Form 8971 - Information Regarding Beneficiaries Acquiring Property From A Decedent Page 3
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4Form 8971 (1-2016)
SCHEDULE A—Information Regarding Beneficiaries Acquiring Property From a Decedent
Information about Form 8971 (including Schedule A) and its separate instructions is at
▶
Check box if this is a supplemental filing
Part 1. General Information
1 Decedent's name
3 Beneficiary's name
4 Beneficiary's TIN
2 Decedent’s SSN
5 Executor's name
6 Executor's phone no.
7 Executor's address
Part 2. Information on Property Acquired
A
B
C
D
E
Item
Description of property acquired from the decedent and the Schedule and item
Did this
Valuation
Estate Tax
No.
number where reported on the decedent's Form 706, United States Estate (and
asset
Date
Value
Generation-Skipping Transfer) Tax Return. If the beneficiary acquired a partial
increase
(in U.S.
interest in the property, indicate the interest acquired here.
estate tax
dollars)
liability?
(Y/N)
Form 706, Schedule
, Item
1
Description —
Notice to Beneficiaries:
You have received this schedule to inform you of the value of property you received from the estate of the decedent named above.
Retain this schedule for tax reporting purposes. If the property increased the estate tax liability, Internal Revenue Code section
1014(f) applies, requiring the consistent reporting of basis information. For more information on determining basis, see IRC section
1014 and/or consult a tax professional.
Page A-1
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