Master Information List (Mil)

There are all sorts of forms executors, beneficiaries, and probate court clerks have to fill out and correspond with during probate and estate settlement, including affidavits, letters, petitions, summons, orders, and notices.

Master Information List (Mil) is a commonly used form within Hawaii. Here’s an overview of what the form is and means, including a breakdown of the situations when (or why) you may need to use it:

Atticus Fast Facts About Master Information List (Mil)

Sometimes it’s tough to find a quick summary— here’s the important details you should know about Master Information List (Mil):

• This form pertains to the State of Hawaii

Government forms are not typically updated often, though when they are, it often happens rather quietly. While Atticus works hard to keep this information about Hawaii’s Form Master Information List (Mil) up to date, certain details can change from time-to-time with little or no communication.

Step 1 - Download the correct Hawaii form based on the name and ID if applicable

Double check that you have both the correct form name and the correct form ID. Some Hawaii probate forms can look remarkably similar, so it’s best to double, even triple-check that you’re using the right one! Keep in mind that not all States have a standardized Form ID system for their probate forms.

Step 2 - Complete the Document

Fill out all relevant fields in Form Master Information List (Mil), take a break, and then review. Probate and estate settlement processes in HI are long enough to begin with, and making a silly error can push your timeline even farther back. No thank you!

Note: If you don’t currently know all of the answers and are accessing Form Master Information List (Mil) online, be sure to avoid closing the browser tab and potentially losing all your progress (or use a platform like Atticus to help avoid making mistakes).

Step 3 - Have Form witnessed or notarized (if required)

Some States and situations require particular forms to be notarized. If you have been instructed to get the document notarized or see it in writing on the document, then make sure to hire a local notary. There are max notary fees in the United States that are defined and set by local law. Take a look at our full guide to notary fees to make sure you aren’t overpaying or getting ripped off.

Step 4 - Submit Master Information List (Mil) to the relevant office

This is most often the local probate court where the decedent (person who passed away) is domiciled (permanently resides) or the institution involved with this particular form (e.g. a bank). Some offices allow you to submit forms online, other’s don’t, and we while we generally recommend going in-person to expedite the process, sometimes that simply isn’t an option.

It’s also a generally good idea to establish a positive working relationship with any probate clerk (unfortunately there’s enough people & process out there making things more difficult and unnecessarily confusing for them), so a best practice is to simply ask the probate clerk proactively exactly how and where they’d prefer you to submit all forms.

Need help getting in touch with a local probate court or identifying a domicile probate jurisdiction?

👉 Find and Contact your Local Probate Court

👉 What is a Domicile Jurisdiction?

Sponsored by Atticus App

Need help with Hawaii Probate?

Join all the other families who have trusted Atticus through probate, and experience the peace that comes from knowing you're taking the right steps, spending the least amount of money, and not wasting a single second.

Start for free

Different probate forms or processes can require different deadlines or response times for completing the appropriate form.

While some steps in the process are bound to specific deadlines (like petitioning for probate, having to submit an inventory of assets, or filing applicable notices to creditors and beneficiaries), many probate forms or processes are not tied to a specific deadline since the scope of work can vary based on situational factors or requirements involved.

Either way, there are a bunch of practical reasons why personal representatives should work to complete each step as thoroughly and quickly as possible when completing probate in Hawaii.

5 reasons you should submit this form as quickly as possible:

1. The sooner you begin, the faster Hawaii can allow heirs and beneficiaries to get their share of assets subject to probate. Acting promptly can also decrease the costs & overall mental fatigue through an otherwise burdensome process.
   
   Helpful Context: What’s the Difference Between Probate and Non-Probate Assets?

2. In general, creditors of an estate usually have around 3-6 months from the time you file notice to creditors to file any claims for debt against the deceased’s assets. If they don’t, then that debt is forfeited (and more importantly, the executor won’t be held personally responsible). So doing this sooner means you have a better idea of who is owed what and ensures you won’t get a surprise collector months later.

3. Not filing a will within 30 days (on average) could mean that the probate process proceeds according to intestate laws (laws that govern what happens to someone's stuff without a will) or is subject to unnecessary supervision by the probate court. And if you aren't directly related to the deceased (a.k.a. next of kin), this could also mean you lose your inheritance.

4. It’s important to file any necessary state tax returns on behalf of the deceased or estate by the following tax season in Hawaii. If you don’t, you could owe penalties and interest. This also includes any necessary federal tax returns such as Forms 1040, 1041, or even a Form 706 estate tax return.

5. If a house in the State of Hawaii is left empty (or abandoned) for a while, insurance can get dicey. For example, if the house burns down and no one has been there for a year, an insurance company may get out of paying your claim.

If you’re not using Atticus to get specific forms, deadlines, and timelines for Hawaii probate, then try and stay as organized as possible, pay close attention to the dates mentioned in any correspondence you have with the State’s government officials, call the local Hawaii probate clerk or court for exact answers regarding Form Master Information List (Mil), and when in doubt— consult a qualified trust & estates lawyer for that area.

Master Information List (Mil) is one of the many probate court forms available for download through Atticus.

It may also be available through some Hawaii probate court sites, such as . In order to access the latest version, be updated with any revisions, and get full instructions on how to complete each form, check out the Atticus Probate & Estate Settlement software or consider hiring a qualified legal expert locally within Hawaii.

While Atticus automatically provides the latest forms, be sure to choose the correct version of Form Master Information List (Mil) f using any other site or resource in order to avoid having to re-complete the form process and/or make another trip to the Hawaii probate court office.

Master Information List (Mil) is a .pdf, so opening it should be as simple as clicking “View Form” from within the Atticus app or by clicking the appropriate link found on any Hawaii-provided government platform. Once you’ve opened the form, you should be able to directly edit the form before saving or printing.

Here’s the text, verbatim, that is found on Hawaii Form Master Information List (Mil). You can use this to get an idea of the context of the form and what type of information is needed.

