Form Rev-1649 Ex - Schedule O - Election Under Sec. 9113(A) (Spousal Trusts)

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REV-1649 EX+ (09-12)
SCHEDULE O
ELECTION UNDER SEC. 9113(A)
INHERITANCE TAXES RETURN
(SPOUSAL TRUSTS)
RESIDENT DECEDENT
ESTATE OF
FILE NUMBER
START
PART A - DEFERRING STATEMENT
For all trust assets reportable for Pennsylvania inheritance tax purposes for which a deferral of tax is being elected under
Section 9113(a), the personal representative responsible for filing the return and the trustee(s) of the trust in question hereby
acknowledge the department’s Statement of Policy set forth at 61 Pa. Code § 94.3 concerning any potential termination of the
trust under 20 Pa.C.S. § 7710.1 that occurs after the return was filed. Specifically, the signatories recognize each individual’s
assumption of liability for inheritance tax consequences that result from any termination of the trust under 20 Pa.C.S. § 7710.1
that occurs after a return has been filed.
PLEASE SIGN AFTER PRINTING
PLEASE SIGN AFTER PRINTING
Signature of Person Responsible for Filing Return
Signature(s) of Trustee(s)
PART B – ELECTION TO TAX AMOUNTS
Complete this section only if making the election to tax available under Section 9113(a) of the Inheritance &
Estate Tax Act.
If the election applies to more than one trust or similar arrangement, a separate form must be filed for each trust. This election
applies to the
Trust (marital, residual A, B, by pass, unified credit, etc.).
Enter the description and value of all interests for which the Section 9113(a) election is made.
DESCRIPTION
VALUE
0.00
Total
If more space is needed, insert additional sheets of the same size.
RETURN TO TOP OF PAGE
PRINT FORM
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