Vt Form Est-191 - Estate Tax Return - Resident And Nonresident Page 2
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1
2Decedent’s Last Name
*171911200*
Social Security Number
* 1 7 1 9 1 1 2 0 0 *
Amount from Line 7 _____________________________
0.00
VERMONT APPORTIONMENT CALCULATION
8.
. . . . . . . . 8. ________________________
Vermont Gross Estate (see instructions) .
9.
Value of gifts included on Line 2b with a
Vermont situs (see instructions) . . . . . . . . . . . . . .
. 9. ________________________
10.
Add Lines 8 and 9 . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . 10. _______________________
11.
Federal Gross Estate
(from Federal Form 706, Line 1) . . . . . . . . . . . . . 11. ________________________
12.
Total value of all gifts reported on Line 2b .
. . . . . 12. ________________________
13.
Add Lines 11 and 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13. _______________________
14.
Divide Line 10 by Line 13 (round to four decimal places) . . . . . . . . . . . . . . . . . . . . 14. _______________________
TAX DUE
15.
Vermont Estate Tax (multiply Line 7 by Line 14) . . . . . . . . . . . . . . . . . . . . . . . . . . . 15. _______________________
16.
Percentage of Vermont Estate Tax due to Vermont . Enter “100 .00%” or, if this
.
%
is an estate of a qualifying farmer, percentage from Schedule EST-192, Line 3 . . . 16. _______________________
100.00
17.
Adjusted Vermont Estate Tax (Multiply Line 15 by Line 16) . . . . . . . . . . . . . . . . . 17. _______________________
18.
Prior tax payments to Vermont . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18. _______________________
19.
REFUND. If Line 17 is less than Line 18, subtract Line 17 from Line 18 . . . . . . . 19. _______________________
20.
AMOUNT DUE. If Line 17 is more than Line 18, subtract Line 18 from
Line 17 . Make check payable to Vermont Department of Taxes. . . . . . . . . . . . . . 20. _______________________
DECLARATION OF FIDUCIARY
I hereby certify this return is true, correct, and complete to the best of my knowledge . Preparers cannot use return information for
purposes other than preparing returns .
Date
Daytime Telephone Number
SIGN
HERE
Check here if authorizing the Vermont Department of Taxes to discuss this return and attachments with your preparer .
Preparer’s
Date
Daytime Telephone Number
Preparer’s
signature
Use Only
Address
City, State, ZIP Code
Make checks payable to Vermont Department of Taxes and mail this return to:
Vermont Department of Taxes
Form EST-191
133 State Street
(formerly E-1)
Montpelier, VT 05633-1401
Page 2 of 2
5454
Rev. 10/17
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