Washington Washington State Estate and Transfer Tax Return

Washington State Estate and Transfer Tax Return
Form EstTranTax-w706
Washington State
Estate and Transfer Tax Return

State of Washington
Department of Revenue
Audit Division - Estate Tax Section
PO Box 47474
Olympia WA 98504-7474

Check all that apply:

For deaths occurring January 1, 2014 and after
(See separate instructions)
Amended return

Decedent died testate (attach copy of will)

Installment election

Federal estate tax return filed with IRS (attach copy of 706)

Part 1 - Decedent, Executor, Preparer, Confidential Release (type or complete in ink)
1. Decedent’s first name

2. M.I.

3. Decedent’s last name

5. Legal residence/domicile - city and county (or foreign country)

6. State

7. Zip code

4. Social Security number
8.	Year domicile
established

11. Probate or estate administration county court
13. Executor’s first name

10. Date of death

12. Cause number
14. M.I.

If multiple executors, check here
17. Mailing address

9. Date of birth

15. Executor’s last name

16. Social Security number

; attach list showing names, SSNs, addresses, email addresses, and telephone numbers of additional executors.
18. City
19. State
20. Zip code

21 Email address

22. Telephone number

23. Preparer’s first name

24. M.I.

25. Preparer’s last name

28. Email address

29. Company name

30. Mailing address

31. City

26. Telephone number 27. Extension

32. State

33. Zip code

34. Confidential Release and Additional Contact Methods/Staff

I,

(Executor)

, on behalf of the estate of

to release confidential estate tax information to

(Decedent)

(Preparer)

, authorize the Department of Revenue
. The preparer is authorized to discuss and receive

confidential estate tax information from the Department of Revenue. In addition, I authorize the Department of Revenue to communicate the estate
tax information through the following unsecured methods (check all that you are authorizing):
Fax
Email
I authorize the Department of Revenue to communicate with other staff from the company listed above (Item 29) by checking here:
Part 2 - Tax Computation
1. Total Gross Estate Less Exclusion (from Page 3, Part 5, Item 12).................................................... 	1.
2. Tentative Total Allowable Deductions (from Page 3, Part 5, Item 22)...............................................	2.
3.
Tentative Taxable Estate (Line 1 less Line 2).....................................................................................	
3.
4.
Adjustments to Tentative Taxable Estate (enter an amount only if eligible for the deduction)
4a. Property Used for Farming (attach Addendum # 2).............................. 4a.
4b. Qualified Family-Owned Business Interests (attach Addendum # 3).... 4b.
Enter the total adjustments (add Lines 4a and 4b)	 4.
5.
Adjusted Taxable Estate (Line 3 less Line 4).....................................................................................	5.
6.
Washington State Applicable Exclusion Amount (see table in instructions, Page 1)........................	6.
7.
Washington Taxable Estate (Line 5 less Line 6) do not enter less than “zero”..................................	
7.
8.
Gross Washington Estate Tax (Table W in instructions) compute tax using the amount on Line 7......... 	
8.
9.
Apportionment for Out of State Property: (enter an amount only if eligible for apportionment)
Apportioned Washington Estate Tax Due (attach Addendum # 4)...............................................	9.
10.
Washington Estate Tax Due (equals Line 8 or, if apportioning for out of state property, Line 9)...............	10.
11.
Tax Previously Paid to Washington State.....................................................................................	11.
12.
Balance ( amount owing or refund due)........................................................................................	12.
13.
Interest (due on any tax not paid within nine months after date of death or payable on a refund)..................	13.
14.
Total Tax and Interest (add Lines 12 and 13).....................................................................................	14.
Under penalty of law, I declare that I have examined this return and, to the best of my knowledge and belief, it is true, correct, and complete.
In addition, by signing below, I am authorizing the confidential release section (Part 1, Item 34) above.
____________________________________________________________________
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(Signature of executor)

Reset This Form

_________________________________
(Date)

Print This Form

Page 1

Estate of:

Decedent’s Social Security Number

Part 3 - Elections by the Executor
Check “Yes” or “No” for each question (see instructions)
Note: Some of these elections may require the posting of bonds or liens.

