Form Tc-41k-1 - Beneficiary'S Share Of Income, Deductions, And Credits

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TC-41K-1
Beneficiary’s Share of Income, Deductions, and Credits
Rev. 12/13
41309
Taxpayer’s SSN
Taxpayer’s name
Estate or trust information
Beneficiary’s Share of Utah Income, Deductions and Credits
.00
A. Estate or trust EIN or SSN ______________________________
1a. Utah U. S. government interest income
.00
1b. Utah municipal bond interest income
B. Estate or trust name
.00
1c. Utah other interest income
.00
2. Utah ordinary dividends
Fiduciary information
.00
3. Utah net short-term capital gain
C. Fiduciary’s name, address, city, state, and ZIP code
.00
4. Utah net long-term capital gain
.00
5. Utah other portfolio and nonbusiness income
.00
6. Utah ordinary business income
.00
7. Utah net rental real estate income
.00
Beneficiary information
8. Utah other rental income
D. Beneficiary’s SSN or EIN ____________________________
9. Utah directly apportioned deductions (describe)
.00
E. Beneficiary’s name, address, city, state, and ZIP code
.00
.00
.00
.00
10. Estate tax deduction
F. Beneficiary’s phone number __________________________
11. Final year Utah deductions (describe)
.00
G. Percent of Utah income _____________________________
.00
H. Dependent beneficiary - enter “X” ______
“Statement of Dependent Beneficiary Income” on file with trustee
.00
Other information
.00
12. Other Utah information
.00
.00
.00
.00
13. Utah nonrefundable credits allocated to beneficiary
Name of credit
Code
Credit amount
.00
For Utah State Tax Commission Use Only
.00
.00
.00
14. Utah refundable credits allocated to beneficiary
Name of credit
Code
Credit amount
.00
.00
.00
.00
.00
15. Utah tax withheld on behalf of beneficiary
“X” if withholding waiver applied for

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Parent category: Financial
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