Government of the
2012
D-41 Fiduciary
District of Columbia
*120410110002*
Income Tax Return
This is a FILL-IN format. Please do not handwrite
OFFICIAL USE ONLY
any data on this form other than your signature.
Vendor ID#0002
Information
amended return
Fill in:
if
See page 3.
Fill in:
if this is your final return.
Estate
Simple trust
Complex trust
Tax year ending (MMYY)
Fill in type of entity:
1 1 1 1
Testamentary (created by a will)
Inter vivos (living)
Fill in type of trust:
Estate or trust’s taxpayer ID number
Daytime telephone number
FEIN
SSN
Estate or trust name
Fiduciary’s name and title
#
Fiduciary’s address (number, street and suite/apartment number (if applicable))
Suite/Apartment
City
State
Zip Code +4
Complete if entity
Complete if entity
(MMDDYYYY)
(MMDDYYYY)
is a trust
is an estate
Date created
Date of deceased’s death
(MMDD)
(MMDD)
If estate ended in 2012, enter date
If trust ended in 2012, enter date
Name of grantor
Yes
No
Yes
No
Address of grantor (number and street)
If no, will one be filed?
City
State
Zip Code
Income
Round cents to nearest dollar. If amount is zero, leave line blank.
.
$
00
1
1 Federal total income
Fill in if loss
from federal Form 1041.
.
$
00
2
2 Additions to federal total income
from Calculation A, line f, page 5 of instructions.
.
$
00
3
3
Fill in if loss
4
Add Lines 1 and 2.
.
$
00
4 Subtractions from federal total income
4
from Calculation B, line d, page 5 of instructions.
.
$
00
5
5 Total DC fiduciary income
Fill in if loss
S
u
t b
a r
t c
Line 4 from Line 3. If zero or a loss,
stop here; do not fill in rest of form.
Deductions and exemptions
.
$
00
6
6 Interest
from federal Form 1041.
.
$
00
7
7 Taxes
Subtract the state, local and DC franchise tax entered on federal Form 1041.
.
$
00
8
8 Deduction for distributions to beneficiaries
from federal Form 1041.
.
$
00
9 Other deductions
9
Enter total of Lines 12, 13, 14, 15a, 15b and 19 from federal Form 1041.
.
$
00
10
10 Exemption
Enter $1,675 for estates and $100 for trusts. If the estate ended during 2012,
prorate the exemption. See page 6 for instructions.
.
$
00
11
11 Total deductions and exemptions
Add Lines 6–10.
.
$
00
12
12 Taxable fiduciary income
Fill in if loss
Subtract Line 11 from Line 5.
2012 D-41 P1
Fiduciary Income Tax Return
Revised 11/12