Form IL-1041 Fiduciary Income and Replacement Tax Return (Includes Schedule D) (R-12/12)

1 Federal taxable income from U S Form 1041 Line 22 1 1 Write the amount from your Form IL 1041 Line 27 1 10 Other additions Attach Illinois Schedule M (for businesses) 10a 11 Add Column B Lines 1 through 10b This amount is your income or loss 11 12 Write the amount of your income or loss from Line 11 12 13 August 1 1969 valuation limitation amount Attach Schedule F 13a 14 Payments from certain retirement plans See instructions 14a 15 Interest income from U S Treasury and other exempt federal obligations 15a 16 Retirement payments to retired partners 16a 17 Enterprise Zone or River Edge Redevelopment Zone Dividend 18 High Impact Business Dividend subtraction Attach Schedule 1299 B 18a 19 Contributions to certain job training projects See instructions 19a 2 Federal net operating loss deduction from 2 Write the apportionment factor from your Form IL 1041 Schedule NR Step 6 Line 3 2 20 Illinois Special Depreciation subtraction Attach Form IL 4562 20a 2012 Form IL 1041 21 Related party expenses subtraction Attach Schedule 80/20 21a 22 Distributive share of subtractions Attach Schedule(s) K 1 P or K 1 T 22a 23 ESBT loss amount See instructions 23a 24 Other subtractions Attach Illinois Schedule M (for businesses) 24a 25 Total subtractions Add Column B Lines 13b through 24b 25 26 Base income or loss Subtract Line 25 from Line 12 26 27 Base income or net loss from Line 26 or if a nonresident from Schedule NR Line 51 27 28 Discharge of Indebtedness adjustment Attach federal Form 982 See instructions 28 29 Adjusted base income or net loss Add Lines 27 and 28 29 3 Taxable income of ESBT if required See instructions 3 30 Illinois net loss deduction Attach Schedule NLD 31 Standard exemption 32 Add Lines 30 and 31 32 33 Net Income Subtract Line 32 from Line 29 34 Replacement tax Multiply Line 33 by 1 5% ( 015) 34 35 Recapture of investment credits Attach Schedule 4255 35 36 Replacement tax before investment credits Add Lines 34 and 35 36 37 Investment credits Attach Form IL 477 37 38 Net replacement tax Subtract Line 37 from Line 36 If the amount is negative write 0 38 39 Write the amount of your net income from Line 33 39 4 Exemption claimed on U S Form 1041 Line 20 4 40 Income tax Multiply Line 39 by 5% ( 05) 40 41 Recapture of investment credits Attach Schedule 4255 41 42 Income tax before credits Add Lines 40 and 41 42 43 Credit for income tax paid to another state while an Illinois resident 44 Income tax credits Attach Schedule 1299 D 44 45 Total credits Add Lines 43 and 44 45 46 Net income tax Subtract Line 45 from Line 42 If the amount is negative write 0 46 47 Trusts only: net replacement tax from Line 38 47 48 Net income tax from Line 46 48 49 Total net income and replacement taxes Add Lines 47 and 48 49 5 Illinois income and replacement tax deducted in arriving at Line 1 5a 50 Payments 51 Total payments Add Lines 50a through 50d 51 52 Overpayment If Line 51 is greater than Line 49 subtract Line 49 from Line 51 52 53 Amount to be credited to 2013 54 Refund Subtract Line 53 from Line 52 This is the amount to be refunded 54 55 Tax Due If Line 49 is greater than Line 51 subtract Line 51 from Line 49 6 State municipal and other interest income excluded from Line 1 6a 7 Add the amounts shown in Column D for nonresident 7 Illinois Special Depreciation addition Attach Form IL 4562 7a 8 Related party expenses addition Attach Schedule 80/20 8a 9 Distributive share of additions Attach Schedule(s) K 1 P or K 1 T 9a A B C D E F G A Check the box that identifies your fiduciary Trust Estate a Illinois Income Tax withheld Attach forms W 2 and W 2G 50a adjustment on Schedule NLD or Form IL 1041 Line 28 attach a copy to this return Attach Schedule CR 43 Attach to your Form IL 1041 Attach your payment and Form IL 1041 V here b Credit from 2011 overpayment 50b B Write your complete legal business name Beneficiaries Fiduciary beneficiaries for which you have entered a check mark Beneficiary type