Form 17-106 - Inheritance Tax Return - Federal Estate Tax Credit

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COMPTROLLER OF PUBLIC ACCOUNTS
17-106
STATE OF TEXAS
(Rev.5-02/12)
INHERITANCE TAX RETURN - FEDERAL ESTATE TAX CREDIT
Do not write in space above
For estates with a date of death on or after September 1, 1983
Note: Returns are due and tax is payable nine months after date of death.
For Comptroller’s use only
SECTION I - ESTATE INFORMATION
T Code
90100
Decedent’s name (Last, first, middle, maiden)
Date of death
Deposit code
110
Amount
County of probate (Enter “NA” if not probated)
Probate case number
Social Security Number
2 -
-
-
-
Postmark date
SECTION II - RESIDENCE/DOMICILE INFORMATION (See instructions for definitions)
Check the item that applies and complete the blanks.
TEXAS RESIDENT - Domicile at date of death (City and county) _______________________________________________________________
1.
ALIEN: NOT A U.S. CITIZEN OR RESIDENT - Domicile at date of death (Foreign country) __________________________________________
2.
NON RESIDENT OF TEXAS; NOT AN ALIEN - Domicile at death (State or country) ________________________________________________
3.
Since July 21, 1987, a separate request must be made to Texas for an extension to pay Texas Inheritance Tax. Also, if a payment is made to the IRS,
a payment must be made to Texas in at least the same proportion. Failure to do this will result in penalty being assessed. Send IRS Form 4768 with
attachments on or before the due date. You must furnish a copy of the approved IRS extension when received.
Texas Extensions
4.
An extension to file the Texas Inheritance Tax Return until _____________________________
has been
requested
granted
5.
An extension to pay the Texas Inheritance Tax until ___________________________________
has been
requested
granted
Federal Extensions
6.
An extension to file the Federal Estate Tax Return until ________________________________
has been
requested
granted
7.
An extension to pay the Federal Estate Tax until _____________________________________
has been
requested
granted
8. Total state death tax credit allowable for Federal Estate Tax purposes (From IRS Form 706 page 1) ......................... $ __________________
9. Amount paid to other states which is allowable as state death tax credit (Texas residents only) .................................
__________________
10. Amount of state death tax credit not paid to other states (Item 8 minus Item 9) (Texas residents only) .......................
__________________
11. Gross value for Federal Estate Tax purposes of property taxable in Texas (See instructions) .....................................
__________________
12. Gross value of decedent's estate for Federal Estate Tax purposes (From IRS Form 706) ...........................................
__________________
.
13. Percent of estate, taxable in Texas (Item 11 divided by Item 12, round to 4 places past the decimal)(see instructions) ...
%
14. Amount of credit for property taxable in Texas (Item 8 multiplied by Item 13) ..............................................................
__________________
15. TAX PAYABLE TO TEXAS -
a. For Texas resident decedent - enter amount of Item 10 or Item 14 whichever is larger; OR
.................................................. $ __________________
b. For non-resident or alien decedent enter amount of Item 14
16. Amount of tax previously paid (See instructions) ..........................................................................................................
__________________
17. Net amount of tax due (Item 15 minus Item 16) ............................................................................................................
__________________
18. Late payment penalty - 5% of item 17 if 1-30 days late; 10% of Item 17 if over 30 days late .......................................
__________________
Late payment interest - (See instructions) ....................................................................................................................
__________________
19.
20. TOTAL TAX, PENALTIES & INTEREST DUE (Total of Items 17, 18 and 19)
.................................................. $ __________________
NOTE - DUE DATE: Returns are due and tax is payable nine (9) months after date of death.
PLEASE NOTE: • Incomplete returns cannot be processed and will be returned.
• This return must be signed by all personal representatives of the estate and the preparer.
• A copy of any Federal Estate Tax Return (Form 706) filed with the IRS and approved extensions must be included with
the return.
• The estate representative will be personally liable for transfers of estate assets before tax is paid.
I declare that this return and any accompanying statements are true, correct and complete to the best of my knowledge.
Name of preparer
Phone (Area code and no.)
Name of Executor, Administrator, Heir-at-law
Phone (Area code & no.)
Address (Street & no. city, state, ZIP code)
Address (Street & no. city, state, ZIP code)
sign
Preparer
Date
sign
Executor, etc.
Date
here
here
Name of Co-Executor,Co-Administrator
Phone (Area code & no.)
Make amount in Item 20 payable to:
STATE COMPTROLLER
Address (Street & no., city, state, ZIP code)
Mail to:
COMPTROLLER OF PUBLIC ACCOUNTS
111 E. 17th Street
sign
Co-Executor, Co-Administrator
Date
Austin, TX 78774-0100
here
For Inheritance Tax assistance call 1-800-531-5441, extension 5-0132, toll free nationwide. The Austin number is 512-475-0132.
(From a Telecommunications Device for the Deaf (TDD) ONLY call 1-800-248-4099 toll free. The Austin TDD number is 512-463-4621.)

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