Vermont Department of Taxes     133 State Street     Montpelier, VT  05633-1401
Phone:  (802) 828-6820
                                                                                       *20E2A1100*
     VT Form
                      ESTATE TAX INFORMATION AND 
                                                                                       *20E2A1100*
     E2A              APPLICATION FOR TAX CLEARANCES                                                                               Page 3
Decedent’s Information
 Decedent’s Last Name                               First Name                 Initial Decedent’s Social Security Number

 Address of Residence (domicile) at Time of Death                                      Spouse’s/CU Partner’s Social Security Number

 City                                               State ZIP Code                     Date of Death (mmddyyyy)      Age at Death
                                                                                                 /        /
Administrator / Executor / Trustee Information
 Administrator / Executor / Trustee Name                                               Telephone Number

 Mailing Address                                                                                 For Department Use Only

 City                                               State ZIP Code

 Foreign Country                                    Email Address
                                                                                                                                   FORM  (Place at FIRST page)
                                                                                                                                   Form pages 
Attorney Information
 Attorney’s Name                                                                       Telephone Number

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

 Foreign Country                                    Email Address

  1. Has the estate been entered in Probate Court? .......         Yes, District ____________________________            No

Section A   VERMONT INCOME TAX (see instructions)  Is a Vermont Income Tax Return required for Year of Death?
          Yes.  A return must be filed before the tax clearance can be issued.
          No.  State reason  _______________________________________________________________________

Section B   VERMONT FIDUCIARY TAX (see instructions)  If income is received by the estate during administration, Fiduciary 
     Tax Returns may be due.  Check appropriate box.  FEIN (required):  _____________________________________
          No returns are                             Required returns          Final required returns will be filed by 
                 required to be filed.               have been filed.           (mmddyyyy) ___________________/        /

Section C   VERMONT ESTATE TAX (see instructions)  
     For deaths BEFORE 2009:  Is a U.S. Estate Tax Return, Form 706, required to be filed?                                         FORM  (Place at LAST page)
                                                                                                                                   Form pages 
     For deaths in 2009 or 2010:  Is the total value of the gross estate, including taxable gifts, more than $2,000,000.00*?  
   For deaths in 2011 through 2019:  Is the total value of the gross estate, including taxable gifts, more than $2,750,000.00*?
   For deaths in 2020:  Is the total value of the gross estate, including taxable gifts, more than $4,250,000.00*?
   For deaths in 2021:  Is the total value of the gross estate, including taxable gifts, more than $5,000,000.00*?
          Yes.  A Vermont Estate Tax Return is required to be filed.                                                              3 - 3
          No.  A Vermont Estate Tax Return is not required to be filed.
                 *The Total Value of an estate at time of death includes jointly owned assets, solely owned assets, 
                 insurances with or without named beneficiaries and trust assets, etc.  For an ancillary estate this 
                 figure includes the value of the other states assets as well as the value of the Vermont assets.
I certify that the information contained herein is true, correct, and complete to the best of my knowledge.

                                                                                                                        Form E2A
        Signature of Administrator/Executor/Trustee       Printed Name                 Date                             Rev. 10/20

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