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Federal forms, ICRs, and supporting documents

OMB control number

Life Insurance Statement

OMB 1545-0022 · TREAS/IRS.

OMB 1545-0022

Form 712 is used to establish the value of life insurance policies for estate and gift tax purposes. The tax is based on the value of these policies. The form is completed by life insurance companies and Executors file Form 712 with Form 706, 706-NA, or 709 for insurance policy or premium amounts.

The latest form for Life Insurance Statement expires 2028-11-30 and can be found here.

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