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Department of Revenue Services
Schedule CT-709 Farmland
Calendar Year
PO Box 2978
Hartford CT 06104-2978
2012
(Rev. 06/12)
.
Complete this schedule in blue or black ink only
Purpose: Use Schedule CT-709 Farmland to report the fair market value of farmland based on its highest and best use as of the
date of the gift. Complete a separate Schedule CT-709 Farmland for each donee. If you are claiming special valuation
on a gift of farmland, this schedule must be attached to Form CT-706/709, Connecticut Estate and Gift Tax Return. You
must also furnish a copy of this schedule and instructions to each donee.
Donor’s fi rst name and middle initial
Last name
Social Security Number (SSN)
• •
• •
• •
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Address (number and street)
PO box
DRS use only
–
– 20
City, town, or post offi ce
State
ZIP code
Schedule of Farmland
A
B
C
D
E
F
Description of Gift
Date of Gift
Fair Market Value of
Value as Farmland
Additional Gift Tax
Item
Include the town, volume, and page
Farmland at Date of
at Date of Gift
Due if Farmland
No.
number of land records in which the
Gift
Is Subsequently
deed of gift is recorded.
Transferred or
Reclassifi ed
Donee’s fi rst name and middle initial
Last name
Donee’s Address (number and street)
City, town, or post offi ce
State
ZIP code
Donee’s SSN
Relationship to donor
• •
• •
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Declaration: I declare under penalty of law that I have examined this return (including any accompanying schedules and statements) and, to the best of my
knowledge and belief, it is true, complete, and correct. I understand the penalty for willfully delivering a false return or document to the Department of Revenue
Services is a fi ne of not more than $5,000, imprisonment for not more than fi ve years, or both.
Donor’s signature
Date