Form 706-D United States Additional Estate Tax Return Under Code Se

Form

706-D

United States Additional Estate Tax Return
Under Code Section 2057

(Rev. December 2008)

OMB No. 1545-1680

Department of the Treasury
Internal Revenue Service

Part I
1a

General Information

Name of qualified heir

1b Address of qualified heir (number and street, including apt. no. or P.O. box)

1c

City, town or post office, state, and ZIP code

4

Decedent’s name reported on Form 706

Part II
1
2
3

5

Decedent’s social security number

Qualified heir’s social security number

3

Commencement date (see instructions)

6

Date of death

Tax Computation (First complete Schedules A and B. See instructions.)

Qualified heir’s share of the total qualified family-owned business interests (from line 4, Schedule T
(Form 706), of the decedent’s estate tax return)

1

Total reported value of qualified family-owned business interests (from line 6, Schedule T (Form 706),
of the decedent’s estate tax return)
Decedent’s estate tax:

2

a Recomputed without the qualified family-owned business interest
deduction (attach computation)
b Reported on Form 706 (or as finally agreed to)
c Gross additional estate tax (subtract line 3b from line 3a)
4

2

3a
3b
3c

Qualified heir’s percentage of qualified family-owned business interests. Divide line 1 by line 2. Enter
result as a percentage (carry out your answer to at least the nearest tenth of a percent)

4

5

Qualified heir’s share of total reduction in estate tax. Multiply line 3c by line 4

5

6

Enter the Total from column (E), Schedule A, page 2

6

7

Divide line 6 by line 1. Enter the result as a percentage (carry out your answer to at least the nearest
tenth of a percent)

7

8

Multiply line 5 by the percentage on line 7

8

9

Applicable percentage (see instructions)

9

.

%

.

%

%

10 Total additional estate tax. Multiply line 8 by the percentage on line 9
10
If you completed Schedule B on page 2, complete lines 11 through 15. If you did not complete Schedule B, skip lines 11 through 14
and enter the amount from line 10 on line 15.
11

Enter the total cost or fair market value (FMV) from column (C), Schedule B, page 2

11

12

Enter the total of column (D), Schedule A, page 2

12

13

Divide line 11 by line 12. Enter the result as a percentage (carry out your answer to at least the nearest
tenth of a percent) (do not enter more than 100%)

13

14

Multiply line 10 by the percentage on line 13

14

15

Additional estate tax due. Subtract line 14 from line 10 (do not enter less than zero)

15

%

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.

Sign
Here
Paid
Preparer’s
Use Only

©

Signature of taxpayer or person filing on behalf of taxpayer
Preparer’s
signature

©

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

Date
Date

©

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

Check if
self-employed

Preparer’s SSN or PTIN

EIN
Phone no.
Cat. No. 26107A

(

)
Form

706-D

(Rev. 12-2008)

Form 706-D (Rev. 12-2008)

Page

2

Schedule A. Disposition of Qualified Family-Owned Business Interest, Failure to Materially
Participate, or Disqualifying Act (Taxable Under Section 2057(f)(1))
(A)
Item
number

1

(C)
Date of disposition, failure to
materially participate, or
disqualifying act (see instructions)

(B)
Description of property and explanation of disqualifying act

Form 706, Schedule
Description —

(D)
Amount realized or fair
market value (FMV) if
applicable (see instructions)

(E)
Date of death value (see
instructions)

, Item

Total. Enter the total of column (D) on page 1, Part II, Tax Computation, line 12,
and the total of column (E) on page 1, Part II, Tax Computation, line 6

Schedule B. Involuntary Conversions or Exchanges
Check if for:

Involuntary Conversion

(A)
Item

Exchange
(C)
Cost or fair
market value
(FMV)

(B)
Description of qualified replacement (or exchange) property

1

Total. Enter the total of column (C) on page 1, Part II, Tax Computation, line 11.

Schedule C. Nontaxable Transfers

Transferee

Last name

First name

Social security number

Relationship to the qualified heir

Check if for:

Disposition to Family Member

(A)
Item

1

Qualified Conservation Contribution

(B)
Description of property and explanation of nontaxable transfers

Form 706, Schedule
Description —

Middle initial

Loss of U.S. Citizenship
(C)
Date of disposition,
contribution, trust agreement,
or bond

, Item

Form

706-D

(Rev. 12-2008)