Yes

No

1. Do you elect alternate valuation?.............................................................................................................................................
2. Do you elect special-use valuation?.........................................................................................................................................
If “Yes,” you must complete and attach Schedule A-1.
3. Do you elect to pay the taxes in installments as described in Internal Revenue Code (IRC) §6166?.....................................
If “Yes,” you must attach the additional information described in the instructions.
4. Do you elect to postpone the part of the taxes attributable to a reversionary or remainder interest as described in
IRC §6163?..............................................................................................................................................................................

Part 4 - General Information

Note: Attach the necessary supplemental documents. You must attach the death certificate. (See instructions)
1. Marital status of the decedent at the time of death (attach a list of all prior marriages that ended due to annulment, divorce or death):
Married
Widow or widower - Name, SSN, and date of death of deceased spouse:________________________________________________
Single
Legally separated
Divorced - Date divorce became final:_______________________________________________________________
2. Surviving spouse’s name

3. Social Security number

4. Amount received (see instructions)

5. Individuals (other than the surviving spouse), trusts, or other estates who receive benefits from the estate (do not include charitable
beneficiaries shown in Schedule O) (See instructions). Attach additional sheet, if necessary.
Name of individual, trust, or estate receiving $5,000 or more

Identifying number

Relationship to
decedent

Amount (see
instructions)

All unascertainable beneficiaries and those who receive less than $5,000...............................................................
Total...........................................................................................................................................................................
Check “Yes” or “No” for each question. If “Yes,” you must attach additional information.

Yes

No

6. Does the gross estate contain any Washington or federal qualified terminable interest property (QTIP) from a prior gift or
estate (RCW 83.100.047 and/or IRC §2044)? (See instructions)............................................................................................
7a. Have federal gift tax returns ever been filed? ........................................................................................................................
If “Yes,” attach copies of the returns, if available, and furnish the following information.
7b. Period(s) covered

7c. Internal Revenue Office(s) where filed

8a. Was there any insurance on the decedent’s life that is not included on the return as part as the gross estate? ..................
8b. Did the decedent own any insurance on the life of another that is not included in the gross estate? ...................................
9. 	 Did the decedent at the time of death own any property as a joint tenant with the right of survivorship in which (a) one
or more of the other joint tenants were someone other than the decedent’s spouse and (b) less than the full value of
the property is included on the return as part of the gross estate? If “Yes,” you must complete and attach Schedule E.....
10a. Did the decedent, at the time of death, own any interest in a partnership (for example, a family limited partnership), an
unincorporated business, or a limited liability company; own a fractional interest in real estate; or own any stock in an
inactive or closely held corporation?....................................................................................................................................
10b. If “Yes,” was the value of any interest owned (from above) discounted on this estate tax return?......................................
If “Yes,” see instructions for Schedule F for reporting the total accumulated or effective discounts taken on a Schedule
A, F, or G.
11. Did the decedent make any transfer described in IRC §2035, §2036, §2037, or §2038? (See instructions).......................
If “Yes,” you must complete and attach Schedule G.
12a. Were there in existence at the time of the decedent’s death any trusts created by the decedent during his or her
lifetime? If “Yes,” attach a copy or copies of trust(s)............................................................................................................
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Page 2

Yes

Check “Yes” or “No” for each question. If “Yes,” you must attach additional information.

