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120005411283
SCHEDULE
K 1
2012
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Final K-1
Amended K-1
FORM 41
Part III – Beneficiary’s Share of Alabama Current Year
A
D
R
Income, Deductions, Credits, and Other Items
LABAMA
EPARTMENT OF
EVENUE
Fiduciary Income Tax
1 Interest income
10a Grantor trust income
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Beneficiary Information
For the calendar year 2012 or fiscal year beginning
2 Ordinary dividends
10b Grantor trust deduction
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____________________, 2012, and ending ____________________, _________
Beneficiary’s Share of Alabama Income,
3 Business income (loss)
10c Net grantor trust income
Deductions, Credits, etc.
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See instructions.
Nonresident beneficiary/grantor
4 Net Alabama capital gain
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Part I – Information About the Estate or Trust
or (loss)
Alabama source income
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A Estate’s or trust’s employer identification number
5 Rents, royalties, partnerships,
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Nonresident beneficiary/grantor
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and other estates and trusts
non-Alabama source income
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B Estate’s or trust’s name
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Directly apportioned
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6 Farm income or (loss)
deductions:
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13a Depreciation
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7 Ordinary gain or (loss) from
C Fiduciary’s name, address, city, state, and ZIP code
Form 4797
13b Depletion
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13c Amortization
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8 Other income (attach
explanation)
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Allocated composite
payment
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Grantor trust
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9 Alabama Tax Exempt Income
Part II – Information About the Beneficiary
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Other information
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E Beneficiary’s identifying number
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F Beneficiary’s name, address, city, state, and ZIP code
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Note: A statement must be attached showing the beneficiary’s share
of income and directly apportioned deductions from each business,
rental real estate, and other rental activity.
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Alabama resident
Nonresident
ADOR