MASTER INFORMATION LIST (MIL) - CONTENTS Check box when Section is completed. Cross through those which do not apply. \\u0000 Decedent (D) ................................. 1.0 \\u0000 D's Will and Named Personal Representative ............................... 2.0 \\u0000 D's Family, Heirs and Devisees ....................................... 3.0 \\u0000 Court Proceedings ........................ 4.0 \\u0000 Safe Deposit Box ........................... 5.0 \\u0000 Business and Professional Advisors ....................................... 6.0 \\u0000 Real Estate ................................... 7.0 \\u0000 U.S. Government Series E Bonds ........................................... 8.0 \\u0000 Marketable Securities including Mutual Funds ................. 9.0 \\u0000 Closely-Held Corporations .......... 10.0 \\u0000 Cash and Bank Deposits .............. 11.0 \\u0000 Notes and Mortgages .................... 12.0 \\u0000 Insurance on D's Life.................... 13.0 \\u0000 Insurance on Life of Others ......... 14.0 \\u0000 Other Insurance ............................ l5.0 \\u0000 Unincorporated Business Interests ....................................... 16.0 \\u0000 Vehicles ...................................... 17.0 \\u0000 Personal, Household and Miscellaneous............................... 18.0 \\u0000 Employee, Government, and Miscellaneous Benefits and Annuities ..................................... 19.0 \\u0000 Taxable but Unusual Items .......... 20.0 \\u0000 Debts and Claims ......................... 21.0 \\u0000 Funeral and Expenses of Last Illness .......................................... 22.0 \\u0000 Expenses of Administration ......... 23.0 \\u0000 Previously Taxed Property ........... 24.0 \\u0000 Taxes for D and D's Estate ............ 25.0 1.0 DECEDENT (D) 1.01 D's name as shown on Will 1.02 D's full name (if different) 1.03 Other names which D used or held title to property 1.04 Date of D's death 1.05 Place of death: Address City County State Zip 1.06 D's age at death 1.07 Date of D's birth 1.08 Place of Birth: City County State Zip 1.09 D's residence at death: Street City County State Zip 1.10 D's domicile at death (if different from residence): Street City County State Zip 1.11 Date on which above domicile was established 1.12 Date on which current Hawaii residence was established NOTE: 1.13 and 1.16 - Reserved. 1.14 Length of D's last illness 1.15 D's Physicians: (A) (B) (C) Name Address City, State, Zip Dates/Service (A) (B) (C) Name of hospital Address City, State, Zip Date/Service 1.17 D's Social Security Number 1.18 D's Employer's Identification Number (if any) 1.19 Branch of D's Military Service (check one) __ None __ Army __ Navy __ Air Force __ Coast Guard __ Marine Corps 1.20 Dates of D's service or N/A 1.21 D's armed service ID number 1.22 D's veteran's administration number 1.23 Description of D's Social Security or V.A. benefits immediately prior to DOD (See also MIL 19.01-19.18) 1.24 D's citizenship, if not U.S. 1.25 D's occupation or business 1.26 D's employment status (check one) __ Self-employed __ Employee __ Retired __ Unemployed 1.27 If self-employed, D's business name, business address and type of business 1.28 If retired, D's former occupation 1.29 If employed, name and address of D's employer and nature of D's occupation 1.30 Name, address and phone number of Personnel Officer to contact concerning D 's employment, pay, W-2 Forms and benefits 1.31 Will D's spouse, reciprocal beneficiary, estate or any person receive a bonus or award as a result of D's employment or death? __ Yes __ No If so, describe: 1.32 Are there any lawsuits against D now pending? __ Yes __ No 1.33 If yes, give details: 1.34 Are there any executory contracts of D which must be carried out? __ Yes __ No 1.35 If yes, describe: A.Contract for sale of real estate B.C ontract for purchase of real estate C.C ontract for purchase of stock not paid for D.C ontract for sale of stock where the certificates have not yet been delivered E.Other 1.36 Does any other person claim an interest in any property apparently includible in D 's estate other than as beneficiary or successor? __ Yes __ No 1.37 If yes, give details 1.38 Did D ever live or own property in a community property state (Louisiana, Texas, New Mexico, Arizona. California. Nevada, Idaho and Washington)? __ Yes __ No A.If yes, indicate which state or states B. As this MIL is prepared, the client should be asked whether each item of property asked for in this MIL is located in or was acquired in such community property state or was acquired with the proceeds of such property. As a reminder Yes'' should now be circled on each of the following: 7.01, 9.01, 10.01, 11.01, 12.01, 13.01, 14.01, 15.01, 16.01, 17.01, and 18.01. C. Secure a list of D's spouse's or, if applicable, reciprocal beneficiary's property and determine which is community property and so indicate after each item. 2.0 DECEDENT'S WILL AND NAMED PERSONAL REPRESENTATIVE 2.01 Did D leave a Will? __ Yes __ No 2.02 Date of D's Will 2.02A Has will been previously probated? __ Yes __ No If yes, provide: Date of order of probate Name of court State 2.03 Is Will holographic? __ Yes __ No If yes, give name and address of one or more persons who can testify as to D's handwriting and signature: (A) (B) 2.04 Name 2.05 Address City, State, Zip 2.06 Phone No. 2.07 Is there a memorandum disposing of tangible personal property? If so, note that some Courts require formal probate if the memorandum is submitted with the Will for probate. Consider submitting the Will without the memorandum to avoid this. 2.08 Is Will self proven? __ Yes __ No 2.09 Witnesses to the Will. If Will is not self proven, or if court otherwise requires proof, give the name and address of all attesting witnesses. (A) (B) (C) 2.10 Name 2.11 Address City, State, Zip 2.12 Phone No. 2.13 Did D leave a Codicil? __ Yes __ No If answer to 2.13 is no, skip 2.14 through 2.21, inclusive. 2.14 Date of D's Codicil 2.15 Is Codicil holographic? __ Yes __ No 2.16 Is Codicil self-proven? __ Yes __ No 2.17 Witnesses to Codicil. If Codicil is not self proven, or if court otherwise requires proof, give name and address of all attesting witnesses. (A) (B) (C) 2.18 Name 2.19 Address City, State, Zip 2.20 Phone No. 2.21 If D left more than one Codicil attach separate page and repeat 2.13 through 2.20, inclusive, for each additional codicil. 2.22 Does Will direct supervised administration (H AW. REV. STAT. § 560:3-502(1) (2007)), or unsupervised administration (H AW. REV. STAT. § 560:3-502(2) (2007)? __ Supervised __ Unsupervised 2.23 Name of attorney for petitioner or applicant 2.23A Attorney registration number 2.24 Address 2.24A Phone No. 2.25 Name of petitioner or applicant for probate 2.26 Address 2.27 Phone No. 2.28 Relationship to D 2.29 Name of named personal representative(s) 2.30 Address 2.31 Phone No. 2.32 Relationship to D 2.33 Qualified __ Yes __ No 2.34 Disqualified __ Yes __ No 2.35 Bond required __ Yes __ No If bank is named as personal representative, give the name and title of the responsible officer who will handle the bank's activities, sign the application or petition and the acceptance. 