Form 101s - Wisconsin Spousal Inheritance Tax Return

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FORM 101S
WISCONSIN
DEPT USE ONLY
SPOUSAL INHERITANCE TAX RETURN
AUD #
SEND BOTH COPIES TO:
Wisconsin Department of Revenue
PO Box 8906
1
2
3
4
5
(FOR DEATHS BETWEEN JULY 1, 1982 AND DECEMBER 31, 1991)
Madison, WI 53708
Estate of
Date of Death
Date of Birth
Decedent’s Social Security Number
Address of Decedent at Date of Death (number and street)
City
State
County
THIS SECTION MUST BE FULLY COMPLETED OR THE PROCESSING OF THIS RETURN WILL BE DELAYED.
Did the decedent have any of the following documents at death:
Will (including any codicils)?
No
Yes
If the answer to any of these is “yes”, a copy of the document(s) must be
Trust agreement(s)?
Yes
No
attached to this return. If the answer is “no”, the “no” box must be checked.
Marital property agreement(s)?
Yes
No
Will the Closing Certificate for Fiduciaries (also called the “income closing certificate”) be needed to close this estate with the Circuit Court?
Yes
No
If “yes”, it is suggested that the request for that certificate and any required fiduciary income tax returns accompany this return. A copy of the
inventory must accompany the request for this certificate (see instructions).
Department Use Only
To be completed by Department after reviewing declaration of surviving
spouse.
CERTIFICATE DETERMINING
NO INHERITANCE TAX
Date
Based upon the declaration of the surviving spouse, the Wisconsin
Department of Revenue, pursuant to Section 72.30(3)(c), Wisconsin
Statutes, certifies that there is no inheritance tax due in this estate.
Read instructions on back of Copy 2 before signing declaration.
WISCONSIN DEPARTMENT OF REVENUE
DECLARATION OF
SURVIVING SPOUSE
Director, Inheritance & Excise Tax Bureau
I hereby declare that I am the surviving spouse of
PREPARER’S NAME (indicate below who prepared this return)
,
who died while a resident of
,
County, Wisconsin, and as such …
Name (print or type)
I have made a diligent and careful search for property of
every kind left by my deceased spouse, and
(
)
I am the only person receiving property from my deceased
Telephone Number
spouse, except the property under $5,000 (if any) disclosed in
Schedule A on the back of Copy 2 of this form, and
RETURN MAILING ADDRESS - This form will be returned to the person
I have no knowledge of any gifts made by my deceased
whose name is entered below. Please print or type name and address on
spouse to any individual in excess of $10,000 in the two years
these three lines.
immediately before death, except as disclosed in the attached
statement (describe gift, date given, value, name of recipient
and relationship to decedent.)
This declaration is true to the best of my knowledge and belief.
Name
Signature of Surviving Spouse
Address
Date
Social Security Number
City
State
Zip Code
HT-008 (R. 6-09)

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