No

12b. Were there in existence at the time of the decedent’s death any trusts not created by the decedent under which the
decedent possessed any power, beneficial interest, or trusteeship?.........................................................................................
12c. Was the decedent receiving income from a trust created after October 22, 1986 by a parent or grandparent?........................
If “Yes,” was there GST taxable termination (under IRC §2612) upon the death of the decedent?...........................................
12d. If there was a GST taxable termination (under IRC §2612), attach a statement to explain. Provide a copy of the trust or
will creating the trust, and give the name, address, and phone number of the current trustee(s). Documents attached?.........
13. Did the decedent ever possess, exercise, or release any general power of appointment?........................................................
If “Yes,” you must complete and attach Schedule H.
14. Did the decedent have an interest in or a signature or other authority over a financial account in a foreign country, such as a
bank account, securities account, or other financial account?...................................................................................................
15. Was the decedent, immediately before death, receiving an annuity described in the “General” paragraph of the instructions
for Schedule I or a private annuity?............................................................................................................................................
If “Yes,” you must complete and attach Schedule I.
16. Was the decedent ever the beneficiary of a trust for which a deduction was claimed by the estate of a pre-deceased
spouse consistent with RCW 83.100.047 and/or IRC §2056(b)(7) and which is not reported on this return?...........................
If “Yes,” attach an explanation.
17. Was a qualified disclaimer filed as a part of the administration of the estate? If “Yes,” you must submit a copy of the
disclaimer.

Part 5 - Recapitulation
Item
Number

Gross Estate

Alternate Value

1

Schedule A - Real Estate ............................................. 1.

2

Schedule B - Stocks and Bonds .................................. 2.

3

Schedule C - Mortgages, Notes, and Cash ................. 3.

4

Schedule D - Insurance on the Decedent’s Life .......... 4.

5

Schedule E - Jointly Owned Property .......................... 5.

6

Schedule F - Other Miscellaneous Property ................ 6.
(May need to attach Addendum # 1)

7

Schedule G - Transfers During Decedent’s Life .......... 7.

8

Schedule H - Powers of Appointment .......................... 8.

9

Schedule I - Annuities .................................................. 9.

10

Total Gross Estate (add Items 1 through 9).............10.

11

Schedule U - Qualified Conservation Easement
Exclusion ..................................................................... 11.

12

Total Gross Estate less Exclusion
(subtract Item 11 from Item 10)
Enter here and on Line 1 of Part 2 - Tax Computation...... 12.

Item
Number

Deductions

13

Schedule J - Funeral Expenses and Expenses Incurred in Administrating Property
Subject to Claims .......................................................................................................... 13.

14

Schedule K - Debts of the Decedent ............................................................................. 14.

15

Schedule K - Mortgages and Liens ............................................................................... 15.

16

Total of Items 13 through 15........................................................................................... 16.

17

Allowable Amount of Deductions from Item 16 (see the instructions for Item 17 of the
Recapitulation)............................................................................................................... 17.

18

Schedule L - Net Losses During Administration............................................................. 18.

19

Schedule L - Expenses Incurred in Administering Property Not Subject to Claims........... 19.

20

Schedule M - Bequests, Etc., to Surviving Spouse (may need to attach Addendum # 1)....... 20.

21

Schedule O - Charitable, Public, and Similar Gifts and Bequests............................................. 21.

22

Tentative Total Allowable Deductions (add Items 17 through 21).
Enter here and on Line 2 of Part 2 - Tax Computation.............................................. 22.

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Value at Date of Death

Amount

Page 3

Estate of:

•	
•	
•	
•	
•	

Decedent’s Social Security Number
Schedule A - Real Estate

For jointly owned property that must be disclosed on Schedule E, see the instructions for Schedule E.
Real estate that is part of a sole proprietorship should be shown on Schedule F.
Real estate that is included in the gross estate under IRC §2035, §2036, §2037, or §2038 should be shown on Schedule G.
Real estate that is included in the gross estate under IRC §2041 should be shown on Schedule H.
If you elect IRC §2032A valuation, you must complete Schedule A and Schedule A-1.

Item
Number

Description

Alternate
Valuation Date

Alternate Value

Value at Date of
Death

1.

Total from continuation schedules (or additional sheets) attached to this schedule........................................
TOTAL (Also enter on Part 5 - Recapitulation, Page 3, at Item 1.).................................................................
(If more space is needed, attach the continuation schedule from the end of this package or additional sheets of the same size and format.)
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Schedule A - Page 4

Estate of:

Decedent’s Social Security Number
Schedule B - Stocks and Bonds

Item
Number

(For jointly owned property that must be disclosed on Schedule E, see the instructions for Schedule E.)
Description, including face amount of bonds or number of
Alternate
Value at Date of
shares and par value for identification. Give CUSIP number.
Unit Value
Alternate Value
Valuation Date
Death
If trust, partnership, or closely held entity, give FEIN.
CUSIP number
or FEIN, where
applicable

1.

