Form
706-D
United States Additional Estate Tax Return
Under Code Section 2057
(Rev. December 2008)
OMB No. 1545-1680
Cat. No. 26107A
Department of the Treasury
Internal Revenue Service
For Privacy Act and Paperwork Reduction Act Notice, see instructions.
Part I General Information
1a Name of qualified heir
1b Address of qualified heir (number and street, including apt. no. or P.O. box)
1c City, town or post office, state, and ZIP code
2
Qualified heir’s social security number
3
Commencement date (see instructions)
4 Decedent’s name reported on Form 706 5
Decedent’s social security number
6 Date of death
Part II Tax Computation (First complete Schedules A and B. See instructions.)
1 Qualified heir’s share of the total qualified family-owned business interests (from line 4, Schedule T
(Form 706), of the decedent’s estate tax return)
1
2 Total reported value of qualified family-owned business interests (from line 6, Schedule T (Form 706),
of the decedent’s estate tax return)
2
3 Decedent’s estate tax:
a Recomputed without the qualified family-owned business interest
deduction (attach computation)
3a
b Reported on Form 706 (or as finally agreed to)
3b
c Gross additional estate tax (subtract line 3b from line 3a)
3c
4 Qualified heir’s percentage of qualified family-owned business interests. Divide line 1 by line 2. Enter
result as a percentage (carry out your answer to at least the nearest tenth of a percent)
%
4
.
5 Qualified heir’s share of total reduction in estate tax. Multiply line 3c by line 4
5
6 Enter the Total from column (E), Schedule A, page 2
6
7 Divide line 6 by line 1. Enter the result as a percentage (carry out your answer to at least the nearest
tenth of a percent)
%
7
.
8 Multiply line 5 by the percentage on line 7
8
9 Applicable percentage (see instructions)
%
9
10 Total additional estate tax. Multiply line 8 by the percentage on line 9
10
If you completed Schedule B on page 2, complete lines 11 through 15. If you did not complete Schedule B, skip lines 11 through 14
and enter the amount from line 10 on line 15.
11 Enter the total cost or fair market value (FMV) from column (C), Schedule B, page 2
11
12 Enter the total of column (D), Schedule A, page 2
12
13 Divide line 11 by line 12. Enter the result as a percentage (carry out your answer to at least the nearest
tenth of a percent) (do not enter more than 100%)
%
13
14 Multiply line 10 by the percentage on line 13
14
15 Additional estate tax due. Subtract line 14 from line 10 (do not enter less than zero) 15
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief,
it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
Sign
Here
Signature of taxpayer or person filing on behalf of taxpayer Date
Paid
Preparer’s
Use Only
Preparer’s
signature
Date
Check if
self-employed
Preparer’s SSN or PTIN
Firm’s name (or
yours if self-employed),
address, and ZIP code
EIN
Phone no.
( )
Form
706-D (Rev. 12-2008)
Form 706-D (Rev. 12-2008) Page 2
Schedule A. Disposition of Qualified Family-Owned Business Interest, Failure to Materially
Participate, or Disqualifying Act (Taxable Under Section 2057(f)(1))
(A)
Item
number
(B)
Description of property and explanation of disqualifying act
(C)
Date of disposition, failure to
materially participate, or
disqualifying act (see instructions)
(D)
Amount realized or fair
market value (FMV) if
applicable (see instructions)
(E)
Date of death value (see
instructions)
1
Form 706, Schedule , Item
Description —
Total. Enter the total of column (D) on page 1, Part II, Tax Computation, line 12,
and the total of column (E) on page 1, Part II, Tax Computation, line 6
Schedule B. Involuntary Conversions or Exchanges
Check if for: Involuntary Conversion Exchange
(A)
Item
(B)
Description of qualified replacement (or exchange) property
(C)
Cost or fair
market value
(FMV)
1
Total. Enter the total of column (C) on page 1, Part II, Tax Computation, line 11.
Schedule C. Nontaxable Transfers
Transferee
Last name First name Middle initial
Social security number Relationship to the qualified heir
Check if for:
Disposition to Family Member
Qualified Conservation Contribution
Loss of U.S. Citizenship
(A)
Item
(B)
Description of property and explanation of nontaxable transfers
(C)
Date of disposition,
contribution, trust agreement,
or bond
1 Form 706, Schedule , Item
Description —
Form 706-D (Rev. 12-2008)