Vermont Department of Taxes     133 State Street     Montpelier, VT  05633-1401
Phone:  (802) 828-6820
                                                                                       *201912100*
    VT Form
                                   ESTATE TAX RETURN
                                                                                       *201912100*
EST-191                            Resident and Nonresident                                                                                                                                    Page 3

                      This form applies only to estates of decedents who died after December 31, 2015.
Decedent’s Information
Last Name of Decedent                      First Name                          Initial Social Security Number

State of Domicile at Time of Death         Date of Death (MM DD YYYY)                                                                                              For Department Use Only
    (Use standard 2-letter abbreviation)
                                                                  /        /
Fiduciary’s Information
Name of Fiduciary                                                                      Daytime Telephone Number

Mailing Address                                                                                                                                                    For Department Use Only

City                                       State                  ZIP Code

Foreign Country (if not United States)     Email Address
                                                                                                                                                                                               FORM  (Place at FIRST page)
                                                                                                                                                                                               Form pages 
Attorney’s Information
Name of Attorney                                                                       Daytime Telephone Number

Mailing Address                                                                                                                                                    For Department Use Only
                                                                                                                                                                                               3 - 4
City                                       State                  ZIP Code

Foreign Country (if not United States)     Email Address

      Check if this is an AMENDED return .

      Check if you filed an EXTENSION request previous to this filing .

VERMONT ESTATE TAX CALCULATION
  1.  Federal tentative taxable estate (from federal Form 706, Line 3a)  . . . . . . . . . . . . . . . 1.   _______________________

 2a.  Federal taxable gifts  
    (from federal Form 706, Line 4)  . . . . . . . . . . . . .  . 2a.  ________________________

 2b.  Portion of Line 2a made within two years of date of death   . . . . . . . . . . . . . . . . . . . 2b.   _______________________

  3.  Any deduction taken for death taxes paid to a foreign country 
    (from federal Form 706, Schedule K)  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  . 3.   _______________________

  4.  Vermont Taxable Estate (Add Lines 1, 2b, and 3)  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  . 4.   _______________________

  5.  Exclusion (See instructions for exclusion amount .)  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  . 5.   _______________________

  6.  Subtract Line 5 from Line 4 .  If negative, enter 0 .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  . 6.   _______________________

  7.  Multiply Line 6 by 16% (0 .16)  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  . 7.   _______________________

                                           (continued on next page)
                                                                                                                                                                   Form EST-191
                                                                                                                                                                   Page 1 of 2
5454                                                                                                                                                               Rev. 10/20

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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