Total from continuation schedules (or additional sheets) attached to this schedule.........................................
TOTAL (Also enter on Part 5 - Recapitulation, Page 3, at Item 2.)..................................................................
(If more space is needed, attach the continuation schedule from the end of this package or additional sheets of the same size and format.)
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Schedule B - Page 5

Estate of:

Decedent’s Social Security Number
SCHEDULE C - Mortgages, Notes, and Cash
(For jointly owned property that must be disclosed on Schedule E, see the instructions for Schedule E.)

Item
Number

Description

Alternate
Valuation Date

Alternate Value

Value at Date of
Death

1.

Total from continuation schedules (or additional sheets) attached to this schedule........................................
TOTAL (Also enter on Part 5 - Recapitulation, Page 3, at Item 3.).................................................................
(If more space is needed, attach the continuation schedule from the end of this package or additional sheets of the same size and format.)
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Schedule C - Page 6

Estate of:

Decedent’s Social Security Number
SCHEDULE D - Insurance on the Decedent’s Life
You must list all policies on the life of the decedent and attach a Federal Form 712 for each policy.

Item
Number

Description

Alternate
Valuation Date

Alternate Value

Value at Date of
Death

1.

Total from continuation schedules (or additional sheets) attached to this schedule........................................
TOTAL (Also enter on Part 5 - Recapitulation, Page 3, at Item 4.).................................................................
(If more space is needed, attach the continuation schedule from the end of this package or additional sheets of the same size and format.)
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Schedule D - Page 7

Estate of:

Decedent’s Social Security Number
Schedule E - Jointly Owned Property

(If you elect IRC §2032A valuation, you must complete Schedule E and Schedule A-1.)
Part 1. Qualified Joint Interests - Interests Held by the Decedent and His or Her Spouse as the Only Joint Tenants (IRC §2040(b)(2))
Item
Number

Description. For securities, give CUSIP number. If trust,
partnership, or closely held entity, give FEIN.

Alternate
Valuation Date

Alternate Value

Value at Date of
Death

CUSIP number
or FEIN, where
applicable
1.

Total from continuation schedules (or additional sheets) attached to this schedule.......................................
1a. Totals...................................................................................................................................................1a.
1b. Amounts included in gross estate (one-half of Line 1a)......................................................................1b.
Part 2. All Other Joint Interests
2a. State the name and address of each surviving co-tenant. If there are more than three surviving co-tenants, list the additional co-tenants on
an attached sheet.
Name

Address (number and street, city, state, and zip code)

A.
B.
C.
Item
Number

Enter Letter
for
Co-tenant

Description (including alternate valuation date, if any).
For securities, give CUSIP number.
If trust, partnership, or closely held entity, give FEIN.
CUSIP number
or FEIN, where
applicable

Percentage
Includible

Includible
Alternate Value

Includible
Value at Date of
Death

1.

Total from continuation schedules (or additional sheets) attached to this schedule.......................................
2b. Total other joint interests.....................................................................................................................2b.
TOTAL includible joint interests (add Lines 1b and 2b) (Also enter on Part 5 - Recapitulation, Page 3,
at Item 5.).......................................................................................................................................................
(If more space is needed, attach the continuation schedule from the end of this package or additional sheets of the same size and format.)
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Schedule E - Page 8

Estate of:

Decedent’s Social Security Number
Schedule F - Other Miscellaneous Property Not Reportable Under Any Other Schedule

(For jointly owned property that must be disclosed on Schedule E, see the instructions for Schedule E.)
(If you elect IRC §2032A valuation, you must complete Schedule F and Schedule A-1.)
(If the estate contains property pursuant to RCW 83.100.047 (§2044 property), Addendum # 1 must be attached.)
1. Did the decedent at the time of death own any works of art, items, or any collection whose artistic or collectible value
exceeded $3,000?...................................................................................................................................................................
If “Yes,” submit full details on this schedule and attach appraisals.

