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 03                                                                                                                                                                                                                                                                                                          03 
 04                                                                                                                                                                                                                                                                                                          04 
            DELAWARE                                                                            TaxYear                                                                                                                                                             Page 1                                   05 
 05 
            FORM 400                                                                                                                                                                                                                                                                                         06 
 06 
                                                                                                2016                                                                                                                                                                                                         07 
 07 
 08                                                                                                                                                                                                                                                                                                          08 
 09                                                         DELAWAREFIDUCIARY                                                                                                                                                                                                                                09 
 10                                                                                                                                                                                                                                                                                                          10 
                                                            INCOME TAX RETURN
 11                                                                                                                                                                                                                                                                                                          11 
 12                                                                                                                                                                                                                                                                                                          12 
 13                                                                                                                                                                                                 *DF20616019999*                                                                                          13 
    FISCALYEAR                                                                                  To                                                                                                                                          DF20616019999
 14                                                                                                                                                                                                                                                                                                          14 
 15 CHECKAPPLICABLEBOX:                                                             INITIAL RETURN                                                         AMENDED RETURN                                                                                                                                    15 
 16                                                                                                                                                                                                                                                                                                          16 
 17 NAMEOFTRUSTORESTATE                                                                                                                                    EMPLOYERIDENTIFICATIONNUMBER                                                     FILINGSTATUS (CHECKONE):                                         17 
 18                                                                                                                                                                                                                                                                                                          18 
 19 TRUSTNUMBER                                                                                                                                                                                                                             RESIDENTESTATE                                                   19 
 20                                                                                                                                                                                                                                                                                                          20 
 21 NAMEANDTITLEOFFIDUCIARY                                                                                                                                                                                                                 NON-RESIDENTESTATE                                               21 
 22                                                                                                                                                                                                                                                                                                          22 
 23 ADDRESS OF FIDUCIARY(NUMBERAND STREET)                                                                                                                                                                                                  RESIDENTTRUST                                                    23 
 24                                                                                                                                                                                                                                                                                                          24 
 25 CITY                                                                            STATE                   ZIP CODE                                                                                                                        NON-RESIDENTTRUST                                                25 
 26                                                                                                                                                                                                                                                                                                          26 
 27                                                                                                                                                                                                                                                                                                          27 
 28                                                                                                                                                                                                                                                                                                          28 
 29 NOTE: YOUMUSTATTACHACOPYOFYOURFEDERALRETURN(FORM1041)ANDSUPPORTINGSCHEDULESTOTHISRETURN                                                                                                                                                                                                                  29 
 30 1.      FEDERALTAXABLEINCOMEOFFIDUCIARY(FORM1041,LINE22)...................................................................................                                                                                                                                                              30 
 31 2.      INCOMEOFELECTINGSMALLBUSINESSTRUSTS............................................................................................................                                                                                                                                                  31 
 32 3.      NETMODIFICATIONSOFELECTINGSMALLBUSINESSTRUSTS(ATTACHSEPARATESCH.A).......................................                                                                                                                                                                                        32 
 33 4.      COMBINELINES1,2AND3..................................................................................................................................................                                                                                                                            33 
 34 5.      FIDUCIARY’SSHAREOFDELAWAREMODIFICATIONS(FROMSCHEDULEB,COLUMNB,LINE1)..................................                                                                                                                                                                                           34 
 35 6.      INCOMEACCUMULATEDFORNON-RESIDENTBENEFICIARIES(SCHEDULEC)...............................................................                                                                                                                                                                          35 
 36 7.      DELAWARETAXABLEINCOME(LINE4PLUS/MINUSLINE5&6)......................................................................................                                                                                                                                                              36 
 37 8.      DELAWARETAX(COMPUTEFROMTAXRATESCHEDULE,PAGE2).................................................................................                                                                                                                                                                   37 
 38 9.      TAXONLUMPSUMDISTRIBUTIONS(FORM329MUSTBEATTACHED)............                                                                                                                                                                                                                                     38 
 39 10.     TOTALTAX-ADDLINES8AND9ANDENTERHERE.........................................................................................................                                                                                                                                                      39 
 40 11.     NON-REFUNDABLECREDITS..............................................................................................................................................                                                                                                                              40 
 41 12.     BALANCE(SUBTRACTLINE11FROMLINE10)(CANNOTBELESSTHANZERO).............................................................                                                                                                                                                                             41 
 42 13.     ESTIMATEDTAXPAIDANDPAYMENTSWITHEXTENSIONS.............................                                                                                                                                                                                                                           42 
 43 14.     OTHERPAYMENTS(INCLUDEREAL ESTATE ESTIMATED TAXES ONTHISLINE).                                                                                                                                                                                                                                    43 
 44 15.     TOTALREFUNDABLECREDITS(ADDLINES13AND14)....................................................................................................                                                                                                                                                      44 
 45 16.     PREVIOUSREFUNDS..........................................................................................                                                                                                                                                                                        45 
 46 17.     NETREFUNDABLECREDITS(SUBTRACTLINE16FROMLINE15)...................................................................................                                                                                                                                                                46 