2.36 Name 2.37 Title If D's Will provides for alternate P.R., for trustees or for guardians or conservators, complete the following: Alternate P.R. Primary Trustee Primary Guardian or Conservator 2.38 Name 2.39 Address City, State, Zip _ ________________ 2.40 Phone No. 2.41 Relationship to D 2.42 If D died without a Will, name of applicant or petitioner for adjudication of intestacy. 2.43 Address City, State Zip 2.44 Phone No. 2.45 Relationship to D 2.46 Name of proposed personal representative 2.47 Address 2.48 Phone No. 2.49 Relationship to D 2.50 List anyone with a prior or equal right to administration. 2.51 Name 2.52 Relationship to D 2.53 Indicate which of the above will disclaim or join in the petition or application. 3.0 DECEDENT'S FAMILY AND DEVISEES 3.01 D's marital status at death (Check one) __ Never Married __ Married __ Divorced __ Legally Separated __ Widow __ Widower __ RB If D was married at death or in a reciprocal beneficiary relationship, complete the following information for D s surviving spouse or reciprocal beneficiary: 3.02 Name 3.03 Address City, State, Zip 3.04 Telephone No. 3.05 Social Security No. 3.06 Date of Birth 3.07 Date of this marriage 3.08 Place of this marriage (relevant to community property) 3.09 Domicile at time of marriage 3.09A Pre- or Post-Nuptial agreement? 3.10 Was spouse pregnant on date of D's death? __ Yes __ No If D was ever divorced complete the-following for each divorce: (A) (B) 3.11 Name of Spouse or Reciprocal beneficiary 3.12 Date of marriage to or Establishment of RB Relationship with D 3.13 Date of divorce 3.14 Place of divorce 3.15 What alimony, support or other obligations were imposed on D in connection with the divorce? 3.16 What alimony, support or other obligations were imposed on D's spouse in connection with the divorce? If any of D's spouses or reciprocal beneficiaries died during marriage or reciprocal beneficiary relationship to D complete the following for each such marriage or reciprocal beneficiary relationship: (A) (B) 3.17 Name of Spouse or RB 3.18 Date of marriage to D or creation of RB 3.19 Date of death 3.20 Probate Case No. Name of court additional information List D's HEIRS (In case of adopted children indicate identity of other parent by reference to 3.02, 3.11 or 3.17 as applicable. For minors and other disabled persons See 3.54-3.60). (A) (B) (C) 3.21 Name 3.22 Address City, State, Zip 3.23 Phone No. 3.24 Relationship 3.25 Natural/Adopted 3.26 If claiming through predeceased ancestor, name and relationship of said ancestor If person takes share of estate, provide in addition: 3.27 Age 3.28 S ocial Security No. (D)(E)(F) 3. 29 Name 3.30 A ddress City, State, Zip 3.31 P hone No. 3.32 Relationship 3.33 N atural/Adopted 3.34 I f claiming through predeceased ancestor, name and relationship of said ancestor If pe rson takes share of estate, provide in addition: 3.35 Age 3.36 Social Security No. 3.37 W ere any of the children born or adopted after the date of the Will (See 2.02)? __ Yes __ No 3.38 If yes, write their names here List DEVISEES UNDER WILL other than spouse or reciprocal beneficiary and other heirs. (A) (B) (C) 3.39 Name 3.40 Address City, State, Zip 3.41 P hone No. 3.42 A ge 3.43 Relationship to D 3.44 Social Security No. (A) (B) (C) 3.45 Nature of Benefit List NONPROBATE BENEFICIARIES and successors (other than listed above) e.g. joint tenants and life insurance beneficiaries: (A) (B) (C) 3.46 Name 3.47 Address City, State, Zip 3.48 Phone No. 3.49 Age 3.50 Relationship to D 3.51 Social Security No. 3.52 Nature of Benefit 3.53 Value of Benefit 3.54 Are any of the heirs, devisees and beneficiaries listed above a minor or otherwise under disability? If so, indicate by each person's name M for minor and I for incompetent. For minors list dates of birth below. ______________________________________________________________________________ 3.55 List person to protect interests of disabled person below. Designate NG for parent as natural guardian, C for conservator, G for guardian other than natural guardian, and GAL for court appointed guardian ad litem. (A) (B) (C) 3.56 Disabled person 3.57 Representative 3.58 Title or relationship 3.59 Address 3.60 Phone No. 3.61 Did any heir or devisee die within 120 hours of decedent? If so, give details. 4.0 COURT PROCEEDING 4.01 D's name (and aliases if any) to be used in court papers. 4.02 Name of court in which filed 4.03 Court docket number 4.04 Address of court 4.05 Date of petition or application for opening estate 4.06 Is opening to be (Circle one) formal informal. If special administration is required, complete 4.07-4.15 below. 4.07 Date of application or petition 4.08 Name of petitioner or applicant 4.09 Address 4.10 Phone number 4.11 Relationship 4.12 Names of proposed special administrator 4.13 Address 4.14 Phone number 4.15 Relationship (Check One) __ named personal representative __ other proper person 4.16 Name of probate clerk or registrar 4.17 Mailing address 4.18 Phone number 4.19 Does clerk prepare (A) Letters? __ Yes __ No (B) Order opening estate? __ Yes __ No 4.20 Has demand for notice been made? __ Yes __ No If so, describe nature of demand and enter name and address on cover sheet of this MIL. __________________________________________________________________________ 4.21 If any interested parties waive notice provide the following: (A) (B) (C) 4.22 Name ___________________ ____________________ _____________________ 4.23 Address ___________________ ____________________ _____________________ 4.24 Interest ___________________ ____________________ _____________________ 4.25 Extent of waiver _________________ __________________ ___________________ 4.26 - 4.29 Reserved 4.30 Is a guardian ad litem to be appointed for unknown or incapacitated heirs or beneficiaries'? __ Yes __ No If yes, complete the following: 4.31 Name of guardian ad litem 4.32 Address City, State, Zip 4.33 Phone number 4.34 Is notice of hearing by publication required? __ Yes __ No If yes, complete the following: 4.35 Name of newspaper 4.36 Address 4.37 Phone number 4.38 Dates of publication 4.39 Date of application or petition 4.39A Date application or petition filed with court 4.40 Date of scheduled hearing (include day of week) 4.41 Date of actual hearing 4.42 Date acceptance (of office) filed 4.43 Is bond required for personal representative? __ Yes __ No If yes, complete the following: 4.44 Value of estate personal property 4.45 Estimated amount of next year's income from real and personal property 4.46 Amount of bond (4.44 plus 4.45) 4.47 Name of surety 4.48 Address 4.49 Phone number 4.50 Person to contact if corporation is surety 4.51 Date bond executed 4.52 Date bond approved by court 4.53 Date of entry of order admitting will or adjudication of intestacy 4.54 Name of personal representative 4.55 Address 4.56 Phone number 4.56B Social Security number 4.57 Date of qualification of P.R. and issuance of letters 4.58 Kind of Letters (check one) __ Testamentary __ Of Administration __ Of Special Administration 4.59 Any limitations on powers of personal representative to act: 4.60 Will appraisers be needed? __ Yes __ No If yes, complete the following: (A) (B) 4.61 Name 4.62 Address 4.63 Phone number 4.64 Name of newspaper for notice to creditors 4.65 Address 4.66 Phone number 4.67 Dates of publication 4.68 Deadline for presentation of claims 4.69 Date proof of publication filed with court 4.69A Note, regarding notice to creditors, that newspaper notice is required as to unknown creditors. As to known or reasonably ascertainable creditors, the personal representative has the option of providing actual notice. Where actual notice is given, the deadline for presentation should be provided. (See note following DLL, Item 13). Where notice is not given there is an outside statutory bar of 18 months after date of death. 