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                                     Nebraska Fiduciary Income Tax Return                                                                                FORM 1041N
                                     for the taxable year January 1, 2020 through December 31, 2020 or other taxable year
                                               beginning                    , 2020  and ending                    , 20                                   2020
  Name of Estate or Trust                                                                            PLEASE DO NOT WRITE IN THIS SPACE

  Name and Title of Fiduciary

  Street or Other Mailing Address of Fiduciary               
                                                             
  City                                         State                                   Zip Code       
                                                                                                      
  Nebraska ID Number                             Federal ID Number                                   Type of Trust (If Grantor Type, See Instructions)                  
   Please Type or Print                                                                                  Testamentary        Inter Vivos        Grantor Type 
  Status of Estate or Trust          Type of Return                                                                                     
 (1)      Resident  (2)  Nonresident      Estate            Simple Trust               Complex Trust          ESBT           Bankruptcy Estate            Amended Return
Check applicable boxes: 
  (1)      Initial Nebraska Return    (2)      Final Return               (3) Change in Address          (4)  7004 Attached            (5) Distributed Form 3800N Credit
  Does the estate or trust have nonresident individual beneficiaries?                                Is the trust a pooled income fund?
          YES (Complete Schedule II)      NO                                                             YES           NO                       
 1    Total federal income .......................................................................                                           1                          00
 2 Federal taxable income.....................................................................                                               2                          00
 3 Undistributed income from U.S. government bonds or other U.S. obligations ...........................                                     3                          00
 4 Undistributed income from non-Nebraska state and local bond interest and other Nebraska adjustments
     increasing federal taxable income (attach a schedule) (see instructions)...............................                                 4                          00
 5 Special Capital Gains/Extraordinary Dividend Deduction  .......................................... 5                                                                 00
 6 Nebraska adjustments decreasing federal taxable income (attach a schedule) (see instructions)............                                 6                          00
 7 Nebraska taxable income  (line 2 plus line 4) minus (lines 3, 5, and 6) ................................                                  7                          00
                                     Nonresident estates and trusts should not make entries on lines 8 through 10.
                        Instead, Nonresident estates and trusts must complete Nebraska Schedule  I                  to determine the line 11 entry.
 8 Nebraska income tax (use the tax rate schedule on page 8 of instructions).............................                                    8                          00
 9 Nebraska other tax (Federal Form 4972) (see instructions) .........................................                                       9                          00
 10   Electing Small Business Trust (ESBT) Nebraska Tax (complete ESBT Worksheet) ...................... 10                                                             00
 11   Total Nebraska tax (total of lines 8, 9, and 10) ................................................... 11                                                           00
 12   Credit for tax paid by resident estate or trust to other states (Schedule III)  ......              12                           00
 13   Community Development Assistance Act credit and Financial Institution Tax credit                        13                       00
 14   Form 3800N nonrefundable credit (attach Form 3800N) .....................                               14                       00
 15   Employer’s credit for expenses incurred for TANF (ADC) recipients (see instr.) ...                      15                       00
 16  School Readiness Tax Credit for providers (see instructions) .................                           16                       00
 17   Total nonrefundable credits (total of lines 12 through 16)........................................... 17                                                          00
 18   Nebr. income tax after nonrefundable credits. Subtract line 17 from line 11 (if line 17 is greater than line 11, enter zero -0-)  18                              00
 19   Nebraska income tax withholding for nonresident individual beneficiaries [total of column (G), Schedule II] ...                      19                           00
 20   Total Nebraska income tax liability (line 18 plus 19)............................................... 20                                                           00
 21   Form 3800N refundable credit (attach Form 3800N) ........................                               21                       00
 22   Tax deposited with Form 7004N and 2020 estimated income tax payments ......                             22                       00
 23   Beginning Farmer credit (attach certificate) ............................... 23                                                  00
 24   Nebraska Property Tax Incentive Act Credit Computation (attach Form PTC) ....                           24                       00
 25   Other credits (attach Nebraska copy of Federal Forms W-2, 1099-R, or W-2G) ...                          25                       00
 26   Total payments (total of lines 21 through 25) .................................................... 26                                                             00
 27  TAX DUE (if line 20 is greater than line 26, subtract line 26 from line 20)   .......................... 27                                                        00
 28   OVERPAYMENT (if line 26 is greater than line 20, subtract line 20 from line 26) ........................ 28                                                       00
 29  Overpayment on line 28 you want credited to 2021 estimated income tax .......................... 29                                                                00
 30   Overpayment to be REFUNDED (line 28 minus line 29)............................................ 30                                                                 00
                  Under penalties of perjury, I declare that as taxpayer or preparer, I have examined this return, including accompanying schedules and statements, 
               and to the best of my knowledge and belief, it is correct and complete.
   sign
               Signature of Fiduciary or Officer Representing Fiduciary  Date                        Email Address
   here                                                                  (       )
       paid    Title                                                     Phone Number 
preparer’s     Preparer’s Signature                                      Date                        Preparer’s PTIN
 use only                                                                                                                                                (   )
               Firm’s Name (or yours if self-employed), Address and Zip Code                         EIN                                                 Daytime Phone 
                                     A copy of the federal return and schedules must be attached to this return.
          Mail this return and payment to: Nebraska Department of Revenue, PO Box 94818, Lincoln, NE 68509-4818.                                                    8-424-2020