 47 18.     IFLINE12ISMORETHANLINE17,SUBTRACTLINE17FROMLINE12.........................................................PAYINFULL>                                                                                                                                                                             47 
 48 19.     IFLINE17ISMORETHANLINE12,SUBTRACTLINE12FROMLINE17(NoCarryoverPermitted)......................REFUND>                                                                                                                                                                                             48 
 49                                                                                                                                                                                                                                                                                                          49 
 50         UNDERPENALTIESOFPERJURY,IDECLARETHATIHAVEEXAMINEDTHISRETURN,INCLUDINGACCOMPANYINGSCHEDULESANDSTATEMENTS,ANDTOTHE                                                                                                                                                                                 50 
            BESTOFMYKNOWLEDGEANDBELIEFITISTRUE,CORRECT,ANDCOMPLETE. IFPREPAREDBYAPERSONOTHERTHANTAXPAYER,THISDECLARATIONIS
 51         BASEDONALLINFORMATIONOFWHICHHE/SHEHASANYKNOWLEDGE.                                                                                                                                                                                                                                               51 
 52                                                                                                                                                                                                                                                                                                          52 
 53                                                                                                                                                                                                                                                                                                          53 
 54                                                                                                                                                                                                                                                                                                          54 
 55 SIGNATUREOFFIDUCIARYOROFFICERREPRESENTING FIDUCIARY                                                                             DATE                                                                                    PREPARER BUSINESS PHONE                                                          55 
 56                                                                                                                                                                                                                                                                                                          56 
 57                                                                                                                                                                                                                                                                                                          57 
 58 SIGNATURE OF PAID PREPARER                                                                                                      DATE                                                            PREPARER EMPLOYER ID OR SOCIALSECURITYNUMBER                                                             58 
 59                                                                                                                                                                                                                                                                                                          59 
 60                                                                                                                                                                                                                                                                                                          60 
 61 STREET ADDRESS OF PREPARER                                                                                                                                                      CITY                                                    STATE                                   ZIP                      61 
 62         MAKE CHECK PAYABLE AND MAIL TO: DIVISION OF REVENUE, P.O. BOX 2044, WILMINGTON, DELAWARE 19899-2044                                                                                                                                                                                              62 
 63                                                                                                                                                                                                                                                                                                          63 
 64                                                                                                                                                                                                                                                                                                          64 
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 04  05  06  07  08  09  10  11  12  13  14  15  16  17  18        19  20  21  22  23  24  25  26  27  28  29  30  31  32  33  34  35  36  37  38  39  40  41  42       43  44  45  46  47  48     49  50  51  52  53  54  55  56  57  58  59  60  61  62      63  64  65  66  67  68  69  70  71  72      73  74  75  76  77  78  79  80  81  82 
 03                                                                                                                                                                                                                                                                                                                                  03 
 04                     FORM 400                                                                                                                                  2016                                                                                                                        PAGE 2                                 04 
 05                                                                                   SCHEDULE A - DELAWARE MODIFICATIONS AND ADJUSTMENTS                                                                                                                                                                                            05 
 06                                                                                                                                                       ADDITIONS                                                                                                                                                                  06 
 07 1.          INTEREST ON OBLIGATIONS OF STATES OTHER THAN DELAWARE ....................................................                                                                                                                                                                                                        1  07 
 08 2.          OTHER ADJUSTMENTS ...............................................................................................................................                                                                                                                                                                 2  08 
 09 3.          STATE INCOME TAX ON FEDERAL RETURN (ALL STATES ) (SEE INSTRUCTIONS) .............................                                                                                                                                                                                                                 3  09 
 10 4.          TOTAL ADDITIONS (ADD LINES 1, 2, AND 3) ..............................................................................................                                                                                                                                                                            4  10 
 11                                                                                                                                                   SUBTRACTIONS                                                                                                                                                                   11 
 12 5.          INTEREST ON U.S. OBLIGATIONS ..............................................................................................................                                                                                                                                                                       5  12 
 13 6.          OTHER ADJUSTMENTS ...............................................................................................................................                                                                                                                                                                 6  13 
 14 7.          TOTAL SUBTRACTIONS (ADD LINES 5 AND 6) ..........................................................................................                                                                                                                                                                                 7  14 
 15 8.          NET DELAWARE MODIFICATIONS (SUBTRACT LINE 7 FROM LINE 4). ENTER HERE AND ON                                                                                                                                                                                                                                       8  15 
 16             SCHEDULE B, COLUMN B, LINE 6 ..............................................................................................................                                                                                                                                                                          16 
 17                                                                                                                                                                                                                                                                                                                                  17 
 18                                                                                                                                                                                                                                                                                                                                  18 
 19                                                                               SCHEDULE B -SHARE OF DELAWARE MODIFICATIONS AND ADJUSTMENTS                                                                                                                                                                                        19 
                                                                                                                                                                                                                                  COLUMN A
 20                                                                   NAME AND ADDRESS                                                                                            TAXPAYER                            SHARE OF FEDERAL                                                                    COLUMN B                   20 
 21                                               (INCLUDE FIDUCIARY SHARE ON LINE 1)                                                                                         IDENTIFICATION                                  SECTION 641(c)                                  %               SHARE OF DELAWARE                      21 
                                                                                                                                                                                      NUMBER                          AND DISTRIBUTABLE                                                               MODIFICATIONS
 22                                                                                                                                                                                                                           NET INCOME                                                          AND ADJUSTMENTS                    22 
 23                                                                                                                                                                                                                                                                                                                                  23 
    1.                                                                                                                                                                                                            $                                                                       $
 24                                                                                                                                                                                                                                                                                                                                  24 