4.70 Is administration to be supervised? __ Yes __ No If yes, complete the following: 4.71 Date inventory due to be filed 4.72 Date inventory actually filed 4.73 Is administration to be unsupervised? __ Yes __ No If yes, complete the following: 4.74 Date inventory due to be filed or delivered to interested parties, if any, who request it. 4.75 Date inventory actually filed or delivered to interested parties, if any, who request it. 4.76 Due dates for filing periodic accounting 4.77 Date of Petition of Final Settlement and Distribution filed with court 4.78 Date of scheduled hearing for formal closing of estate (include day of week and time) 4.79 Date of estate Closing Order 4.80 Date of filing of Final Receipts 4.81 Date of Decree and Final Discharge 5.0 SAFE DEPOSIT BOX 5.01 If D maintained one or more safe deposit boxes, either alone or with another person or had access to another safe deposit box as a deputy or joint holder give the following information with respect to each safe deposit box: (A) (B) 5.02 Name of Institution 5.03 Address City, State, Zip 5.04 Box No. 5.05 Title in name of If in other than D alone, complete 5.06 - 5.09 as to joint owner, corporation, partnership, etc. 5.06 Name of other or joint owner 5.07 Address City, State, Zip 5.08 Telephone No. 5.09 Relationship to D 5.10 Date of Inventory Attach copy of Inventory to this sheet. 6.0 BUSINESS AND PROFESSIONAL ADVISERS APPRAISERS 6.01 Name 6.02 Person responsible 6.03 Address 6.04 Telephone No. CASUALTY INSURANCE AGENT 6.05 Name 6.06 Person responsible 6.07 Address 6.08 Telephone No. STOCK BROKER OR INVESTMENT ADVISOR (See 9.14) 6.09 Name 6.10 Person responsible 6.11 Address 6.12 Telephone No. ATTORNEYS OTHER THAN FOR ESTATE ADMINISTRATION 6.13 Name 6.14 Person responsible 6.15 Address 6.16 Telephone No. 6.17 Nature of Representation ACCOUNTANT Estate Other 6.18 Name 6.19 Person responsible 6.20 Address City, State, Zip 6.21 Telephone No. 6.22 Nature of representation SEE § 13.02 FOR LIFE INSURANCE AGENTS 7.0 REAL ESTATE 7.01 Is the community property to be considered (Refer to 1.38) __ Yes __ No 7.02 If D owned any interest in real estate furnish the following information for each tract of real estate. Attach separate sheet for length legal descriptions and for additional properties. (Use the following abbreviations for type of property: FR-Family Residence; RR-Rental Residence; C-Commercial; F-Farm or Ranch; U-Unimproved; M-Non- producing mineral or royalty interest; PM-Producing mineral or royalty interest.) 7.03 Type of property (Circle) (A) FR RR C F U M PM (A) FR RR C F U M PM 7.04 Legal Description (include approximate acreage if undeveloped or rural) 7.05 Street address 7.06 City, County, State 7.07 Title in name of: 7.08 Fair market value at death 7.08A Does the property qualify for special Federal Estate Tax valuation based on current use rather than highest and best use? See worksheets WS-4 regarding § 2032A qualification and perfection. 7.09 Alternate value 7.10 Name of lienholder 7.11 Address 7.12 City, State, Zip 7.13 Loan No. 7.14 Principal balance due on date of D's death $ $ 7.15 Interest rate % % 7.16 Accrued interest at date of death $ $ 7.17 Taxes accrued for prior year, not paid $ $ 7.18 Taxes accrued for current year, not paid $ $ 7.19 Is property insured for fire and extended coverage? __ YES __ NO 7.20 What is the amount of coverage? $ $ 7.21 Is property leased? 7.22 Lessee's Name 7.23 Lessee's Address 7.24 City, State, Zip 7.25 Telephone No. 7.26 Nature of Lease 7.27 Name of royalty pay or for producing mineral property 7.28 Address 7.29 City, State, Zip 7.30 Division Order No. 7.31 Evidence of Title: Furnish the following information as to each tract: WD-Warranty Deed; QCD-Quit Claim Deed; A- Abstract of Title; TI- Owner's Title Insurance Policy; Land Court TCT 7.32 Date of recording deed and book and page number 7.33 Date of last certificate of abstract or title insurance policy 7.34 If any of the above was co- owned provide the following: 7.35 Nature of co-ownership (joint tenancy or tenancy in common) 7.35A Name, address and relationship to D of joint tenant 7.36 If joint, date of creation of joint tenancy 7.37 Did the surviving joint tenant contribute to the purchase of the property? __ YES __ NO __ YES __ NO __ YES __ NO __ YES __ NO __ YES __ NO 7.38 In what proportion? 7.39 Evidence of Contribution 7.40 Is it possible that anyone else has placed their real estate in joint tenancy with D? If yes, obtain the above information __ YES __ NO __ YES __ NO 7.41 Does client have any preference as to who is used to appraise real estate? If yes, list the name of the appraiser or appraisers at MIL 6.01. _ _ YES __ NO __ YES __ NO *NOTE: If surviving joint tenant is the spouse, for federal estate tax purposes the contribution will be treated as 50/50 and half of the value will be included in D's federal taxable estate, I.R.C. § 2040. In such case, the amount and evidence of contribution is not needed. This rule does not apply, however, to non-United States resident spouses under I.R.C. § 2056(d)(1)(B). Note further, however, the holding in Gallenstein v. United States, 91-2 USTC ¶ 60,088 (E.D. Ky. 1991), aff'd, 975 F.2d 286 (6th Cir. 1992), that spouses with joint interests created prior to 1977 are subject to the consideration-furnished test - the same standard that applies to unmarried joint owners. This approach may enable a surviving joint owner to obtain a stepped-up basis in 100% of the property. 8.0 U.S. GOVERNMENT SERIES 8.01 List Series E Bonds below which D owned or had an interest in. List chronologically by issue date with separate listings for each denomination and co-owner. Then in 8.02-8.04 summarize information on solely owned bonds and 8.05-8.16 summarize information by co-owner. # of Bonds Issue date, Denomination and Serial # Cost Per Bond Total Redemption Value Total Accrued Interest Name of Co-owner 8.02 Total redemption value of solely owned bonds 8.03 Total initial cost of solely owned bonds 8.04 Total accrued interest of solely owned bonds (8.02 less 8.03) For each co-owner provide the following: (A) (B) (C) 8.05 Name 8.06 Address 8.07 Relationship 8.08 Social Security No. 8.09 Total cost 8.10 Total redemption value 8.11 Total accrued interest 8.12 Date of creation of co-tenancy 8.13 Did survivor contribute to purchase (See Note following MIL 7.37) 8.14 In what proportion 8.15 Evidence of contribution 8.16 Is it possible that anyone else has placed their Series E Bonds in co-ownership with D? If yes, obtain the above information. 