Form 41 - Oregon Fiduciary Income Tax Return - 2003 Page 2
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1
2Form 41 (2003) — page 2
Name of Estate or Trust
Federal Employer Identification Number
SCHEDULE 1 — OREGON CHANGES TO DISTRIBUTABLE NET INCOME (DNI) AND TAXABLE INCOME OF FIDUCIARY (TIF)
(refer to specific instructions)
(Column A)
(Column B)
DNI
TIF
22. Distributable net income (from federal Form 1041, Schedule B, line 7) ................... 22
23. Taxable income of fiduciary (from federal Form 1041, line 22) ......................................................................... 23
24. Changes in depreciation for Oregon ............................................................................ 24
24
25. Other changes. Identify ___________________________________ ......................... 25
25
26. Line 24 plus line 25 ...................................................................................................... 26
26
27. Revised distributable net income (Column A, line 22 plus line 26)
Enter here and on page 1, line 1 ................................................................................. 27
28. Total taxable income (Column B, line 23 plus line 26) ......................................................................................... 28
29. Changes included on Column A, line 26, that were distributed (see instructions) ............................................ 29
30. Revised taxable income of fiduciary (total or net of lines 28 and 29)
Enter here and on page 1, line 4 ......................................................................................................................... 30
SCHEDULE 2 — FIDUCIARY ADJUSTMENT
(refer to specific instructions)
Subtractions
31. 2003 federal income tax subtraction—limited to $3,500 (see instructions) ......................................................... 31
32. Interest on U.S. obligations included in income on federal Form 1041 $ _______________,
less allocation of administration and miscellaneous expenses $ _______________ (see instructions) ........... 32
33. Oregon income tax refund included as income on federal Form 1041 ................................................................ 33
34. Other subtractions (attach explanation) ............................................................................................................... 34
35. Add lines 31 through 34 ....................................................................................................................................... 35
Additions
36. Oregon income tax deducted on 2003 federal Form 1041 .................................................................................. 36
37. Interest on obligations of other states or their political subdivisions .................................................................... 37
38. Depletion in excess of adjusted basis .................................................................................................................. 38
39. Estate taxes on income in respect of a decedent not taxable by Oregon ............................................................ 39
40. Other additions (attach explanation) .................................................................................................................... 40
41. Add lines 36 through 40 ....................................................................................................................................... 41
42. Fiduciary adjustment (difference between lines 35 and 41) ................................................................................. 42
This fiduciary adjustment is to be
added or
subtracted on page 1, line 5.
2003 RATE SCHEDULE
Compute the Tax Using the Following Rates
If your taxable income is:
Your tax is:
Not over $2,550 ................................................................. 5% of taxable income
Over $2,550 but not over $6,350 ....................................... $128 plus 7% of the excess over $2,550
Over $6,350 ....................................................................... $394 plus 9% of the excess over $6,350
I declare under the penalties for false swearing that this return (and any accompanying schedules and statements) has been examined by
me, and to the best of my knowledge and belief, it is true, correct, and complete.
Signature of Fiduciary
Print Name
Date
x
Title (if applicable)
Daytime Telephone Number
(
)
By signature above, I hereby authorize the preparer to receive and provide any confidential tax information relating to this return.
Signature of Preparer other than Fiduciary
Print Name
Date
x
Title (if applicable)
Daytime Telephone Number
(
)
150-101-041 (Rev. 12-03)
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