 25                                                                                                                                                                                                                                                                                                                                  25 
 26 2.                                                                                                                                                                                                                                                                                                                               26 
 27                                                                                                                                                                                                                                                                                                                                  27 
 28                                                                                                                                                                                                                                                                                                                                  28 
 29 3.                                                                                                                                                                                                                                                                                                                               29 
 30                                                                                                                                                                                                                                                                                                                                  30 
 31                                                                                                                                                                                                                                                                                                                                  31 
 32 4.                                                                                                                                                                                                                                                                                                                               32 
 33                                                                                                                                                                                                                                                                                                                                  33 
 34                                                                                                                                                                                                                                                                                                                                  34 
 35 5.                                                                                                                                                                                                                                                                                                                               35 
 36                                                                                                                                                                                                                                                                                                                                  36 
 37                                                                                                                                                                                                                                                                                                                                  37 
 38                                                                                                                                                                                                                                                                                                                                  38 
 39 6. TOTAL                                                                                                                                                                                                      $                                                       100%            $                                          39 
 40                                                                                                                                                                                                                                                                                                                                  40 
 41                                                                                                                                                                                                                                                                                                                                  41 
 42                                                                               SCHEDULE C - INCOME ACCUMULATED FOR NON-RESIDENT BENEFICIARY                                                                                                                                                                                       42 
                                                  (IF BENEFICIARY RESIDED IN DELAWARE DURING ANY PART OF THE TAXABLE YEAR, SPECIFY DATES)
 43                                                               Column A                                Column B                                Column C                            Column D                                Column E                        Column F                            Column G                           43 
 44                                                                                               Amount of ColumnA,                                                                                                                                                                                                                 44 
                    Last Four Digits of                           Amount from                 From Delaware Source                    Share of Modifications,                     Column A, Plus or                       Dates, Resided                          %                       Multiply Column D 
 45                 Beneficiary’s FEIN                        Schedule B, Col A                   (Information Only)                  Schedule B, Column B                        Minus Column C                      Outside Delaware                                                        by Column F                            45 
 46                                                                                                                                                                                                                                                                                                                                  46 
 47                                                                                                                                                                                                                                                                                                                                  47 
 48                                                                                                                                                                                                                                                                                                                                  48 
 49                                                                                                                                                                                                                                                                                                                                  49 
 50                                                                                                                                                                                                                                                                                                                                  50 
 51                                                                                                                                                                                                                                                                                                                                  51 
 52             DEDUCTIONS FOR INCOME ACCUMULATED FOR NON-RESIDENT BENEFICIARIES (ENTER TOTAL, COLUMN G ON PAGE 1 LINE 6).............................    $                                                                                                                                                                          52 
 53                                                                                                                                                                                                                                                                                                                                  53 
 54     TAX RATE SCHEDULE                                                                                                                                                                                                                                                                                                            54 
                                                                                                                                                                                                                                              DF20616029999
 55                                 IF INCOME ON LINE 7 IS:                                                                                                                                                                                                                   DF20616029999                                          55 
 56                                                       AT LEAST                                            BUT NOT OVER                                                            YOUR TAX IS:                                                                                                                                   56 
 57                                     $                                                     0. $                                                2,000. ------------                                                                                                                         $   0.                                 57 
 58                                                                                   2,000.                                                      5,000. ------------                                                      2.20% OF AMOUNT OVER $2,000.                                                                              58 
 59                                                                                   5,000.                                                  10,000. ------------                                     $66.00 + 3.90% OF AMOUNT OVER $5,000.                                                                                         59 
 60                                                                               10,000.                                                     20,000. ------------                                $261.00 + 4.80% OF AMOUNT OVER $10,000.                                                                                            60 
 61                                                                               20,000.                                                     25,000. ------------                                 $741.00 + 5.20% OF AMOUNT OVER $20,000.                                                                                           61 
 62                                                                               25,000.                                                     60,000. ------------                            $1,001.00 + 5.55% OF AMOUNT OVER $25,000.                                                                                              62 
 63                                                                       $60,000 AND OVER                                                                        ------------                $2,943.50 + 6.60% OF AMOUNT OVER $60,000.                                                                                              63 
 64                             (Revised 07/2016)                                                                                                                                                                                                                                                                                    64 
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