Form ESBT Fillable Worksheet for electing Small business and Qualified Subchapter S trusts
(all forms fillable on Windows, Mac, Android tablets, and iPad using Adobe Reader XI)

*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