Form 504 - Maryland Fiduciary Income Tax Return - 2012 Page 2
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1
2MARYLAND FIDUCIARY
FORM
Page 2
504
INCOME TAX RETURN
2012
NAME ______________________ FEIN ________________________
FIDUCIARY’S SHARE OF MARYLAND MODIFICATIONS
(a) Do not complete lines 1 through 10g if the fiduciary distributes all of the income from the tax year. See instructions. (b) Complete lines 1
through 8 and enter on line 17 (Page 1) if the fiduciary retains 100% of the income for the tax year. (c) Complete lines 1 through 8, and lines 9a
through 9d or 10a through 10g if a partial distribution of income is made by the fiduciary during the tax year. Enter the result on line 17 (page
1) as a positive or negative number accordingly. Write a minus sign (-) in front of any negative numbers.
ADDITIONS
1
1. Interest on state and local obligations other than Maryland . . . . . . . . . . . . . .
2
2. Income taxes deducted on federal return . . . . . . . . . . . . . . . . . . . . . . . . . . .
3
3. Other additions to income (Specify). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4
4. Total additions (Add lines 1 through 3). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
SUBTRACTIONS
5
5. Income from U.S. obligations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6. Other subtractions (Specify) (Do not include non-MD source income as a subtraction)
6
7
7. Total subtractions (Add lines 5 and 6) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8
8. Net Maryland modifications (Subtract line 7 from line 4) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
FIDUCIARY’S SHARE OF NET MARYLAND MODIFICATIONS
(you may choose to allocate your modifications based upon the formula method or alternative method below. you may not use both methods)
Formula Method
9 a
9a. Federal Distributable Net Income (DNI from federal schedule B, Form 1041) . . . . . . . . . . . . . . . . . . . . . .
9 b
9b. Fiduciary’s share of the federal DNI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
.
9 c
9c. Fiduciary’s percentage of federal DNI (Divide 9b by 9a) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9d
9d. Fiduciary’s share of net Maryland modification (Multiply line 8 by line 9c; enter here and on line 17) . . . . . .
Alternative Method
In the alternative, net Maryland modifications may be allocated based on how the fiduciary has allocated all of its income.
(B) Social Security Number
(A) Name of Beneficiary
(C) Share of Net MD Modifications
& Domicile state code
If there are more than 4 beneficiaries, use and attach a separate statement.
Example: Beneficiary Name
999-99-4321 MD
$
10a.
$
10b.
$
10c.
$
10d.
$
10e. Beneficiaries subtotal from separate attached statement (if any)
$
10f.
Fiduciary (Enter here and on line 17)
$
10g.
Total: $
NONRESIDENT BENEFICIARY DEDUCTION
Complete this area only if any beneficiaries are nonresidents of Maryland. See Instruction 9 for required supporting
documents to submit with Form 504. Attach Form 504 Schedule K-1 for each beneficiary.
11
11. Income from intangible personal property accumulated for a nonresident (See Instruction 9) . . . . . . . . . . . . .
12
12. Related expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
13. Nonresident beneficiary deduction (Subtract line 12 from line 11; if less than 0, enter 0.) Enter on line 19 (page 1) . . .
13
AMENDED RETURNS
If you are filing an amended fiduciary income tax return, check the applicable boxes and draw a line through any bar codes on the
front. Explain the changes you are making in the space below. Attach a copy of the amended federal Form 1041 if the federal return is
being amended, and any other required documentation.
EXPLANATION OF CHANGES
MAIL TO: COMPTROLLER OF MARyLAND
Check here
if you authorize your preparer to discuss this return with us. Under penalties of perjury, I declare
REVENUE ADMINISTRATION DIVISION
that I have examined this return, including accompanying schedules and statements and to the best of my
110 CARROLL STREET
knowledge and belief it is true, correct and complete. If prepared by a person other than taxpayer, the declara-
ANNAPOLIS, MARyLAND 21411-0001
tion is based on all information of which the preparer has any knowledge.
Signature of preparer other than fiduciary
Date
Signature of fiduciary or officer representing fiduciary
Date
Address and telephone of preparer
COM/RAD-021
12-49
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