Form 1041 Form 1041 U.S. Income Tax Return for Estates and Trusts

Version A, Cycle 3
Form

1041

Department of the Treasury—Internal Revenue Service

U.S. Income Tax Return for Estates and Trusts

A Type of entity (see instr.):
Decedent’s estate

For calendar year 2009 or fiscal year beginning

2009

OMB No. 1545-0092

, 2009, and ending

, 20

Name of estate or trust (If a grantor type trust, see page 14 of the instructions.)

C Employer identification number

Name and title of fiduciary

D Date entity created

Number, street, and room or suite no. (If a P.O. box, see page 14 of the instructions.)

E Nonexempt charitable and splitinterest trusts, check applicable
boxes (see page 15 of the instr.):

Simple trust
Complex trust
Qualified disability trust
ESBT (S portion only)
Grantor type trust
Bankruptcy estate-Ch. 7
Bankruptcy estate-Ch. 11
Pooled income fund
B Number of Schedules K-1
attached (see
instructions) ©

City or town, state, and ZIP code
F Check

applicable
boxes:

Initial return

Income
Deductions
Tax and Payments

Final return

Change in fiduciary
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Amended return

Change in trust's name

Change in fiduciary's name

Change in fiduciary's address

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Interest income . . . . . . . . . . . . . . . . . . . . . . . . . .
Total ordinary dividends . . . . . . . . . . . . . . . . . . . . . . .
Qualified dividends allocable to: (1) Beneficiaries
(2) Estate or trust
Business income or (loss). Attach Schedule C or C-EZ (Form 1040) . . . . . . . .
Capital gain or (loss). Attach Schedule D (Form 1041) . . . . . . . . . . . . .
Rents, royalties, partnerships, other estates and trusts, etc. Attach Schedule E (Form 1040)
Farm income or (loss). Attach Schedule F (Form 1040) . . . . . . . . . . . . .
Ordinary gain or (loss). Attach Form 4797 . . . . . . . . . . . . . . . . .
Other income. List type and amount
Total income. Combine lines 1, 2a, and 3 through 8 . . . . . . . . . . . . .
. . . . . . . . . . . . . .
Interest. Check if Form 4952 is attached ©

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DRAFT AS OF
September 18, 2009

Taxes . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Fiduciary fees . . . . . . . . . . . . . . . . . . . . . . . . . .
Charitable deduction (from Schedule A, line 7) . . . . . . . . . . . . . . .
Attorney, accountant, and return preparer fees . . . . . . . . . . . . . . .
Other deductions not subject to the 2% floor (attach schedule) . . . . . . . . . .
Allowable miscellaneous itemized deductions subject to the 2% floor . . . . . . . .
Add lines 10 through 15b . . . . . . . . . . . . . . . . . . . . . .
17
Adjusted total income or (loss). Subtract line 16 from line 9 . . .
Income distribution deduction (from Schedule B, line 15). Attach Schedules K-1 (Form 1041)
Estate tax deduction including certain generation-skipping taxes (attach computation) . .
Exemption . . . . . . . . . . . . . . . . . . . . . . . . . . .
Add lines 18 through 20 . . . . . . . . . . . . . . . . . . . . . . .
Taxable income. Subtract line 21 from line 17. If a loss, see page 23 of the instructions . .
Total tax (from Schedule G, line 7) . . . . . . . . . . . . . . . . . . .
Payments: a 2009 estimated tax payments and amount applied from 2008 return
. . .
Estimated tax payments allocated to beneficiaries (from Form 1041-T) . . . . . . .
Subtract line 24b from line 24a . . . . . . . . . . . . . . . . . . . .
Tax paid with Form 7004 (see page 24 of the instructions)
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Federal income tax withheld. If any is from Form(s) 1099, check ©
Other payments: f Form 2439

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Sign
Here

Not a private foundation
Described in section 4947(a)(2)

G Check here if the estate or filing trust made a section 645 election .

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Described in section 4947(a)(1)

; g Form 4136

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; Total ©

Total payments. Add lines 24c through 24e, and 24h . . . . . . . . . . . . . ©
Estimated tax penalty (see page 24 of the instructions) . . . . . . . . . . . . . .
Tax due. If line 25 is smaller than the total of lines 23 and 26, enter amount owed . . . . .
Overpayment. If line 25 is larger than the total of lines 23 and 26, enter amount overpaid . .
Amount of line 28 to be: a Credited to 2010 estimated tax ©
; b Refunded ©

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24b
24c
24d
24e
24h
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Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct,
and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.

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Signature of fiduciary or officer representing fiduciary

Paid
Preparer’s
Use Only

©

Firm’s name (or
yours if self-employed),
address, and ZIP code

Date

EIN of fiduciary if a financial institution
Date

Preparer’s
signature

©

For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.

