Form Ia 1041 - Iowa Fiduciary Return - 2012

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Iowa Department of Revenue
2012 IA 1041
For Calendar Year 2012 or fiscal year beginning _______ ,2012, and ending _________ , 20 ___
Iowa Fiduciary Return
Name of Estate or Trust
Federal Employer ID Number
Check one:
Estate
Name, Address, and Title of Fiduciary
Decedent’s Social Security Number
Simple Trust
Complex Trust
Name of Attorney
Attorney’s Phone Number
Iowa County in which
Bankruptcy Estate
estate is pending
If trust, check one:
Testamentary
Mailing Address (city, state, ZIP)
Probate No.
Inter Vivos
Authorization is granted to the attorney listed above to receive confidential tax information under Iowa Code section 421.60 to act as the trust
Date of decedent’s death
or estate’s representative before the Iowa Department of Revenue and to make written or oral presentations on behalf of the trust or estate.
Is this an amended IA 1041?
Yes
No
Is Income Tax Certificate of Acquittance requested?
Yes
No
_____/______/_____
Is an Iowa 706 being filed?
Yes
No
Have prior returns been filed for this estate or trust?
Yes
No
1. Dividends. Enter full amount. ................................................................................................. 1. _____________________
2. Interest ................................................................................................................................... 2. _____________________
3. Income from partnerships and other fiduciaries. Attach supporting schedule. ................. 3. _____________________
4. Net rents and royalties ............................................................................................................ 4. _____________________
5. Net business and farm income or loss. Attach Schedules C or C-EZ and F, federal form 1040. ... 5. _____________________
6. Net gain (loss) from capital assets ........................................................................................ 6. _____________________
7. Ordinary gains (losses). Attach federal form 4797. ............................................................. 7. _____________________
8. Other income. State nature of income. ................................................................................. 8. _____________________
0
9. Total income. Add lines 1 through 8. ................................................................................................................................. 9. __________________ 
10. Interest. Enter on Schedule D, page 2. .............................................................................. 10. _____________________
11. Taxes. Enter on Schedule D, page 2. ................................................................................. 11. _____________________
12. Fiduciary fees. Enter on Schedule D, page 2. ................................................................... 12. _____________________
13. Charitable deduction from income in compliance with Will or Trust instrument. ............ 13. _____________________
14. Attorney, accountant, and return preparer fees. Enter on Schedule D, page 2. ............ 14. _____________________
15. Other deductions not subject to 2% floor. Enter on Schedule D, page 2. ...................... 15. _____________________
21
16. Allowable miscellaneous itemized deductions. Enter on Schedule D, page 2. .............. 16. _____________________
21
17. Total. Add lines 10 through 16. ........................................................................................................................................ 17. __________________ 
18. Balance. Subtract line 17 from line 9 ............................................................................................................................... 18. __________________ 
19. Distributions to beneficiaries. Complete Schedule B on page 2 or attach federal Schedule K-1. .... 19. _____________________
20. Federal estate tax attributable to income in respect of a decedent (fiduciary’s share) . 20. _____________________
0
21. Total. Add lines 19 and 20. ............................................................................................................................................... 21. ____________________
22. Taxable income of fiduciary. Subtract line 21 from line 18. Must be zero on final return ....................................... 22. __________________ 
Complete lines 23-32. Nonresidents, also complete Schedule C and enter on line 28.
23. Compute tax from rate Schedule E, page 2. ...................................................................... 23. _____________________
24. Iowa lump sum tax. Attach federal Schedule 4972. .......................................................... 24. _____________________
25. Iowa minimum tax. Attach IA 6251. .................................................................................... 25. _____________________
0
26. Tax before credits. Add lines 23 through 25. .................................................................................................................. 26. ____________________
40.00
27. Personal exemption credit. This is a nonrefundable credit. .............................................. 27. _____________________
28. Out-of-state tax credit or nonresident credit. Attach copy of out-of-state return and
Schedule IA 130 or IA 1041 Schedule C. ........................................................................... 28. _____________________
29. Motor fuel tax credit. Attach Schedule IA 4136. ................................................................ 29. _____________________
40
30. Other credits. Attach IA 148 Tax Credits Schedule. .......................................................... 30. _____________________
0
31. Total credits. Add lines 27 through 30. ............................................................................................................................ 31. ____________________
32. Tax liability. Subtract line 31 from 26. ............................................................................................................................. 32. ____________________
33. Tax paid with additional Iowa Fiduciary Income Tax Payment Voucher ...................................................................... 33. ____________________
34. Refund. If line 33 is larger than line 32, enter the difference. ....................................................................................... 34. __________________ 
35. Amount due. If line 33 is less than line 32, enter the difference. ................................................................................. 35. __________________ 
0
Mail to: Fiduciary Return Processing, Iowa Department of Revenue, PO Box 10467, Des Moines, IA 50306-0467
DECLARATION: The undersigned hereby certifies and declares that this return, and any schedules or papers attached hereto, has been duly examined; that to the best
knowledge and belief of the undersigned, it is a true, correct, and complete return for the taxable year as required by the income tax law of the State of Iowa and the
rules and regulations issued under authority thereof. Note: State tax information may be disclosed to tax officials of another state or of the United States for tax
administrative purposes.
Signature of fiduciary or officer representing fiduciary
Date
Signature of preparer other than fiduciary
Preparer’s ID No.
Address
Date
63-001a (09/17/12)

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