9.0 SECURITIES 9.01 Is community property to be considered? (Refer to 1.38) __Yes __No 9.02 If D had a brokerage account individually or with another: 9.03 Account in name of (A) (B) 9.04 Name of broker 9.05 Name of firm 9.06 Address City, State, Zip 9.07 Telephone 9.08 Account No 9.09 Type of account 9.10 Did broker hold D's funds or securities? __ YES __ NO __ YES __ NO 9.11 Did D owe broker funds or securities? __ YES __ NO __ YES __ NO 9.12 Did D have open or unexecuted orders? __ YES __ NO __ YES __ NO 9.13 Does client have any preference as to which stockbroker is used for sale of securities? __ YES __ NO __ YES __ NO 9.14 If yes, note on 6.09-6.12 9.15 Reserved 9.16 Reserved If a security listed below was held in a stock broker's account, note by placing the letter B following the name of the Company (line 9.17, 9.48 and 9.77). If a security is held in a dividend reinvestment account or other custodian account, provide name and address of custodian together with account number. Differentiate between number of shares registered in name of custodian and in name of deceased. If the same security is owned solely in part and jointly in part or jointly with different owners, list each separate form of ownership in a separate column. 9.17 Name of Company STOCKS (A) __ Common __ Preferred (B) __ Common __ Preferred 9.18 Type 9.19 Par value, series etc. 9.20 Total shares 9.21 Certificate numbers 9.22 Exchange where traded 9.23 If not listed: A. Address of business office B. State of incorporation C. Date of incorporation 9.24 Shares issued in name of 9.25 Name of transfer agent 9.26 Address City, State, Zip Per share value at death: 9.27 High 9.28 Low 9.29 Mean 9.30 Total value (9.20 x 9.29) Adjustments: 9.31 Ex-Dividend amount per share 9.32 Total amount 9.33 Declared but unpaid amount Per share 9.34 Total amount Alternate value of/date: 9.35 High 9.36 Low 9.37 Mean 9.38 Total value (9.20 x 9.37) 9.39 If any of the above were owned in joint tenancy provide the following: 9.40 Name of joint tenant 9.41 Address City, State, Zip 9.42 Relationship to D 9.43 Date of creation of joint tenancy 9.44 Did the surviving joint tenant contribute to the purchase of the property? (May not be applicable if J.T. is spouse.) (See note following MIL 7.37) __ YES __ NO __ YES __ NO 9.45 In what proportion? __________________________ ________________________ 9.46 Evidence of contribution __________________________ ________________________ 9.47 Is it possible that anyone else has placed their stocks in joint tenancy with D? __Yes __ No; If yes, obtain the above information. BONDS 9.48 Name of company (A) (B) 9.49 Kind of bond 9.50 Interest Rate % % 9.51 Total face amount $ $ 9.52 Maturity date 9.53 Bond numbers 9.54 Negotiability (Circle) Bearer Registered Bearer Registered 9.55 Registered owner 9.56 Name of transfer agent 9.57 Address City, State, Zip Per bond value at death: 9.58 High 9.59 Low 9.60 Mean 9.61 Total Value 9.62 Total accrued interest at date of death Alternate value of/date: 9.63 High 9.64 Low 9.65 Mean 9.66 Total Value 9.67 Total accrued interest at date of death 9.68 If any of the above were owned in joint tenancy (or are co-owned U.S. Government obligations) provide the following: 9.69 Name of joint tentant 9.70 Address City, State, Zip 9.71 Relationship to D 9.72 Date of creation of joint tenancy 9.73 Did the surviving joint tenant contribute to the purchase of the property? (May not be applicable if J. T. is spouse) __ YES __NO __YES __NO 9.74 In what proportion? 9.75 Evidence of contribution 9.76 Is it possible that anyone else has placed their bonds in joint tenancy with D? __ Yes __No If yes, obtain the above information. 9.77 Name of fund MUTUAL FUNDS (A) (B) 9.78 Total shares owned 9.79 Number of issued shares 9.80 Number of unissued shares held by Custodian or company 9.81 Custodian account in name of: 9.82 Name of Custodian 9.83 Address of Custodian City, State, Zip 9.84 Account No. 9.85 Issued shares Registered in Name of: 9.86 Certificate numbers of issued shares 9.87 Name of transfer agent 9.88 Address City, State, Zip 9.89 Bid price at death 9.90 Total value (9.78 x 9.89) Dividends and Capital Gains Distributions: 9.92 Declared but unpaid amount per share 9.93 Total value Alternate value of/date: 9.94 Bid price 9.95 Total value (9.78 x 9.94) 9.96 If any of the above were owned in joint tenancy provide the following: 9.97 Name of joint tenant 9.98 Address City, State, Zip 9.99 Relationship to D 9.100 Date of creation of joint tenancy 9.101 Did surviving joint tenant contribute to the purchase of the property? (May not be application if J.T. is spouse.) (See Note following MIL 7.37) __YES __NO __YES __NO 9.102 If yes, what proportion? 9.103 Evidence of contribution 9.104 Is it possible that anyone else has placed their mutual funds in joint tenancy with D? __ Yes __No If yes, obtain the above information. 10.0 CLOSELY HELD CORPORATIONS 10.01 Is community property to be considered? (Refer to 1.38) __ Yes __ No 10.02 Stock in name of (A) (B) 10.03 Name of company 10.04 Address City, State, Zip 10.04A Is corporation Sub S? (If so, see Special Instruction 35A) 10.05 Person to contact 10.06 Nature of business 10.07 D’s position 10.08 Total voting preferred shares outstanding 10.09 Total non-voting preferred shares outstanding 10.10 Total voting common shares outstanding 10.11 Total non-voting preferred shares outstanding 10.12 Number of D’s voting preferred shares 10.13 Number of D’s non-voting preferred shares 10.14 Number of D’s voting common shares 10.15 Number of D’s non-voting common shares 10.16 Is any of D’s stock subject to “Buy-sell” agreement? __ Yes __ No __ Yes __ No 10.17 Parties to agreement and relationship to D 10.18 Is D’s death an event forcing an offer to sell? __ Yes __ No __ Yes __ No 10.19 Value of stock per agreement 10.20 Is agreed price binding on D’s estate? __ Yes __ No __ Yes __ No 10.21 If no binding price has been set by agreement, give value per share of D’s stock 10.22 Total value of D’s stock 10.23 Does family or estate wish to retain ownership if possible? 10.24 If retained, who will run the business? 10.25 Does stock qualify for §303 redemption? __ Yes __ No __ Yes __ No 10.26 Does real estate in the corporation qualify for special Federal estate tax valuation? __ Yes __ No __ Yes __ No 10.27 Does stock qualify for federal estate tax installment payment? __ Yes __ No __ Yes __ No 10.28 Name of joint tenant, if applicable 10.29 Address City, State, Zip 10.30 Relationship to D 10.31 Date of creation of joint tenancy 10.32 Did the surviving joint tenant contribute to the purchase of the property? (Circle) (May not be applicable if J.T. is spouse) (See Note following MIL 7.37) __ Yes __ No __ Yes __ No 10.33 In what proportion? 10.34 Evidence of contribution __ Yes __ No __ Yes __ No 11.0 CASH AND BANK ACCOUNTS 11.01 Is community property to be considered? (Refer to 1.38) __ Yes __ No Complete the following for each bank, savings and loan and credit union account: (Use the following abbreviations for type: C-Checking Account; S-Savings Account; CD-Certificate of Deposit, Savings Certificate or other time deposit.) (A) (B) (C) 11.02 Name of bank or other institution 11.03 Address City, State, Zip 11.04 Type (Circle) C S CD C S CD C S CD 11.05 Account No. 11.06 Title in name of 11.07 Balance or face amount 11.08 Date of issue, if CD 11.09 Date from which interest accrues 11.10 Interest rate % % % 11.11 Accrued interest available to D on date of death 11.12 Maturity date, if CD If any of the above were owned in joint tenancy provide the following: 11.13 Name of joint owner 11.14 Address City, State, Zip 11.15 Relationship to D 11.16 Date of creation of joint tenancy 11.17 Did the surviving joint tenant contribute to the purchase of the property? (May not be relevant if J.T. is spouse) __ Yes __ No __ Yes __ No __ Yes __ No 11.18 In what proportion? 