Wisconsin Request for a Closing Certificate for Fiduciaries

Request for a Closing Certificate for Fiduciaries
2023 I-030 Wisconsin Schedule CC, Request for a Closing Certificate for Fiduciaries (fillable)
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Schedule

CC

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Request for a Closing Certificate
for Fiduciaries

DO NOT STAPLE

ESTATES ONLY – Decedent’s last name

Decedent’s first name

M.I.

Decedent’s social security number

TRUSTS ONLY – Legal name

Estate’s/Trust’s federal EIN

Individual or firm to whom the closing certificate should be mailed Attention or c/o

County of jurisdiction (Name Only)

Address

Probate case number

City

State

PART I

Zip code

Clear

2023

Wisconsin Department of Revenue

Use BLACK INK

Print

Date of decedent’s death (MM DD YYYY)

Information Required When Requesting a Closing Certificate for Estates

Complete lines 1 through 11 and sign.
1	 Is a certificate required by the court? ................. 	

Yes		

No	

(See instructions)

		
If no, DO NOT submit Schedule CC. The department only issues a Closing Certificate if a court requires it to close a proceeding.
2	 Does the decedent have a will? .......................... 	

Yes		

3	 Type of probate	

Other	

Formal	

Informal	

No	

(If yes, include a copy)

4	 If the decedent did not file tax returns for the 4 years prior to death, enter the year and the decedent’s approximate income:
		
20	$	

,	
20	$	

,	
20	$	

,	
20	$	

5	 Was the decedent contacted by the IRS and/or Wis. Dept. of Revenue in the last 3 years?	

Yes	

.

No

DO NOT ATTACH SCHEDULE CC TO FORM 2 (see instructions)

		 If yes, explain:
6	 Is the gross income of the estate
less than $600? .................................................. 	Yes	 No
7	 Will a final Form 2 be filed at a later date? .......... 	Yes	 No
8	 Was the decedent a resident of Wisconsin
at the time of death? ........................................... 	Yes	 No
9	 Did the decedent own an interest in any
partnership, S corporation, LLC, or LLP? ........... 	Yes	 No
	 10	 Enter the totals of each of the assets listed below.
Probate Assets (Required: Include a copy of the inventory)

NO COMMAS; NO CENTS

	 a	 Real Estate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 	10a

.00

	 b	 Stocks and Bonds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 	10b

.00

	 c	 Mortgages, Notes, and Cash . . . . . . . . . . . . . . . . . . . . . . . . . . 	10c

.00

	 d	 Land Contracts and Installment Sales . . . . . . . . . . . . . . . . . . . 	10d

.00

	 e	 Insurance Payable to Estate . . . . . . . . . . . . . . . . . . . . . . . . . . 	10e

.00

	 f	 Annuities and Employee Death Benefits Payable to Estate . . . 	10f

.00

	 g	 Other Miscellaneous Property . . . . . . . . . . . . . . . . . . . . . . . . . 	10g

.00

Nonprobate Assets
	 h	 Jointly Owned Survivorship – Decedent’s share of property . . 	10h

.00

	 i	 Decedent’s Share of Survivorship Marital Property . . . . . . . . . 	10i

.00

	 j	 Insurance Payable to Named Beneficiaries . . . . . . . . . . . . . . . 	10j

.00

	 k	 Transfers During Decedent’s Life (gifts, etc.) . . . . . . . . . . . . . . 	10k

.00

	 L	 Other Assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 	10L

.00

	 m	 Wisconsin GROSS Estate (add lines 10a through 10L) . . . . . . . . . . . . . . . . . . . . . . . 	10m
	 11	 Fiduciary fees paid or payable to the personal representative or trustee  . . . . . . . . . . . . . . . 	11
I-030 (R. 8-23)

NOTE
W h e r e a ny l i n e
from 10a through
10L is left blank,
it will be deemed
that NONE is the
D E C L A R AT I O N
for that line by the
person(s) signing
Schedule CC.

.00
.00

2023 Schedule CC 	

PART II

Page 2

Information Required When Requesting a Closing Certificate for Trusts

Complete lines 1 through 10 and sign.
	 1	 Is a certificate required by the court? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  1	Yes	

No

		 If yes, include a statement from the court verifying that a Closing Certificate is required to close a proceeding.
		 If no, DO NOT submit Schedule CC. The department only issues a Closing Certificate if a court requires it to close a proceeding.
	2	 Include a copy of the trust instrument with amendments (will/codicils).
	 3	 a	 Grantor(s) name(s)
			

Grantor(s) Social Security number(s) (SSN)	

		 b	 Grantee(s) name(s)
			

Grantee(s) Social Security number(s) (SSN)

	 4	 On what date was the trust funded? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  	 4

M	M

D	D

Y	Y	Y	Y

	 5	 Was the trust contacted by the IRS and/or Wis. Dept. of Revenue in the last 3 years?  . . . . . . . . .  5	Yes	

No

		 If yes, explain:
	 6	 State reason for closing the trust. If death of beneficiary, provide name of beneficiary, social security number, last address,
and date of death.
	 7	 Have you petitioned the court to close the trust? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  7	Yes	

No

		 If yes, include a copy of the petition. If no, explain why no petition has been filed:
	
	 8	 Has the trust filed fiduciary income tax returns with Wisconsin in any of the last four years? . . . . .  8	Yes	

No

		 If no, provide either a) copies of informal or formal annual accountings for the past four years, or showing the trust’s income
and expenses for each of the past four years.
	 9	 Enter the total fair market value of each of the assets listed below that are held by the trust at the end of the year preceding the
final year of the trust. (NOTE Where any line from 9a through 9f is left blank, it will be deemed that NONE is the DECLARATION
for that line by the person(s) signing Schedule CC.)
a	 Real Estate. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 	9a

.00

b	 Stocks and Bonds. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 	9b

.00

c	 Mortgages, Notes, and Cash . . . . . . . . . . . . . . . . . . . . . . 	9c

.00

d	 Annuities and Life Insurance. . . . . . . . . . . . . . . . . . . . . . . 	9d

.00

e	 Interest in Partnerships, LLCs, and S Corporations. . . . . 	9e

.00

f	 Other Miscellaneous Property . . . . . . . . . . . . . . . . . . . . . 	9f

.00

NO COMMAS; NO CENTS

g	 Total Assets (add lines 9a through 9f) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 	9g

.00

	10	 Fiduciary fees paid or payable to the personal representative or trustee  . . . . . . . . . . . . . . 	 10

.00

Yes	 Complete the following.	
Third Do you want to allow another person to discuss this schedule with the department (see instructions)?	
Personal
Party
Designee’s
Phone
identification
no.	 (	)
Designee name
number (PIN)

No

I, as fiduciary, declare under penalties of law that I have examined this schedule (including accompanying documents and
statements) and to the best of my knowledge and belief it is true, correct, and complete.
Your signature		

Date	

Daytime phone

(	)
Fiduciary’s address	
PERSON PREPARING FORM if other than the preceding signer	

City	
Signature of preparer	

State	
Date	

Zip code
Daytime phone

(	)
Mail completed form to:
Wisconsin Department of Revenue
PO Box 8918 • Madison WI 53708-8918