Form Pa-41b - Pa-41 Schedule B - Dividend And Capital Gains Distributions Income - 2013
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11304710054
PA-41 SCHEDULE B
Dividend and Capital Gains
Distributions Income
2013
OFFICIAL USE ONLY
PA-41B (06–13) (FI)
START
Name as shown on the PA-41
Federal EIN or Decedent’s SSN
Caution: Federal and Pennsylvania rules for taxable dividend income are different. You cannot use the federal schedule to report Pennsylvania dividend
income. Read the instructions. If the taxable dividend income is $2,500 or less, the fiduciary must report the income, but is not required to submit PA-41
Schedule B. If the dividend income is more than $2,500, the fiduciary must submit PA-41 Schedule B. List the name of each payer and the amount of
Pennsylvania-taxable dividend income you received during the year. Important: Capital gains distributions are dividend income for Pennsylvania purposes.
1. $
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2. $
2. Total dividend income. Add all amounts listed
3. $
3. Capital gains distributions
4. $
4. Dividend income from partnership(s), from PA Schedule(s) RK-1
5. $
5. Dividend income from PA S corporation(s), from PA Schedule(s) RK-1
6. Total dividend income
$
Add Lines 2, 3, 4, and 5. Enter on Line 2 of the PA-41.
6.
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