TENNESSEE DEPARTMENT OF REVENUE
            INHERITANCE TAX RETURN SCHEDULE
              ANNUITIES
SCHEDULE  I
INH
301

ESTATE OF                                                    DECEDENT'S SOCIAL SECURITY NUMBER

Enter all benefit plans payable to the decedent or survivors.

Item No.      Description                                                                                                                              Value at
                                                                                                                                                       Date of Death

1. Total ..............................................................................................................................................
2. Total (From any attached sheets).................................................................................................
3. Total (Add Lines 1 & 2, enter here and also on Page 3, Line 9-I)................................................

RV-F1400901                                                                                                                                            INTERNET (1-98)