11.19 Evidence of contribution 11.20 Cash in decedent’s possession at DOD 11.21 Uncashed travelers checks 11.22 Estate Bank Account Checking Savings Bank Address City, State Zip Account No. 12.0 MORTGAGES AND NOTES RECEIVABLES 12.01 Is community property to be considered? (Refer to 1.38) __ Yes __. No (A) (B) (C) 12.02 Face Amount $ $ $ 12.03 Principal of balance at DOD $$ $ 12.04 Names of obligors Address City, State, Zip Relationship to D 12.05 Date of instrument 12.05A Frequency of payment. If installment note attach amortization schedule if available. 12.06 Maturity Date 12.07 Interest Date 12.08 Accrued interest at DOD 12.09 Secured? __ Yes __ No __ Yes __ No __ Yes __ No 12.10 Nature of security 12.11 Value if less than face $ $ $ 12.12 Alternate value, if less than face/date $ $ $ 12.13 Name(s) of payee 12.14 Names of joint tenant, if applicable Address City, State, Zip 12.15 Relationship to D 12.16 Date of creation of joint tenancy 12.17 Did the surviving joint tenant contribute to the purchase of the property? (May not be relevant if J.T. is spouse) (See Note following MIL 7.37) __ Yes __ No __ Yes __ No __ Yes __ No 12.18 In what proportion? 12.19 Evidence of contribution Note: If installment obligation is acquired by the estate, post death distribution to the beneficiary may constitute a taxable disposition. To avoid this result, consider distribution of property to be sold to beneficiaries and let them consummate the sale and carry back the installment obligation. 13.0 INSURANCE ON DECEDENT’S LIFE 13.01 Is community property to be considered? (Refer to 1.38) __ Yes __ No 13.02 If there was any insurance on D’s life give the following information regarding each of D’s life insurance agents: (A) (B) (C) 13.03 Name 13.04 Address City, State, Zip 13.05 Telephone No. 13.06 Company represented Complete the following for each policy payable by virtue of D's death. Use the full amounts shown on I.R.S. Form 712, part I. Attach separate sheets for additional items. Alternatively, extra copies of the Form 712 when received may be attached. (A) (B) (C) 13.07 Company 13.08 Address City, State, Zip 13.09 Type of kind of policy 13.10 Policy No. 13.11 Face Amount $ $ $ 13.12 Policy already sent for payment? __ Yes __ No __ Yes __ No __ Yes __ No 13.13 Policy to be sent for payment? __ Yes __ No __ Yes __ No __ Yes __ No 13.14 Form 712 already requested? __ Yes __ No __ Yes __ No __ Yes __ No 13.15 Form 712 to be requested by us? __ Yes __ No __ Yes __ No __ Yes __ No 13.16 Form 712 received? __ Yes __ No __ Yes __ No __ Yes __ No 13.17 Benefits already paid? __ Yes __ No __ Yes __ No __ Yes __ No 13.18 Are we to obtain payment? __ Yes __ No __ Yes __ No __ Yes __ No 13.19 Beneficiary name 13.20 Address City, State, Zip 13.21 Social Security No. 13.22 Date of Birth of Beneficiary if a minor 13.23 Relationship of Beneficiary to D 13.24 Policy loans, if any A.Principal B.Interest at date of death C.Total of principal and i nterest 13.25 Net proceeds A.Accumulated dividends B.Post mortem dividends or interest C.Returned premiums D.Amount of proceeds if payable in one sum E.Value of proceeds as of date of death (if not payable in one sum) F.Net proceeds after all increases and deductions 13.26 Was policy assigned to D? __ Yes __ No __ Yes __ No __ Yes __ No 13.27 Date of assignment 13.28 Exclude from D’s taxable estate? __ Yes __ No __ Yes __ No __ Yes __ No 13.29 If excluded, give details 13.30 Owner of policy if not D 13.31 Address City, State, Zip 13.32 Relationship to D 13.33 Name of applicant for policy 13.34 If any policy is payable in deferred payments or installments, obtain a copy of the Settlement Contract and attach here. If payments are measured by the life of another, give name, address and date of birth. 14.0 INSURANCE ON LIFE OF OTHERS 14.01 Is community property to be considered? (Refer to 1.38) __ Yes __ No 14.02 If D owned an interest in a policy insuring the life of someone else give names and addresses for each life insurance agent responsible for such policies. (A) (B) (C) 14.03 Name 14.04 Address City, State, Zip 14.05 Telephone No. 14.06 Company represented Complete the following for each policy on the life of someone other than D in which D owned an interest. Use the full amounts shown on I.R.S. Form 712, part 2. Attach separate sheets for additional items. Attach copies of the Form 712 to this sheet. (A) (B) (C) 14.07 Company 14.08 Address City, State, Zip 14.09 Type of kind of policy 14.10 Policy No. 14.11 Insured’s name and sex 14.12 Address 14.13 City, State, Zip 14.14 I.R.S. Form 712, part 2 to be requested by us? __ Yes __ No __ Yes __ No __ Yes __ No 14.15 Interpolated terminal reserve value from I.R.S. Form 712, part 2 14.16 Amount of last premium paid 14.17 Date of payment of last premium 14.18 Proportionate part of last last premium covering period after death ((See Treas. Reg. § 20.2031-8(a)(2)) 14.19 Total Value (14.15 and 14.18) 14.20 Is ownership to be charged? __ Yes __ No __ Yes __ No __ Yes __ No 14.21 If so, to whom 14.22 Address City, State, Zip 14.23 Social Security No. 15.0 OTHER INSURANCE 14.01 Is community property to be considered? (Refer to 1.38) __ Yes __ No 14.02 If D maintained any insurance other than life insurance, give names and addresses of the appropriate insurance agents. (A) (B) (C) 15.03 Name 15.04 Address City, State, Zip 15.05 Telephone No. 15.06 Company Use the following abbreviations for type of insurance: A-Accident; H-Health; MM-Major Medical; HO-Homeowners; F-Fire and Extended Coverage; L-Liability. 15.07 Type of insurance (Circle) A H HM HO F L A H HM HO F L A H HM HO F L 15.08 On policies not terminating at D’s death, what are the amounts of coverages on each? 15.09 Are the coverages adequate? __ Yes __ No __ Yes __ No __ Yes __ No 15.10 If so, what should the coverage be? 15.11 Should the policy be transferred? __ Yes __ No __ Yes __ No __ Yes __ No 15.12 If yes, to whom 15.13 Name 15.14 Address City, State, Zip 15.15 Should the policy be cancelled and unused premium be claimed? __ Yes __ No __ Yes __ No __ Yes __ No 15.16 Amount of refunded premium 24.05 Probate Case No. 24.06 Court 16.0 UNINCORPORATED BUSINESS INTERESTS 16.01 Should community property be considered? (Refer to 1.38) __ Yes __ No 16.02 If D owned or operated a sole proprietorship complete the following (16.03—16.17): 16.03 Name of business 16.04 Address City, State, Zip 16.05 Telephone No. 16.06 Nature of business 16.07 Employer’s identification No. 16.08 Do family or beneficiaries desire to retain ownership? __ Yes __ No 16.09 Is special administration needed? __ Yes __ No 16.10 Will the personal representative take possession and operate the business? __ Yes __ No 16.11 If no, who will run the business? 16.12 Are assets of business known on other schedules? __ Yes __ No 16.13 Which schedules? 