Yes

No

2. Has the decedent’s estate, spouse, or any other person, received (or will receive) any bonus or award as a result of the
decedent’s employment or death?..........................................................................................................................................
If “Yes,” submit full details on this schedule.
3. Did the decedent at the time of death have, or have access to, a safe deposit box?.............................................................
If “Yes,” state location, and if held in joint names of the decedent and another, state name and relationship of joint
depositor.
If any of the contents of the safe deposit box are omitted from the schedules in this return, explain fully why omitted.
Item
Number

Description. For securities, give CUSIP number.
If trust, partnership, or closely held entity, give FEIN.

Alternate
Valuation Date

Alternate Value

Value at Date of
Death

CUSIP number
or FEIN, where
applicable
1.

Total from continuation schedules (or additional sheets) attached to this schedule.......................................
TOTAL (Also enter on Part 5 - Recapitulation, Page 3, at Item 6.)................................................................
(If more space is needed, attach the continuation schedule from the end of this package or additional sheets of the same size and format.)
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Schedule F - Page 9

Estate of:

Decedent’s Social Security Number
SCHEDULE G - Transfers During Decedent’s Life

(If you elect IRC §2032A valuation, you must complete Schedule G and Schedule A-1.)
Item
Number

Description. For securities, give CUSIP number. If trust, partnership,
or closely held entity, give FEIN.

Alternate
Valuation Date

A.

Gift tax paid or payable by the decedent or the estate for all gifts made by the
decedent or his or her spouse within three years before the decedent’s death
(IRC §2035(b)).....................................................................................................

X X X X X

B.
1.

Alternate Value

Value at Date of
Death

Transfers includible under IRC §2035(a), §2036, §2037, or §2038:

Total from continuation schedules (or additional sheets) attached to this schedule........................................
TOTAL (Also enter on Part 5 - Recapitulation, Page 3, at Item 7.).................................................................

SCHEDULE H - Powers of Appointment

Item
Number
1.

(Include “5 and 5 lapsing” powers (IRC §2041(b)(2)) held by the decedent.)
(If you elect IRC §2032A valuation, you must complete Schedule H and Schedule A-1.)
Alternate
Description
Alternate Value
Valuation Date

Value at Date of
Death

Total from continuation schedules (or additional sheets) attached to this schedule........................................
TOTAL (Also enter on Part 5 - Recapitulation, Page 3, at Item 8.).................................................................
(If more space is needed, attach the continuation schedule from the end of this package or additional sheets of the same size and format.)
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Schedules G and H - Page 10

Estate of:

Decedent’s Social Security Number
Schedule I - Annuities

Note: Generally, no exclusion is allowed for the estates of decedents dying after December 31, 1984 (see instructions).
A. Are you excluding from the decedent’s gross estate the value of a lump-sum distribution described in IRC §2039(f)(2)
(as in effect before its repeal by the Federal Deficit Reduction Act of 1984)?.........................................................................
If “Yes,” you must attach the information required by the instructions.
Item
Number

Description
Show the entire value of the annuity before any exclusions

Alternate
Valuation Date

Includible
Alternate Value

Yes

No

Includible
Value at Date of
Death

1.

Total from continuation schedules (or additional sheets) attached to this schedule.......................................
TOTAL (Also enter on Part 5 - Recapitulation, Page 3, at Item 9.)................................................................
(If more space is needed, attach the continuation schedule from the end of this package or additional sheets of the same size and format.)
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Schedule I - Page 11

Estate of:

Decedent’s Social Security Number
Schedule J - Funeral Expenses and Expenses Incurred in Administering Property Subject to Claims

Note: Do not list on this schedule expenses of administering property not subject to claims. For those expenses, see the instructions for
Schedule L.
If executors’ commissions, attorney fees, etc., are claimed and allowed as a deduction for estate tax purposes, they are not allowable
as a deduction in computing the taxable income of the estate for the federal income tax purposes.
Item
Number
1.

