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IMPORTANT: FILL IN FORM MUST BE DOWNLOADED ONTO YOUR COMPUTER PRIOR TO COMPLETING
1505619105
(EX) MOD 03-19 (FI)
OFFICIAL USE ONLY
REV-1500 County Code Year File Number
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
START Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
Ü
Decedent’s Last Name Suffix Decedent’s First Name MI
(If Applicable) Enter Surviving Spouse’s Information Below Last Four Digits of
Spouse’s Last Name Spouse’s First Name MI Spouse’s SSN
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
TYPE OF RETURN (only select one)
Original Estate Return Supplemental Estate Return Individual-Transferee Return Remainder Return
(Only include items not previously (Individual reporting non-probate assets (Date of death prior to 12/13/1982)
reported) separate from the estate; Schedule F
and G assets only)
FILL IN ALL OVALS THAT APPLY
1. Decedent Died Testate 2. Spouse is Sole Beneficiary 3. Litigation Proceeds Received
(Attach copy of Will) (With no Trust involved)
4. Federal Estate Tax Return Required 5. Agricultural Exemption 6. Family-Owned Business Exemption
(Date of death after 6/30/2012) (Date of death after 6/30/2013)
7. Business Assets 8. Decedent Maintained Living Trust 9. Future Interest Compromise
(Attach copy of Trust) (Date of death after 12/12/1982)
10.Deferral/Election of Spousal Trust 11. ____ Total Number of Safe Deposit Boxes
CORRESPONDENT – THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
First Line of Address
Second Line of Address
City or Post Office State Zip Code
Correspondent’s email address: REGISTER OF WILLS USE ONLY
DATE FILED STAMP
PLEASE USE ORIGINAL FORM ONLY REGISTER OF WILLS USE ONLY
DATE FILED MMDDYYYY
1505619105 1505619105
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