Form Il-1041 - Fiduciary Income And Replacement Tax Return - 2013 Page 4
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4Illinois Department of Revenue
Year ending
Schedule D
Beneficiary Information
Month
Year
Attach to your Form IL-1041.
IL Attachment no. 1
Write your name as shown on your Form IL-1041.
Write your
federal employer identification number (FEIN).
Step 1: Provide the following information
1
1
Write the amount from your Form IL-1041, Line 27.
2
2
Write the apportionment factor from your Form IL-1041, Schedule NR, Step 6, Line 3.
Step 2: Identify your beneficiaries.
Attach additional sheets if necessary.
A
B
C
D
E
F
G
Beneficiary’s
Check the box if
Pass-through
Excluded from
amount of base
the beneficiary
entity payment
pass-through
Beneficiary type
income or loss
is an Illinois
amount
entity payments
Name and Address
SSN or FEIN
(See instructions.)
(See instr.)
nonresident
(See instr.)
(See instr.)
1
2
3
4
5
6
7
Add the amounts shown in Column D for nonresident
beneficiaries for which you have entered a check mark
7
in Column E. Write the total here. (See instructions.)
*363701110*
Schedule D (R-12/13)
IL-1041 (R-12/13)
Page 4 of 4
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