706-CE
Certificate of Payment of Foreign Death Tax
Form
OMB No. 1545-0260
(Rev. October 2013)
Information about Form 706-CE and its instructions is at
▶
Department of the Treasury
For Paperwork Reduction Act Notice, see instructions.
▶
Internal Revenue Service
Decedent’s first name and middle initial
Decedent’s last name
Social security number
Country of citizenship at time of death
Country of legal residence (domicile) at time of death
Date of death
Last address (number and street, city, town or post office, state or province, country, and ZIP or foreign postal code)
Name of executor, administrator, etc.
Address (number and street, apt. or suite no., city, town or post office, state or province, country, and ZIP or foreign postal code)
1
Name of foreign government imposing the tax
2
Death tax finally determined by that government. Do not include any interest
or penalty. Show amount in foreign currency.
3
Was the amount on line 2 figured under the provisions of a death tax convention? .
.
.
.
.
.
.
.
.
.
Yes
No
4
List amount(s) of death tax paid (other than interest and penalties) and the date(s) of payment. Show amount(s) in foreign currency.
5
The description, location, and value (as established and accepted by the death tax officials of the government named above) of the property
subjected to the death tax are as follows:
Value
Item
(show in
Description and location
Number
foreign currency)
1
706-CE
(If necessary, attach additional sheets and follow the same format.)
Form
(Rev. 10-2013)
Cat. No. 10149C