distributable is an Illinois amount entity payments c Form IL 505 B (extension) payment 50c C Write your mailing address Cash Accrual Other check this box and attach federal Form 982 City: State: ZIP: D Check the box if one of the following apply d Pass through entity payments Attach Schedule(s) K 1 P or K 1 T 50d Due on or before the 15th day of the 4th month following the close of the tax year E Check your method of accounting Electing small business trust (ESBT) F Check this box if you completed federal Form 8886 and Fiduciary Income and Replacement Tax Return Final return (If final write the date ) First return G Write your federal employer identification no (FEIN) H Check the box if you are an: I Check this box if your residency is not in Illinois and you attached Illinois Schedule NR If a payment is enclosed mail this return to: Illinois Department of Revenue P O Box 19053 Springfield IL 62794 9053 If a payment is not enclosed mail this return to: Illinois Department of Revenue P O Box 19009 Springfield IL 62794 9009 If Line 29 is zero or a negative amount write 0 30 If the amount is negative write 0 33 If this return is not for calendar year 2012 write your fiscal tax year here If you are a nonresident of Illinois complete Schedule NR; otherwise go to Step 4 If you have a name change check this box If you have an address change or this is a first return check this box If you owe tax on Line 55 complete a payment voucher Form IL 1041 V make your check payable to Illinois Department of Revenue and attach them to the first page of this form Illinois Department of Revenue Illinois Department of Revenue Year ending in Column E Write the total here (See instructions ) 7 Individual bankruptcy estate J Check this box if you attached Illinois Schedule 1299 D K Check this box if you attached Illinois Schedule I L Check this box if you attached Form IL 4562 M Check this box if you attached Illinois Schedule M (for businesses) Mailing address: mm dd yyyy month day month day year Month Year N Check this box if you attached Schedule 80/20 Name and Address SSN or FEIN (See instructions ) (See instr ) nonresident (See instr ) (See instr ) Name: Nonresidents only: Write the amount from Schedule NR Line 54 31 NS DR O If you are making a Discharge of Indebtedness Report Column A Lines 13a through 24a on Schedule K 1 T Step 5 Report Column A Lines 5a through 10a on Schedule K 1 T Step 5 Residents only: Write $1 000 Schedule D (R 12/12) Schedule D Beneficiary Information subtraction Attach Schedule 1299 B 17a Tax year beginning 2012 ending 20 This is the amount you owe 55 Total amount of Check the box if Pass through Excluded from base income (loss) the beneficiary entity payment pass through U S Form 1041 Line 15a This amount cannot be negative 2 Write the amount of your payment on the top of Page 1 in the space provided Address Check this box if we may discuss this return with the IL 1041 (R 12/12) IL Attachment no 1 information is REQUIRED Failure to provide information could result in a penalty Page 1 of 4 Page 2 of 4 Phone Preparer s firm name (or yours if self employed) Preparer s Social Security number or firm s FEIN preparer shown in this step Signature of fiduciary Signature of preparer Step 1: Identify your fiduciary Step 1: Provide the following information Step 2: Figure your income or loss A B Step 2: Identify your beneficiaries Attach additional sheets if necessary Step 3: Figure your base income or loss A B Step 4: Figure your net income Step 5: Figure your net replacement tax For trusts only estates go to Step 6 Step 6: Figure your net income tax Step 7: Figure your refund or balance due Step 8: Sign here This form is authorized as outlined by the Illinois Income Tax Act Disclosure of this Title Under penalties of perjury I state that I have examined this return and to the best of my knowledge it is true correct and complete Write the amount you are paying Write your name as shown on your Form IL 1041 Write your federal employer identification number (FEIN)