Check if
self-employed

May the IRS discuss this return
with the preparer shown below
(see instr.)?
Yes
No

Preparer’s SSN or PTIN

EIN
Phone no.
Cat. No. 11370H

Form 1041 (2009)

Version A, Cycle 3
Page 2

Form 1041 (2009)

Schedule A
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Charitable Deduction. Do not complete for a simple trust or a pooled income fund.

Amounts paid or permanently set aside for charitable purposes from gross income (see page 25)
Tax-exempt income allocable to charitable contributions (see page 25 of the instructions) . . .
Subtract line 2 from line 1 . . . . . . . . . . . . . . . . . . . . . . . .
Capital gains for the tax year allocated to corpus and paid or permanently set aside for charitable purposes
Add lines 3 and 4 . . . . . . . . . . . . . . . . . . . . . . . . . . .
Section 1202 exclusion allocable to capital gains paid or permanently set aside for charitable
purposes (see page 25 of the instructions) . 26
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Charitable deduction. Subtract line 6 from line 5. Enter here and on page 1, line 13 . . . . .

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5

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Adjusted total income (see page 25 of the instructions) . . . . . . . . . . . . . . .
Adjusted tax-exempt interest . . . . . . . . . . . . . . . . . . . . . . .
Total net gain from Schedule D (Form 1041), line 15, column (1) (see page 26 of the instructions) .
Enter amount from Schedule A, line 4 (minus any allocable section 1202 exclusion) . . . . .
Capital gains for the tax year included on Schedule A, line 1 (see page 26 of the instructions) . .
Enter any gain from page 1, line 4, as a negative number. If page 1, line 4, is a loss, enter the loss
as a positive number . . . . . . . . . . . . . . . . . . . . . . . . . .

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Distributable net income. Combine lines 1 through 6. If zero or less, enter -0- . . . . . .
If a complex trust, enter accounting income for the tax year as
determined under the governing instrument and applicable local law .
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Income required to be distributed currently . . . 27
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Other amounts paid, credited, or otherwise required to be distributed . . . . . . . . .
Total distributions. Add lines 9 and 10. If greater than line 8, see page 26 of the instructions .
Enter the amount of tax-exempt income included on line 11 . . . . . . . . . . . .
Tentative income distribution deduction. Subtract line 12 from line 11 . . . . . . . . .
Tentative income distribution deduction. Subtract line 2 from line 7. If zero or less, enter -0- .
Income distribution deduction. Enter the smaller of line 13 or line 14 here and on page 1, line 18

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Schedule B

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Income Distribution Deduction

DRAFT AS OF
September 18, 2009

Schedule G
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1d

Tax Computation (see page 27 of the instructions)

Tax: a Tax on taxable income (see page 27 of the instructions) . .
b Tax on lump-sum distributions. Attach Form 4972 . . . .
c Alternative minimum tax (from Schedule I (Form 1041), line 56)
d Total. Add lines 1a through 1c . . . . . . . . . .
Foreign tax credit. Attach Form 1116 . . . . . . . . . . .
Other nonbusiness credits (attach schedule) . . . . . . . .
General business credit. Attach Form 3800 . . . . . . . . .
Credit for prior year minimum tax. Attach Form 8801 . . . . .
Total credits. Add lines 2a through 2d . . . . . . . . . .
Subtract line 3 from line 1d. If zero or less, enter -0- . . . . . .
Recapture taxes. Check if from:
Form 4255
Form 8611 .
Household employment taxes. Attach Schedule H (Form 1040) . .
Total tax. Add lines 4 through 6. Enter here and on page 1, line 23 .

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Other Information
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Yes No

Did the estate or trust receive tax-exempt income? If “Yes,” attach a computation of the allocation of expenses
Enter the amount of tax-exempt interest income and exempt-interest dividends © $
Did the estate or trust receive all or any part of the earnings (salary, wages, and other compensation) of any
individual by reason of a contract assignment or similar arrangement? . . . . . . . . . . . . . . .
At any time during calendar year 2009, did the estate or trust have an interest in or a signature or other authority
over a bank, securities, or other financial account in a foreign country? . . . . . . . . . . . . . .
See page 29 of the instructions for exceptions and filing requirements for Form TD F 90-22.1. If “Yes,” enter the
name of the foreign country ©
During the tax year, did the estate or trust receive a distribution from, or was it the grantor of, or transferor to, a
foreign trust? If “Yes,” the estate or trust may have to file Form 3520. See page 29 of the instructions . . . .
Did the estate or trust receive, or pay, any qualified residence interest on seller-provided financing? If “Yes,” see
page 29 for required attachment . . . . . . . . . . . . . . . . . . . . . . . . . . .
If this is an estate or a complex trust making the section 663(b) election, check here (see page 30) .
To make a section 643(e)(3) election, attach Schedule D (Form 1041), and check here (see page 30) .

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If the decedent’s estate has been open for more than 2 years, attach an explanation for the delay in closing the estate, and check here

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Are any present or future trust beneficiaries skip persons? See page 30 of the instructions .

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Form 1041 (2009)