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                             Nebraska Schedule            I     Computation of Nebraska Tax for Nonresident Estate or Trust                                      FORM 1041N
                             Nebraska Schedule            II    Nonresident Beneficiary’s Share of Nebraska Income,                                              Schedules
                                                                   Deductions, and Credits                                                                        I II,  , and III
                             Nebraska Schedule            III   Credit for Tax Paid to Another State                                                                2020
 Name on Form 1041N                                                                                        Nebraska ID Number
  
                     Nebraska Schedule  I      Computation of Nebraska Tax for Nonresident Estate or Trust
 31  Nebraska taxable income (line 7, Form 1041N) .................................................. 31                                                                        00
 32  Nebraska income tax on line 31 amount (see line 8 instructions) ................................... 32                                                                    00
 33  Nebraska other tax (see line 9 instructions)  ................................................... 33                                                                      00
 34  Total Nebraska tax (line 32 plus line 33)........................................................ 34                                                                      00
 35  Income derived from Nebraska sources, except capital and ordinary gain (loss) (attach schedule) 
     (see instructions).......................................................................... 35                                                                           00
 36  Nebraska capital and ordinary gain (loss) (attach schedule) (see instructions) .......................... 36                                                              00
 37  Adjustments, if any, applied to Nebraska income (see instructions)
   List:                                                                                                                            37                                         00
 38  Nebraska adjusted gross income (line 35 plus or minus lines 36 and 37) .............................. 38                                                                  00
 39  Nebraska share of line 34. Compute below.
     Calculate the ratio to five decimal places and round to four
  =  x        = Line 38                                   .
         (Line 1 + Line 4) - (Lines 3, 5, and 6)                 (Ratio)             (Line 34)                                      39                                         00
 40  Electing Small Business Trust (ESBT)  Nebraska Tax. (from line 18 of ESBT worksheet) .................                         40                                         00
 41  Total Nebraska tax (add lines 39 and 40 and enter result on line 11, Form 1041N) ...................... 41                                                                00
       Nebraska Schedule  II                 Nonresident Beneficiary’s Share of  Nebraska Income, Deductions, and Credits
                  Note: If simple trust with out-of-state beneficiaries and only portfolio income, do not complete Schedule II. Instead check this box.  
                                                 Name And Address Of Each Nonresident Beneficiary
                           Name                                  Street or Other Mailing Address                   City                                        State  Zip Code

   1

   2

   3

   4
                                                                                                                   Computation of Nebraska Tax Withheld
                                                                                            (D)
                        (A)                               (B)               (C)             Check if       (E)                                                        (G)
         Social Security Number or             Nebraska Income              Nebraska        Form 12N    Nebraska Source Income                               (F)  Nebraska Income
                                                                                                                                                                   Tax Withholding 
                Nebraska ID Number             (see instructions)        Deductions         Attached       Subject to Withholding                            Rate [Col. (E) times Col. (F)]
        of Nonresident Beneficiary                                                                    [Column (B) minus Column (C)]
                                                                                                                                                                  (Enter on Nebr. Sch. K-1N)

   1                                                            00                   00                                       00   .0684                                       00

     2                                                          00                   00                                       00   .0684                                       00

     3                                                          00                   00                                       00   .0684                                       00

     4                                                          00                   00                                       00   .0684                                       00
     5 TOTALS [enter total of column
       (G) on line 19, Form 1041N]                              00                   00                                       00                                               00
                Nebraska Schedule III — Credit for Tax Paid to Another State for Resident Estate or Trust Only
         A copy of the return filed with another state must be attached. If the other state return is not attached, this credit will not be allowed.
  1  Nebraska tax (line 11, Form 1041N) ..........................................................                                                           1                 00
 2 Taxable income from another state . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   2                 00
 3 Computed tax credit                           Line 2, Schedule   III          x     Line 1, Schedule III
                                                 Line 7, Form 1041N                                                                                          3                 00

 4 Tax due and paid to another state (attachment required) (see instructions) ............................                                                   4                 00

 5 Maximum tax credit (line 1, 3, or 4, whichever is least). Enter amount here and on line 12, Form 1041N .....                                              5                 00
                                             revenue.nebraska.gov, 800-742-7474 (NE and IA), 402-471-5729






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