Form La 709 - Gift Tax Return Of Donor Page 3

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Schedule B — Total Gifts During Calendar Year
Item
Donee’s name and address,
Indicate community or
Date of
Value
number
description of gift
separate property
gift
of gift
Total gifts for calendar year
u
(Enter on Line 1, Schedule A.)
Schedule C — Prior Year Gifts
1. Have you been the donor of any gifts in prior years?
 Yes
 No
If “Yes”, complete Lines A and B.
A. Total amount of taxable gifts received in prior years. See instructions.
u
Print this amount on Schedule A, Line 5.
B. Total specific lifetime exemption claimed in prior years
u
Schedule D — Consent for Gift Splitting of Separate Property
1. Name of consenting spouse _____________________________________________________________
2. Social Security Number of consenting spouse _______________________________________________
3. Were you married during the entire calendar year?
 Yes
 No
4. If no, please check one of the following:
A.  Married
Date ___________________________
B.  Divorced
Date ___________________________
C.  Widowed
Date ___________________________
Declaration by Signature
Signature of donor/executor
Telephone
Date
Signature of consenting spouse
Telephone
Date
Signature of preparer, if different from donor
Telephone
Date
1604

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