN
Street Address or Rural Route
County
NONRESIDENT BENEFICIARY'S SHARE OF DISTRIBUTABLE
INCOME FROM SOUTH CAROLINA SOURCES:
Ordinary Income . . . . . . . . . . . . . . .
$
City
State
ZIP Code
Long-term Capital Gain . . . . . . . . . .
$
Short-term Capital Gain . . . . . . . . . .
$
Amount of Tax Withheld . . . . . . . . .
$
STATE OF SOUTH CAROLINA - INCOME TAX
20
SC41
FIDUCIARY REPORT OF NONRESIDENT BENEFICIARY TAX WITHHELD
ENDING DATE OF ESTATE'S OR TRUST'S TAX YEAR
Nonresident Beneficiary's Name
Social Security No.
NAME OF ESTATE OR TRUST
FEIN
Street Address or Rural Route
County
NONRESIDENT BENEFICIARY'S SHARE OF DISTRIBUTABLE
INCOME FROM SOUTH CAROLINA SOURCES:
Ordinary Income . . . . . . . . . . . . . . .
$
City
State
ZIP Code
Long-term Capital Gain . . . . . . . . . .
$
Short-term Capital Gain . . . . . . . . . .
$
Amount of Tax Withheld . . . . . . . . .
$
STATE OF SOUTH CAROLINA - INCOME TAX
20
FIDUCIARY REPORT OF NONRESIDENT BENEFICIARY TAX WITHHELD
SC41
ENDING DATE OF ESTATE'S OR TRUST'S TAX YEAR
Nonresident Beneficiary's Name
Social Security No.
NAME OF ESTATE OR TRUST
FEIN
Street Address or Rural Route
County
NONRESIDENT BENEFICIARY'S SHARE OF DISTRIBUTABLE
INCOME FROM SOUTH CAROLINA SOURCES:
Ordinary Income . . . . . . . . . . . . . . .
$
City
State
ZIP Code
Long-term Capital Gain . . . . . . . . . .
$
Short-term Capital Gain . . . . . . . . . .
$
Amount of Tax Withheld . . . . . . . . .
$

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