Form Schedule G Fillable Grantor Statement of Income, Deductions, Credits (Form 41)
(all forms fillable on Windows, Mac, Android tablets, and iPad using Adobe Reader XI)

Final Amended *140006SG* 1 Interest Income 10 Interest 11 Taxes 12 Fiduciary Fees 13 Charitable Deduction 14 Attorney accountant and return preparer fees 15 Other deductions not subject to the 2% floor (attach explanation) 16 Allowable miscellaneous itemized deduction subject to the 2% floor (attach explanation) 17 Depreciation 18 Depletion 19 Amortization 2 Dividend Income 20 Composite payment Paid by TIN 21 Tax Exempt Income 22 Capital Credit 23 Other information 3 Capital Gain or (Loss) 4 Rent Royalties Partnerships Business Income and other Estates and Trusts 5 Farm Income or (Loss) 6 Ordinary Gain or (Loss) from Form 4797 7 Other Income 8 Nonresident grantor Alabama source Income 9 Nonresident grantor non Alabama source Income ADDITIONAL INFORMATION AlAbAmA DepArtment of revenue City State Zip City State Zip DIRECTLY APPORTIONED DEDUCTIONS GRANTOR INFORMATION TRUST INFORMATION GRANTOR S SHARE OF DEDUCTIONS GRANTOR S SHARE OF INCOME Grantor Statement of Income Deductions Credits Name Name SCHEDULE G FORM 41 2014 SSN FEIN Street Address Street Address Tax year beginning 2014 and ending 20