16.14 Does real estate in the business qualify for special Federal estate tax valuation? __ Yes __ No 16.15 Value at death 16.16 Alternate value of/date 16.17 If D owned an interest in a partnership, limited partnership or joint venture, complete the following (16.19 – 16.33): (A) (B) (C) 16.18 Nature of interest 16.19 Interest in name of 16.20 Name of partnership 16.21 Address City, State, Zip 16.22 Telephone No. 16.23 Person to contact 16.24 Nature of business 16.25 D’s % interest 16.26 Does real estate in the partnership qualify for special Federal estate tax valuation? __ Yes __ No __ Yes __ No __ Yes __ No 16.27 Is interest subject to “Buy- sell” agreement? __ Yes __ No __ Yes __ No __ Yes __ No 16.28 Is D’s death an event forcing an offer to sell? __ Yes __ No __ Yes __ No __ Yes __ No 16.29 Purchase price under this agreement 16.30 Is agreed price binding on D’s estate? __ Yes __ No __ Yes __ No __ Yes __ No 16.31 If not binding, state value at D’s death 16.32 Alternate value of/date 16.33 If any of the above were owned in joint tenancy, provide the following: 16.34 Name of joint tenant 16.35 Address City, State, Zip 16.36 Relationship to D 16.37 Date of creation of joint tenancy 16.38 Did the surviving joint tenant contribute to the purchase of the property? (May not be applicable if J.T. is spouse) __ Yes __ No __ Yes __ No __ Yes __ No 16.39 In what proportion? 16.40 Evident of contribution 17.0 VEHICLES 17.01 Should community property be considered? (Refer to 1.38) __ Yes __ No 17.02 If D owned any automobiles, motorcycles, boats, airplanes or other vehicles complete the following for each: (A) (B) (C) 17.03 Year 17.04 Make 17.05 Model 17.06 Description of Vehicle 17.07 Motor No. 17.07A Vehicle identification Number (VIN) (if different from Motor Number) 17.08 Name in which registered 17.09 Value at death 17.10 Currently license? 17.11 Title to be transferred? 17.12 Transferee’s name 17.13 Address City, State, Zip 17.14 Insured? __ Yes __ No __ Yes __ No __ Yes __ No 17.15 Cancel insurance? __ Yes __ No __ Yes __ No __ Yes __ No 17.16 Transfer insurance? __ Yes __ No __ Yes __ No __ Yes __ No 17.17 Name of joint tenant, if any 17.18 Address City, State, Zip 17.19 Relationship to D 17.20 Date of creation of joint tenancy 17.21 Did the surviving joint tenant contribute to the purchase of the property? (May not be applicable if J.T. is spouse) __ Yes __ No __ Yes __ No __ Yes __ No 17.22 In what proportion? 17.23 Evidence of contribution 18.0 PERSONAL, HOUSEHOLD AND MISCELLANEOUS 18.01 Is community property to be considered? (Refer to 1.38) __ Yes __ No Complete the following for the following items: (Check I, TC, or JT to indicate nature of ownership as individual I, tenancy in common TC, or joint tenancy JT). On this sheet indicate full value without reduction for partial ownership. Attach separate sheets for additional items. Indicate name of co-owner and percentage of D's ownership in D's estate and receive a basis adjustment. In case of joint tenancies with a spouse, one half of D's tax basis may carry over to the spouse since only one half will be taxed in D's estate so as to receive a basis adjustment. I TC JT D’s Tax Basis Value at Death Alternate Value of Date Basis for Valuation 18.02 Clothing and misc. personal effects 18.03 Jewelry 18.04 Stamp collection 18.05 Coin collection 18.06 Other collection (Specify) 18.07 Works of art 18.08 Furs 18.09 Rare books 18.10 Valuable antiques 18.11 Miscellaneous household goods and furnishings 18.12 Tools and equipment (Specify) 18.13 Livestock 18.14 Farm products and growing crops 18.15 Claim for salary 18.16 Insurance premium refunds due 18.17 Income tax refund due- -Hawaii and Federal I TC JT D’s Tax Basis Value at Death Alternate Value of Date Basis for Valuation 18.21 Copyrights 18.22 Royalty interests other than minerals 18.23 Franchises 18.24 Other contract rights 18.25 Club memberships 18.26 Causes of action 18.27 Pending lawsuits 18.28 Judgments 18.29 Reversionary interests 18.30 Remainder interests 18.31 Interests in estates 18.32 Interest in trusts created by others (Obtain copy of instrument and valuation date) 18.33 Debts due decedent other than notes and mortgages and accounts receivable listed elsewhere 18.34 Miscellaneous not listed above 18.35 As to the above assets owned by Joint tenancy, provide the following: 18.36 Asset involved (by above number) 18.37 Name of joint tenant 18.38 Address City, State, Zip 18.39 Relationship to D 18.40 Date of creation of joint tenancy 18.41 Did the surviving joint tenant contribute to the purchase of property? (May not be applicable if J.T. is souse) __ Yes __ No __ Yes __ No __ Yes __ No 18.42 In what proportion? 18.43 Evidence of contribution 18.44 Is it possible that anyone else has placed their property above described in joint tenancy with D? __ Yes __ No If yes, obtain the above information. l9.0 EMPLOYEE AND GOVERNMENT BENEFITS AND ANNUITIES SOCIAL SECURITY 19.01 Was D covered by provisions of the Social Security Act? __ Yes __ No 19.02 Was D receiving payments from Social Security Administration? __ Yes __ No Description: 19.03 Was D's spouse receiving payments from Social Security Administration? __ Yes __ No Description: 19.04 Will D's death entitle either D's spouse or children to receive payments from Social Security Administration? __ Yes __ No 19.05 Is $255.00 Social Security lump sum benefit to be paid? __ Yes __ No Note: The benefit is payable only to a surviving spouse or, if none, to minor children. 19.06 If so, has it been collected? __ Yes __ No 19.07 Should we apply for death benefits? __ Yes __ No 19.08 Should we aid D's spouse or children in applying for survivors' benefits? __ Yes __ No RAILROAD RETIREMENT 19.09 Was D covered by provisions of Railroad Retirement Act? __ Yes __ No 19.10 Was D or D's spouse receiving payments pursuant to the Act? __ Yes __ No Description: 19.11 Will D's death entitle either D's spouse or children to receive such payments? __ Yes __ No 19.12 Should we aid D's spouse or children in applying for survivors' benefits? __ Yes __ No VETERANS ADMINISTRATION (VA) 19.13 Was D or D's spouse receiving payments from VA? __ Yes __ No Description: 19.14 Will D's death entitle either D's spouse or children to receive payments from VA? __ Yes __ No 19.15 Are death benefits payable? __ Yes __ No 19.16 Have death benefits been collected? __ Yes __ No 19.17 Should we apply for death benefits? __ Yes __ No 19.18 Should we aid D's spouse or children in applying for survivors' benefits'? __ Yes __No ANNUITIES 19.19 Was D receiving an annuity at time of D's death? __ Yes __ No 19.20 If so, name of payor 19.21 Address City, State, Zip 19.22 Qualified plan? __ Yes __ No 19.23 Contribution by Employee toward total cost of annuity 19.24 Name of Employer 19.25 Address City, State, Zip 19.26 At the time of D's death was D receiving an annuity which D purchased, which is payable to another on D's death (Refund or joint and survivor annuity)? __ Yes __ No 19.27 Name of Payor 19.28 Address City. State, Zip 19.29 What is the monthly benefit payable to the survivor? $ 19.30 Name of survivor 19.31 Age of survivor OTHER EMPLOYEE BENEFITS 19.32 As a result of D 's employment and death, will an annuity become due and payable to and by virtue of a beneficiary surviving D? __ Yes __ No 19.33 If yes, give the ratio of D's contribution to the total cost of the annuity ________________% and complete the following for each beneficiary: (A) (A) 19.34 What was the total cost of annuity? $ $ 19.35 What was the amount of D's contribution? $ $ 19.36 Ratio of D’s contribution to the total cost of the annuity 19.37 Name 19.38 Address 19.39 Telephone No. 19.40 Relationship to D 19.41 Value of annuity 19.42 Was D receiving payments from a qualified plan (i.e., a pension, profit sharing, stock bonus or Keogh plan or employee stock ownership plan), an I.R.A. or a tax-deferred Section 403(b) annuity at the time of D's death? Available? __ Yes __ No 19.43 If so, on December 31, 1982 had payment to D begun and had D elected the form of payment before January 1, 1983? __ Yes __ No 19.44 On December 31, 1984 had payments to D begun and had D elected the form of payment before July 18, 1984? __ Yes __ No 19.45 Was D entitled to benefits from a qualified plan, I.R.A. or tax-deferred annuity at the time of D's death, the payment of which has not yet begun? __ Yes __ No 19.46 Payor: 19.47 Address: City, State, Zip: 19.48 Contribution made by D to the plan? 19.49 Are the benefits or remaining benefits held in an individual account plan, i.e., a plan with a specifically designated account in D's name? __ Yes __ No 19.50 If so, what was the account balance at the date of D's death? 