Description

Expense Amount

Total Amount

A. Funeral expenses

Total funeral expenses (less one-half in a community property estate)........................................................
B. Administration expenses
1. Executors’ commissions - amount
2. Attorney fees - amount
3. Accountant fees - amount

estimated,

estimated,
estimated,

agreed upon, or

agreed upon, or
agreed upon, or

paid

paid
paid

4. Miscellaneous expenses

Expense Amount

1.

Total miscellaneous expenses from continuation schedules (or additional sheets)
attached to this schedule................................................................................................
Total miscellaneous expenses.....................................................................................................................................
TOTAL (Also enter on Part 5 - Recapitulation, Page 3, at Item 13.)...........................................................................
(If more space is needed, attach the continuation schedule from the end of this package or additional sheets of the same size and format.)
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Schedule J - Page 12

Estate of:

Decedent’s Social Security Number
Schedule K - Debts of the Decedent, and Mortgages and Liens

Item
Number

Debts of the Decedent - Creditor and Nature of Claim

Amount Unpaid to
Date

Amount in
Contest

Amount Claimed
as a Deduction

1.

Total from continuation schedules (or additional sheets) attached to this schedule....................................................................
TOTAL (Also enter on Part 5 - Recapitulation, Page 3, at Item 14.)...........................................................................................
Item
Number

Mortgages and Liens - Description

Amount

1.

Total from continuation schedules (or additional sheets) attached to this schedule....................................................................
TOTAL (Also enter on Part 5 - Recapitulation, Page 3, at Item 15.)...........................................................................................
(If more space is needed, attach the continuation schedule from the end of this package or additional sheets of the same size and format.)
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Schedule K - Page 13

Estate of:

Decedent’s Social Security Number
Schedule L - Net Losses During Administration and Expenses Incurred
in Administering Property Not Subject to Claims

Item
Number

Net Losses During Administration
(Note: Do not deduct losses claimed on a federal income tax return.)

Amount

1.

Total from continuation schedules (or additional sheets) attached to this schedule....................................................................
TOTAL (Also enter on Part 5 - Recapitulation, Page 3, at Item 18.)...........................................................................................
Item
Number

Expenses Incurred in Administering Property Not Subject to Claims
(Indicate whether estimated, agreed upon, or paid.)

Amount

1.

Total from continuation schedules (or additional sheets) attached to this schedule....................................................................
TOTAL (Also enter on Part 5 - Recapitulation, Page 3, at Item 19.)...........................................................................................
(If more space is needed, attach the continuation schedule from the end of this package or additional sheets of the same size and format.)
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Schedule L - Page 14

Estate of:

Decedent’s Social Security Number
SCHEDULE M - Bequests, etc., to Surviving Spouse
Yes

No

1. Did any property pass to the surviving spouse as a result of a qualified disclaimer?........................................................
If “Yes,” attach a copy of the written disclaimer required by IRC §2518(b).
2. a. In what country was the surviving spouse born?___________________________________________
b. What is the surviving spouse’s date of birth? _____________________________________________
c. Is the surviving spouse a U.S. citizen?..........................................................................................................................
d. If the surviving spouse is a naturalized citizen,
when did the surviving spouse acquire citizenship?_________________________________________
e. If the surviving spouse is not a U.S. citizen,
of what country is the surviving spouse a citizen?__________________________________________
3. Election Out of QTIP Treatment of Annuities. Do you elect under IRC §2056(b)(7)(C)(ii) not to treat as QTIP any
joint and survivor annuities that are included in the gross estate and would otherwise be treated as QTIP under IRC
§2056(b)(7)(C)? (See instructions).....................................................................................................................................
Item
Number
A1

Description of Property Interests Passing to Surviving Spouse.
For securities, give CUSIP number. If trust, partnership, or closely held entity, give FEIN.

