Form Ia 1041 - Iowa Fiduciary Return - 2011 Page 2
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1
2Fiduciary Schedules A, B, D, and E
Schedule A - Background Information:
Answer all applicable questions.
1. Date estate was opened or created: ______________________________
2. Date of decedent’s death: ______________________
3. Decedent’s business or occupation: ______________________________
4. Decedent’s age at death: ______________________
5. Was a decedent’s final return filed?
Yes
No
6. Did will of decedent create trust?
Yes
No
7. Did decedent file IOWA return(s) up to the date of death?
Yes
No If no, attach earnings statement or explanatory affidavit.
8. Enter decedent’s name and address: ____________________________________________________________________________________________
______________________________________________________________________________________________________________________________
9. Name and Social Security Number of decedent’s spouse, if any: _____________________________________________________________________
10. Enter name(s) of executor(s): __________________________________________________________________________________________________
11. Enter date(s) and amount(s) of executor’s fees paid to executor(s): ___________________________________________________________________
12. Had federal audit been made on prior returns of decedent or the estate or trust?
Yes
No
Is an audit now in the process?
Yes
No
13. Have expenses of administration or selling expenses been deducted for federal estate tax purposes?
Yes
No
14. Did you as fiduciary withhold on income distributions made to nonresident beneficiaries?
Yes
No
15. Does the estate/trust elect to recognize the gain or loss on a distribution of property under section IRC 643(d)(e)?
Yes
No
Schedule B - Beneficiaries’ Shares of Income and Credits:
Attach additional pages as necessary. In lieu of Sch. B, attach federal Sch. K-1.
Beneficiary A
Beneficiary B
Beneficiary C
TOTALS
1. Names of each beneficiary ...................................... 1. ______________________________________________________________________________
2. Social Security Number ............................................ 2. ______________________________________________________________________________
3. Address ...................................................................... 3. ______________________________________________________________________________
4. Iowa resident (Yes/No) ............................................. 4. ______________________________________________________________________________
5. Net short-term capital gain ...................................... 5. ______________________________________________________________________________
6. Net long-term capital gain (100%) .......................... 6. ______________________________________________________________________________
7. Depreciation and depletion ...................................... 7. ______________________________________________________________________________
8. Ordinary income subject to Iowa income tax ......... 8. ______________________________________________________________________________
9. Income not subject to Iowa income tax .................. 9. ______________________________________________________________________________
10. Excess deductions .................................................. 10. ______________________________________________________________________________
REGARDING IOWA NONRESIDENT INCOME .........................................................................................................................................................................
11. Iowa income tax withheld, if any ........................... 11. ______________________________________________________________________________
12. Withholding agent’s identification number ........... 12. ______________________________________________________________________________
Schedule D - Explanation of Expenses
Line No.
Explanation
Amount
Schedule E - Tax Rates
Of Excess
Taxable Income
Over But Not Over
Tax Rate
Over
$0
$1,439
$0.00
+ (0.36%
x
$0)
$1,439
$2,878
$5.18
+ (0.72%
x
$1,439)
$2,878
$5,756
$15.54
+ (2.43%
x
$2,878)
$5,756
$12,951
$85.48
+ (4.50%
x
$5,756)
$12,951
$21,585
$409.26
+ (6.12%
x
$12,951)
$21,585
$28,780
$937.66
+ (6.48%
x
$21,585)
$28,780
$43,170
$1,403.90
+ (6.80%
x
$28,780)
$43,170
$64,755
$2,382.42
+ (7.92%
x
$43,170)
$64,755
over
$4,091.95
+ (8.98%
x
$64,755)
63-001b (09/21/11)
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