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Last Name of Decedent
Social Security Number *201912200*
*201912200*
Page 4
Amount from Line 7 _____________________________
VERMONT APPORTIONMENT CALCULATION
8. Vermont Gross Estate (See instructions) . . . . . . . . 8. ________________________
9. Value of gifts included on Line 2b with a
Vermont situs (See instructions) . . . . . . . . . . . . . . . 9. ________________________
10. Add Lines 8 and 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10. _______________________
11. Federal Gross Estate
(from federal Form 706, Line 1) . . . . . . . . . . . . . . 11. ________________________
12. Total value of all gifts reported on Line 2b . . . . . . 12. ________________________
13. Add Lines 11 and 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13. _______________________ FORM (Place at LAST page)
Form pages
14. Divide Line 10 by Line 13 (Round to four decimal places) . . . . . . . . . . . . . . . . . . . 14. _______________________
TAX DUE
15. Vermont Estate Tax (Multiply Line 7 by Line 14) . . . . . . . . . . . . . . . . . . . . . . . . . . 15. _______________________
3 - 4
16. Percentage of Vermont Estate Tax due to Vermont . Enter “100 .00%” or, if this
is an estate of a qualifying farmer, percentage from Schedule EST-192, Line 3 . . .16. _______________________100.00. %
17. Adjusted Vermont Estate Tax (Multiply Line 15 by Line 16) . . . . . . . . . . . . . . . . . 17. _______________________
18. Prior tax payments to Vermont . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18. _______________________
19. REFUND. If Line 17 is less than Line 18, subtract Line 17 from Line 18 . . . . . . . 19. _______________________
20. AMOUNT DUE. If Line 17 is more than Line 18, subtract Line 18 from
Line 17 . Make check payable to Vermont Department of Taxes. . . . . . . . . . . . . . 20. _______________________
DECLARATION OF FIDUCIARY
I hereby certify this return is true, correct, and complete to the best of my knowledge . Preparers cannot use return information for
purposes other than preparing returns .
Date Daytime Telephone Number
SIGN
HERE
Check here if authorizing the Vermont Department of Taxes to discuss this return and attachments with your preparer .
Preparer’s
Preparer’s Signature Date Daytime Telephone Number
Use Only Address
City, State, ZIP Code
Make checks payable to Vermont Department of Taxes and mail this return to:
Vermont Department of Taxes
133 State Street Form EST-191
Montpelier, VT 05633-1401 Page 2 of 2
5454 Rev. 10/20
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