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South Dakota Estate Tax Return
SD EForm - 1284
V2
To be filed for deaths occurring on or after July 1, 2001
Is this an amended return?
Instructions on reverse
1a Decedent’s first name and middle initial (and maiden name, if any)
1b Decedent’s last name
2 Decedent’s Social Security No.
3 Date of birth
4 Date of death
5 Legal residence (domicile) at time of death
6 Name and address of personal representative or applicant
7 Name and address of attorney, if applicable
8 County and circuit number of court where Will was probated or estate administered
1. Federal gross estate..............................................................................................................$_________________
2. Portion of federal gross estate in South Dakota per SDCL 10-40A-2 ..........................................$_________________
3. Percentage of property in South Dakota (line 2 ÷ line 1) ............................................................%________________
0%
4. Amount of credit for state taxes on Federal Return ................................................................. $_________________
5. South Dakota estate tax (line 4 multiplied by line 3) ................................................................ $_________________
0.00
6. Interest due ......................................................................................................................... $_________________
0.00
7. Total estate tax and interest (if any) (line 5 plus line 6) .............................................................$_________________
8. Total Amount of Previously Paid Tax........................................................................................$_________________
0.00
9. Balance Due or Refund..........................................................................................................$_________________
Under penalty of perjury, I declare that this return, including accompanying documents, has been examined by me, and is,
to the best of my knowledge and belief, true, correct and complete.
_________________________________________________________
________________________________
Signature of personal representative or applicant
Date
__________________________________________________________
______________________________
Signature of Preparer (other than personal representative)
Date
___________________________________________________________
________________________________
Address
Phone Number
Please attach required documents
and mail to: SD Department of Revenue, 445 East Capitol Avenue, Pierre, SD 57501
RV 135 (01/05)