Amount

QTIP / QDOT property (must attach Addendum # 1):

Total from continuation schedules (or additional sheets) attached to this schedule....................................................................
B1

All other property:

Total from continuation schedules (or additional sheets) attached to this schedule....................................................................
Total amount of property interests listed on Schedule M
(Also enter on Part 5 - Recapitulation, Page 3, at Item 20.)........................................................................................................
(If more space is needed, attach the continuation schedule from the end of this package or additional sheets of the same size and format.)
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Schedule M -Page 15

Estate of:

Decedent’s Social Security Number
SCHEDULE O - Charitable, Public, and Similar Gifts and Bequests
Yes

No

1a. If the transfer was made by will, has any action been instituted to have interpreted or to contest the will or any of its
provisions affecting the charitable deductions claimed in this schedule?.............................................................................
If “Yes,” full details must be submitted with this schedule.
1b. According to the information and belief of the executor, is any such action planned?.........................................................
If “Yes,” full details must be submitted with the schedule.
2.

Did any property pass to a charity as the result of a qualified disclaimer?...........................................................................
If “Yes,” attach a copy of the written declaimer required by IRC §2518(b).

Item
Number

Name and Address of Beneficiary

Character of Institution

Amount

1.

Total from continuation schedules (or additional sheets) attached to this schedule.........................................................
TOTAL (Also enter on Part 5 - Recapitulation, Page 3, at Item 21).................................................................................
(If more space is needed, attach the continuation schedule from the end of this package or additional sheets of the same size and format.)
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Schedule O - Page 16

Estate of:

Decedent’s Social Security Number
Schedule A-1 - IRC §2032A Valuation

Part 1. Type of Election (Before making an election, see the checklist in the instructions):
Protective election (IRC Regulations §20.2032A-8(b)). Complete Part 2, Line 1, and Column A of Lines 3 and 4. (See instructions)
Regular election. Complete all of Part 2 (including Line 11, if applicable.) (See instructions)
Before completing Schedule A-1, see the checklist in the instructions for the information and the documents that must be included to make a
valid election.
Part 2. Notice of Election (IRC Regulations §20.2032A-8(a)(3))
Note: All real property entered on Lines 2 and 3 must also be entered on Schedules A, E, F, G, or H, as applicable.
1. Qualified use - check one

Farm used for farming, or
Trade or business other than farming
2. Real property used in a qualified use, passing to qualified heirs, and to be specially valued on this return.
A
Schedule / Item Number from
Return

B
Full Value
(without IRC §2032A(b)(3)(B)
adjustment)

C
Adjusted Value
(with IRC §2032A(b)(3)(B)
adjustment)

D
Value Based on Qualified Use
(without IRC §2032A(b)(3)(B)
adjustment)

Totals:..........................................
Attach a legal description of all property listed on Line 2.
Attach copies of appraisals showing the Column B values for all property listed on Line 2.
3. Real property used in a qualified use, passing to qualified heirs, but not specially valued on this return.
A
Schedule / Item Number from
Return

B
Full Value
(without IRC §2032A(b)(3)(B)
adjustment)

C
Adjusted Value
(with IRC §2032A(b)(3)(B)
adjustment)

D
Value Based on Qualified Use
(without IRC §2032A(b)(3)(B)
adjustment)

Totals:..........................................
If you checked “Regular election,” you must attach copies of appraisals showing the Column B values for all property listed on Line 3.
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4. Personal property used in a qualified use and passing to qualified heirs.
B
Adjusted Value
(with IRC §2032A(b)(3)(B)
adjustment)

A
Schedule / Item Number from
Return

“Subtotal” from Col. B, below left

Subtotal:.......................................

B
Adjusted Value
(with IRC §2032A(b)(3)(B)
adjustment)

A
Schedule / Item Number from
Return

........

Total adjusted value...................

5. Enter the value of the total gross estate as adjusted under IRC §2032A(b)(3)(A)__________________________________
6. Attach a description of the method used to determine the special value based on qualified use.
7. Did the decedent and/or a member of his or her family own all property listed on Line 2 for at least five of the eight years
immediately preceding the date of the decedent’s death? ..........................................................................
Yes
No
8. Were there any periods during the eight-year period preceding the date of the decedent’s death during which the decedent
or a member of his or her family:
a. Did not own the property listed on Line 2? .............................................................................................
Yes
No
b. Did not use the property listed on Line 2 in a qualified use?...................................................................
Yes
No
c. Did not materially participate in the operation of the farm or other business within the meaning of
IRC §2032A(e)(6)? .................................................................................................................................
Yes
No
If “Yes,” to any of the above, you must attach a statement listing the periods. If applicable, describe whether the exceptions
of IRC §2032A(b)(4) or (5) are met.
9. Attach affidavits describing the activities constituting material participation and the identity and relationship to the
decedent of the material participants.
10. Persons holding interests. Enter the requested information for each party who received any interest in the specially valued
property.
Name

