*14000741*
1 Interest income
1 NAME 2 FEIN
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
16 Allowable miscellaneous itemized deductions subject to the 2% floor
17 Total deductions (add lines 10 through 16)
18 Adjusted total income/(loss) (subtract line 17 from line 9)
19 Total electing small business trust income (from line 18)
2 Dividend income
20 Tax rate 5%
21 Credits
22 Tax on ESBT income (report on Form 41 line 6)
3 Business income/(loss)
3 STREET ADDRESS
4 Capital gain or (loss)
4 CITY STATE ZIP
5 Rent royalties partnership and other estates and trusts
6 Farm income or (loss)
7 Ordinary gain or (loss) from Form 4797
8 Other income
9 Total Income (add lines 1 through 8)
AlAbAmA DepArtment of revenue
and Qualified Subchapter S trusts
DEDUCTIONS
FORM 41
INCOME
SCHEDULE
SOURCE OF INCOME FEIN NAME
TAX CALCULATION
Tax year beginning 2014 and ending
TOTAL ESBT/QSST
TRUST INFORMATION
Worksheet for electing Small business
