Vt Form E-2a - Estate Tax Information And Application For Tax Clearances
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1Vermont Department of Taxes
133 State Street
Montpelier, VT 05633-1401
*17E2A1100*
Phone: (802) 828-6820
ESTATE TAX INFORMATION AND
VT Form
* 1 7 E 2 A 1 1 0 0 *
E2A
APPLICATION FOR TAX CLEARANCES
Decedent’s Information
Decedent’s Last Name
First Name
Initial
Decedent’s Social Security Number
Address of Residence (domicile) at Time of Death
Spouse’s/CU Partner’s Social Security Number
City
State
ZIP Code
Date of Death (mmddyyyy)
Age at Death
-
Administrator / Executor / Trustee Information
Administrator / Executor / Trustee Name
Telephone Number
For Department Use Only
Mailing Address
City
State
ZIP Code
-
Foreign Country
Email Address
Attorney Information
Attorney’s Name
Telephone Number
For Department Use Only
Mailing Address
City
State
ZIP Code
-
Foreign Country
Email Address
1. Has the estate been entered in Probate Court? . . . . . . . Yes, District ____________________________
No
Section A VERMONT INCOME TAX (see instructions) Is a Vermont Income Tax Return required for Year of Death?
Yes. A return must be filed before the tax clearance can be issued.
No. State reason _______________________________________________________________________
Section B VERMONT FIDUCIARY TAX (see instructions) If income is received by the estate during administration, Fiduciary
tax returns may be due. Check appropriate box.
No returns are required to be filed.
Required returns have been filed. EIN (required): ___________________________________________
Required returns will be filed by (mmddyyyy) ________________. EIN (required): ________________
Section C VERMONT ESTATE TAX (see instructions)
For deaths BEFORE 2009: Is a U.S. Estate Tax Return, Form 706, required to be filed?
For deaths in 2009 or 2010: Is the total value of the estate, including taxable gifts, more than $2,000,000.00*?
For deaths in or after 2011: Is the total value of the estate, including taxable gifts, more than $2,750,000.00*?
Yes. A Vermont Estate Tax Return is required to be filed.
No. A Vermont Estate Tax Return is not required to be filed.
*The Total Value of an estate at time of death includes jointly owned assets, solely owned assets,
insurances with or without named beneficiaries and trust assets, etc. For an ancillary estate this
figure includes the value of the other states assets as well as the value of the Vermont assets.
I certify that the information contained herein is true, correct, and complete to the best of my knowledge.
Form E2A
Rev. 10/17
Signature of Administrator/Executor/Trustee
Printed Name
Date
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Parent category: Financial