Address

A
B
C
D
E
F
G
H
Identifying Number

Relationship to Decedent

Fair Market Value

Special-Use Value

A
B
C
D
E
F
G
H
if you wish to make a Woodlands election as described in IRC §2032A(e)(13). Enter the schedule
11. Woodlands election Check here
and item numbers from this return of the property for which you are making this election _____________________________________ .
You must attach a statement explaining why you are entitled to make this election. The Department may require more information to
substantiate this election. You will be notified by the Department if you must supply further information.
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Schedule A-1- Page 18

Estate of:

Decedent’s Social Security Number
SCHEDULE U - Qualified Conservation Easement Exclusion

Part 1 - Election
Note: The executor is deemed to have made the election under IRC §2031(c)(6) if he or she files Schedule U and excludes any qualifying
conservation easements from the gross estate.

Part 2 - General Qualifications
1. Describe the land subject to the qualified conservation easement (see instructions.) _______________________________
__________________________________________________________________________________________________
2. Did the decedent or a member of the decedent’s family own the land described above during the
three-year period ending on the date of the decedent’s death? ............................................................

Yes

No

3. Describe the conservation easement with regard to which the exclusion is being claimed (see instructions).
__________________________________________________________________________________________________
Part 3 - Computation of Exclusion
4. Estate tax value of the land subject to the qualified conservation easement (see instructions) ..... 4.
5. Date of death value of any easements granted prior to decedent’s death and included on line 10
below (see instructions) ..................................................................................................................5.
6. Add lines 4 and 5 ............................................................................................................................6.
7. Value of retained development rights on the land (see instructions)...............................................7.
8. Subtract line 7 from line 6................................................................................................................8.
9. Multiply line 8 by 30% (.30).............................................................................................................9.
10. Value of qualified conservation easement for which the exclusion is being claimed
(see instructions).............................................................................................................................10.
Note: If line 10 is less than line 9, continue with line 11. If line 10 is equal to or more than line 9,
skip lines 11 through 13, enter “.40” on line 14, and complete the schedule.
11. Divide line 10 by line 8. Figure to 3 decimal places (for example, “.123”).......................................11.
Note: If line 11 is equal to or less than .100, stop here; the estate does not qualify for the
conservation easement exclusion.
12. Subtract line 11 from .300. Enter the answer in hundredths by rounding any thousandths up to the
next higher hundredth (that is, .030 = .03; but .031 = .04)..............................................................12.
13. Multiply line 12 by 2.........................................................................................................................13.
14. Subtract line 13 from .40.................................................................................................................14.
15. Deduction under IRC §2055(f) for the conservation easement (see instructions)...........................15.
16. Amount of indebtedness on the land (see instructions)...................................................................16.
17. Total reductions in value (add lines 7, 15, and 16)..........................................................................17.
18. Net value of land (subtract line 17 from line 4)................................................................................18.
19. Multiply line 18 by line 14................................................................................................................19.
20. Enter the smaller of line 19 or the exclusion limitation (see instructions).
(Also enter on Part 5 - Recapitulation, Page 3, at Item 11.)............................................................20.
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Estate of:

Decedent’s Social Security Number
CONTINUATION SCHEDULE
Continuation of Schedule 	������������������������������������
(Enter letter of schedule you are continuing.)

Item
Number

Description.
For securities, give CUSIP number.
If trust, partnership, or closely held entity, give FEIN.

Unit Value
Alternate
(Sch. B, E, or
Alternate Value
Valuation Date
G only)

Value at Date
of Death
or Amount
Deductible

TOTAL (Carry forward to main schedule.).......................................................................................................
(In case you will need more than one, make copies of this continuation schedule before completing it.)
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