Form D-41 Fillable 2015 Fiduciary Income Tax Return

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Download Form D-41

(AMENDED RETURN) Unchecked (Bank Account Number) (Bank Routing Number) (checkbox) Unchecked (checkbox) Unchecked (CHECKING ACCT: C) Unchecked (CHECKING ACCT: S) Unchecked (Clear) Clear (COMPLEX TRUST: COM 1) Unchecked (COMPLEX TRUST: EST 1) Unchecked (COMPLEX TRUST: SMT 1) Unchecked (DAYTIME PHONE NUMBER) (FINAL RETURN) Unchecked (IAT yes indicator: NO) Unchecked (IAT yes indicator: YES) Unchecked (Inrer vivos: No 1) Unchecked (Inrer vivos: Yes 1) Unchecked (MMDD) (NO: 1) Unchecked (NO: 2) Unchecked (Payment Type: No 1) Unchecked (Payment Type: Yes 1) Unchecked (Print) Print (STATE) (Tax year ending) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (WILL A D 76 BE FILED YES: no) Unchecked (WILL A D 76 BE FILED YES: Yes) Unchecked (YES: no) Unchecked (YES: Yes) Unchecked )elbacilppafirebmuntnemtrapa/etiusdnateerts rebmun(sserddas yraicudiFCity State Zip Code +4 *150410110002* *150410120002* 1 $ 00 1 Federal total income from federal Form 1041 Fill in if loss 10 $ 00 10 Exemption Enter $1 775 for estates and $100 for trusts If the estate ended during 2015 11 $ 00 11 Total deductions and exemptions Add Lines 6 10 12 $ 00 12 Taxable fiduciary income Subtract Line 11 from Line 5 Fill in if loss 13 $ 00 13 Tax on fiduciary income 14 $ 00 14 Credit for taxes paid to other states Credit may not exceed amount on Line 13 See 15 $ 00 15 Net tax on fiduciary income Line 13 minus Line 14 16a Income tax withheld 16b 2015 estimated fiduciary income tax payments 17 $ 00 17 Payments made with extension of time to file from FR 127F calculation Line 3 18 $ 00 18 If this is an amended 2015 return payments made with original 2015 D 41 19 $ 00 19 Total payments Add Lines 16a 18 2 $ 00 2 Additions to federal total income from Calculation A line f page 6 of instructions 2015 D 41 Fiduciary 2015 D 41 P1 2015 D 41 P2 21 Amount if any to be applied to 2016 estimated tax 22 Refund Subtract 23 Amount owed 3 $ 00 3 Add Lines 1 and 2 Fill in if loss 4 4 $ 00 4 Subtractions from federal total income from Calculation B line d page 6 of instructions 5 $ 00 5 Total DC fiduciary income tcartbuS Line 4 from Line 3 If zero or a loss Fill in if loss 6 $ 00 6 Interest from federal Form 1041 7 $ 00 7 Taxes Subtract the state local and DC franchise tax entered on federal Form 1041 8 $ 00 8 Deduction for distributions to beneficiaries from federal Form 1041 9 $ 00 9 Other deductions Enter total of Lines 12 13 14 15a 15b 15c and 19 from federal Form 1041 Address of grantor (number street and suite/apartment number if applicable) Amount of and 2015 D 41 on your payment Attach check or money order (US dollars) to the D 41P voucher only; City State Zip Code Complete if entity (MMDDYYYY) D 41 PAGE 2 Date created Date of deceased s death Declaration of paid preparer is based on the information available to the preparer Deductions and exemptions Direct Deposit To have your refund deposited to your checking OR savings account fill in oval and enter bank routing and account numbers See instructions District of Columbia edoCpiZetatSytiC)teertsdnarebmun(sserddas reraperPRefund Options: Estate or trust name Estate or trust s federal employer ID number Daytime telephone number etaDyraicudfiehtgnitneserperrecfiforoyraicudfifoerutangiSSignature of paid preparer Preparer s Tax Identification Number (PTIN) Fiduciary Income Tax Return Fiduciary s name and title Fill in type of entity: Estate Simple trust Complex trust Fill in type of trust: Testamentary (created by a will) Inter vivos (living) Government of the If estate ended in 2015 enter date If Line 19 is less than Line 15 subtract Line 19 from Line 15 If Line 19 is more than Line 15 subtract Line 15 from Line 19 If no will one be filed? Yes No If trust ended in 2015 enter date Income Income Tax Return Information Fill in: if amended return See instructions Fill in: if this is your final return instructions page 7 Attach copy of state return is a trust is an estate Line 21 from Line 20 $ 00 make it payable to: DC Treasurer Write the estate or trust s FEIN Mark one refund choice: Direct deposit Paper check Name of grantor Office of Tax and Revenue OFFICIAL USE ONLY overpayment Payment PO Box 96153 prorate the exemption See page 7 for instructions return to: Revised 03/15 Revised 03/15 Fiduciary Income Tax Return Round cents to nearest dollar If amount is zero leave line blank Routing Number Account Number Send your signed and completed original Signature Under penalties of law I declare that I have examined this return and to the best of my knowledge it is correct stop here; do not fill in rest of form Tax and payments Tax period ending (MMYY) This is a FILL IN format Please do not handwrite any data on this form other than your signature Vendor ID#0002 Washington DC 20090 6153 Will this payment come from an account outside the U S ? Yes No See instructions Will this refund you requested go to an account outside the U S ? Yes No See instructions Yes No

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