Form It-R - Inheritance Tax Resident Return - New Jersey Division Of Taxation Page 19
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26SCHEDULE B (1) - STOCK
RESIDENT DECEDENT
DO NOT INCLUDE STOCK HELD IN A BROKERAGE ACCOUNT ON THIS SCHEDULE
_______________________________________________________
____________/____________/____________
Decedent’s Name
Decedent’s Social Security Number
(A) Report the number of shares owned of each stock.
(B) List the name of the company and all names registered on each stock.
(C) List the state of registration for each corporation (ie., NJ, DE, MD, etc.), if known.
(D) Report the per-share market value of each stock as of the date of death.
(E) Full market value of all shares (number of shares x per share value).
(F) Total value of decedent’s equity (Claims for partial ownership must be supported in supplemental affidavits).
(List accrued dividends as of date of death along with each item.)
(A)
(B)
(C)
(D)
(E)
(F)
Division Use Only
Number of
Name of Stock - Registered Owner(s)
State of Inc.
Date of Death Per
Total Market Value
Decedent’s Equity
Shares
Share Value
Insert this total on SCHEDULE B-1 Recapitulation, Line 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(If additional space is required, attach riders of the same size. All forms may be reproduced)
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