Form 706-NA Form 706-NA United States Estate (and Generation-Skipping Transfer)

Form

706-NA

United States Estate (and GenerationSkipping Transfer) Tax Return

Department of the Treasury
Internal Revenue Service

To be filed for decedents dying after December 31, 2011.
▶

Information about Form 706-NA and its separate instructions is at www.irs.gov/form706na.

Attach supplemental documents and translations. Show amounts in U.S. dollars.
Decedent, Executor, and Attorney

Part I

1a Decedent’s first (given) name and middle initial
3

b Decedent’s last (family) name

4 Domicile at time of death

Place of death

7a Date of birth

b Place of birth

9a Name of executor

In
United
States

5

Citizenship (nationality)

8

Business or occupation

b Address

Outside
United
States
Part II

2 U.S. taxpayer ID number (if any)
6 Date of death

10a Name of attorney for estate
b Address

11a Name of executor

1
2

OMB No. 1545-0531

Estate of nonresident not a citizen of the United States

(Rev. August 2013)

12a Name of attorney for estate

b Address (City or town, state or province, country, and ZIP or foreign postal code.)

b Address (City or town, state or province, country, and ZIP or
foreign postal code.)

Tax Computation

Taxable estate from Schedule B, line 9 . . . . . . . . . . . . . . . . . . . . .
Total taxable gifts of tangible or intangible property located in the U.S., transferred (directly or indirectly)
by the decedent after December 31, 1976, and not included in the gross estate (see section 2511) . .

1

3
4
5
6
7
8
9
10
11

Total. Add lines 1 and 2 . . . . . . . . . . . . . . . . . . . .
Tentative tax on the amount on line 3 (see instructions) . . . . . . . . . .
Tentative tax on the amount on line 2 (see instructions) . . . . . . . . . .
Gross estate tax. Subtract line 5 from line 4 . . . . . . . . . . . . .
Unified credit. Enter smaller of line 6 amount or maximum allowed (see instructions)
Balance. Subtract line 7 from line 6 . . . . . . . . . . . . . . . .
Other credits (see instructions) . . . . . . . . . . . . . . . .
9
Credit for tax on prior transfers. Attach Schedule Q, Form 706 . . . . .
10
Total. Add lines 9 and 10 . . . . . . . . . . . . . . . . . . . .

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8

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11

12
13

Net estate tax. Subtract line 11 from line 8 . . . . . . . . . .
Total generation-skipping transfer tax. Attach Schedule R, Form 706 .

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16

Total transfer taxes. Add lines 12 and 13 . . . . . . .
Earlier payments. See instructions and attach explanation . .
Balance due. Subtract line 15 from line 14 (see instructions) .

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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. I understand that a complete return requires listing all property constituting the part of the decedent’s gross estate (as defined by the statute)
situated in the United States. Declaration of preparer other than the executor is based on all information of which preparer has any knowledge.

▲ ▲

Paid
Preparer
Use Only

▲ ▲

Sign
Here

Signature of executor
Signature of executor

Print/Type preparer’s name

Firm’s name

Preparer’s signature

Date
Date

Date

PTIN

Firm's EIN ▶

▶

Firm’s address ▶

For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.

Check
if
self-employed
Phone no.

Cat. No. 10145K

Form 706-NA (Rev. 8-2013)

Page 2

Form 706-NA (Rev. 8-2013)

Part III

General Information
Yes No

7

Did the decedent make any transfer (of
property that was located in the United States
at either the time of the transfer or the time of
death) described in sections 2035, 2036,
2037, or 2038 (see the instructions for Form
706, Schedule G)? . . . . . . . . .
If “Yes,” attach Schedule G, Form 706.

2

Did the decedent, at the time of death, own any:
a Real property located in the United States? .
b U.S. corporate stock? . . . . . . . .
c Debt obligations of (1) a U.S. person, or (2) the
United States, a state or any political
subdivision, or the District of Columbia?
.

8

At the date of death, were there any trusts in
existence that were created by the decedent
and that included property located in the
United States either when the trust was
created or when the decedent died? . . .

d Other property located in the United States? .
3
Was the decedent engaged in business in the
United States at the date of death? . . .

9

1a Did the decedent die testate? . . . . .
b Were letters testamentary or of administration
granted for the estate? . . . . . . .
If granted to persons other than those filing the
return, include names and addresses on page 1.

a

If “Yes,” attach Schedule G, Form 706.
At the date of death, did the decedent:
Have a general power of appointment over
any property located in the United States? .

At the date of death, did the decedent have
access, personally or through an agent, to a
safe deposit box located in the United States?

b Or, at any time, exercise or release the power?
If “Yes” to either a or b, attach Schedule H, Form 706.
10a Have federal gift tax returns ever been filed? .

At the date of death, did the decedent own
any property located in the United States as a
joint tenant with right of survivorship; as a
tenant by the entirety; or, with surviving
spouse, as community property? . . . .
If “Yes,” attach Schedule E, Form 706.
6a Had the decedent ever been a citizen or resident
of the United States (see instructions)? . . .
b If “Yes,” did the decedent lose U.S. citizenship or
residency within 10 years of death? (see instructions)

b Periods covered ▶
c IRS offices where filed ▶
11
Does the gross estate in the United States
include any interests in property transferred to
a “skip person” as defined in the instructions
to Schedule R of Form 706? . . . . . .
If “Yes,” attach Schedules R and/or R-1, Form
706.

4

Yes No

5

Schedule A. Gross Estate in the United States (see instructions)

Yes No
Do you elect to value the decedent’s gross estate at a date or dates after the decedent’s death (as authorized by section 2032)? ▶
To make the election, you must check this box ‘‘Yes.’’ If you check ‘‘Yes,’’ complete all columns. If you check ‘‘No,’’ complete
columns (a), (b), and (e); you may leave columns (c) and (d) blank or you may use them to expand your column (b) description.
(a)
Item
no.

(b)
Description of property and securities
For securities, give CUSIP number

(c)
Alternate
valuation date

(d)
Alternate value in
U.S. dollars

(e)
Value at date of
death in U.S. dollars

1

Total

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(If you need more space, attach additional sheets of same size.)
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Schedule B. Taxable Estate
Caution. You must document lines 2 and 4 for the deduction on line 5 to be allowed.
1
2
3
4

Gross estate in the United States (Schedule A total) . . . . . . . . . . . .
Gross estate outside the United States (see instructions) . . . . . . . . . .
Entire gross estate wherever located. Add amounts on lines 1 and 2 . . . . . .
Amount of funeral expenses, administration expenses, decedent’s debts, mortgages
and losses during administration. Attach itemized schedule. (see instructions) . . .

5
6

Deduction for expenses, claims, etc. Divide line 1 by line 3 and multiply the result by line 4 . . .
Charitable deduction (attach Schedule O, Form 706) and marital deduction (attach Schedule M,
Form 706, and computation) . . . . . . . . . . . . . . . . . . . . . . .

7
8
9

State death tax deduction (see instructions) . . . . . . . . . . .
Total deductions. Add lines 5, 6, and 7 . . . . . . . . . . . . .
Taxable estate. Subtract line 8 from line 1. Enter here and on line 1 of Part II .

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liens,
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Form 706-NA (Rev. 8-2013)