19.51 If the benefits or remaining benefits are not held in an individual account plan, are such benefits to be paid to D's beneficiary in a lump-sum payment? __ Yes __ No 19.52 If so, what is the amount thereof? 19.53 If not, what would the amount of such a lump-sum distribution have been? 19.54 Are the benefits or remaining benefits to be paid to D's beneficiary in the form of annuity or installment payments? __ Yes __ No 19.55 If so, what is the period over which the benefits will be paid? 19.56 If payable over the life expectancy of the beneficiary, what is the beneficiary's date of birth? 19.57 Did the qualified plan hold life insurance on D's life which is payable to D's beneficiary? __ Yes __ No 19.58 If so, in what amount? 19.59 Name of beneficiary 19.60 Relationship to D 19.61 Address of Beneficiary City, State, Zip 19.62 As a result of D's employment and death, will any other employee benefit become due and payable to anyone or to D's estate? __ Yes __ No If yes, complete the following: Type of Benefit Available? To whom Payable or Transferable 19.63 Insurance of D's life __ Yes __ No 19.64 Medical Insurance __ Yes __ No 19.65 Stock Options __ Yes __ No 19.66 Credit Union (Savings account may carry life insurance benefit) __ Yes __ No 19.67 Workmen's Compensation __ Yes __ No 19.68 Other (Describe) _______________________ __ Yes __ No ________________________ NOTE: Because of the complexity of describing and valuing employee benefits, a letter should be written to D's employers requesting detailed information. Copies of responses should be attached to this page. __ Yes __No 19.69 Did D belong to a Union or to a Fraternal Organization which provides benefits by virtue of D's death? If yes, complete the following: 19.70 Name of Union or Fraternal Organization 19.71 Person to contact 19.72 Address City, State, Zip 19.73 Telephone No. 19.74 Nature of benefits 20.0 TAXABLE BUT UNUSUAL ITEMS NOTE: This section applies generally to transfers during D's lifetime where D may no longer own an asset, but where the value of that asset may be includible in D's estate for tax purposes. None of these items are included in D's probate inventory. 20.01 If D ever did any of the following acts. circle the applicable answer and provide detail: 20.02 Create a trust during lifetime? __ Yes __ No 20.03 If so, was trust in existence at D's death? __ Yes __ No 20.04 If so, was trust amendable or revocable by D? __ Yes __ No 20.05 If so, did D retain a reversionary interest? (Need not be revocable.) __ Yes __ No 20.06 Make a transfer to take effect at D's death? __ Yes __ No 20.07 Make a transfer where D retained possession or enjoyment or income from the transferred property? __ Yes __ No 20.08 Possess a general or special power of appointment? __ Yes __ No 20.09 Date created, if yes 20.10 Exercise or release to any extent a power of appointment by Will or otherwise (including lapse of power)? __ Yes __ No 20.11 Date of exercise, release or lapse, if yes 20.12 Make a transfer where D retained the right to designate the person who could possess or enjoy property? __ Yes __ No 20.13 Make a transfer where D had the right to alter the enjoyment of the transferred property? __ Yes __ No 20.14 Regarding Federal Estate Tax Return Schedule G: __ Yes __ No A. Date of Gift or Transfer B. Amount of Gift or Transfer C. Character of Gift or Transfer 20.15 Make any transfer not listed above after 12/31/76 and prior to 3 years immediately preceding D’s death? (Federal Schedule G: gift tax paid; I.R.C. § 2035(c)) __ Yes __ No 20.16 Relinguish a power to alter a transfer previously made by D? __ Yes __ No 20.17 File a gift tax return? __ Yes __ No 20.18 Give years for such returns, if yes. 20.18A IRS office where filed. 20.19 Act as Trustee under any trust __ Yes __ No 20.19A Have judiciary powers sufficiently broad to be treated as a general power of appointment? __ Yes __ No 20.20 Serve as Personal Representative of any estate? __ Yes __ No 20.21 Serve as Custodian or Trustee of Uniform Transfer to Minors Act account or §2503(c) trust of which D was donor or settlor? __ Yes __ No 20.22 At times of D’s death have a beneficial interest in a trust not created by D? __ Yes __ No Note: If answer to any of the above questions is yes, obtain copies of documents and complete details with respect to each affirmative answer. Details should include the names, addresses, social security numbers and relationship of the done or transferee to the D. 21.0 DEBTS AND CLAIMS 21.01 Does D owe Income Taxes in year of death? __ Yes __ No If yes, list below as a debt. 21.02 Does D owe Income Taxes for any years preceding death? __ Yes __ No 21.03 List all debts owed by D at date of death. Include utility bills, real estate taxes, department store, credit card and other retail accounts. Write S in left margin if debt is secured by lien and list security. Check appropriate description. Attach separate sheets for additional items CAVEAT: Under H AW. REV. STAT. § 560:3-806 (2007), claims are deemed allowed if not affirmatively disallowed by the Personal Representative (apparently subject to a right in the Personal Representative later to change its position regarding allowance). Claims should be posted to the Worksheet WS-2 (Creditors Claims) and deadlines noted and posted to the office tickler slip. Name and Address of Creditor Note or Account Amount of Debt Date Paid 21.04 N A 21.05 N A 21.06 N A 21.07 N A Name and Address of Creditor Note or Account Amount of Debt Date Paid 21.08 N A 21.09 N A 21.10 N A 21.11 N A 21.12 N A 21.13 Which of the foregoing debts constituted business expenses or interest, taxes, expenses for the production of income or expenses for the management or maintenance of income producing property? 22.0 FUNERAL EXPENSES AND EXPENSES OF LAST ILLNESS List only those items and accounts unpaid at date of death. Amounts should be net of payments made directly by Social Security, etc. to debtor. To Whom Paid? Total Amount 22.01 Funeral Home $ 22.02 Burial Plot, perpetual care and other interment expense 22.03 Monument and inscription 22.04 Flowers 22.05 Religious services 22.06 Long distance calls 22.07 Other (List) Total $ By Whom Paid? Total Amount $ 22.08 Less reimbursement of items 22.01 22.07 by payment to estate from Social Security, VA., etc. Total $ 22.09 Physicians $ 22.10 Hospital bills 22.11 Nurses 22.12 Other expenses of last illness (List) $ Total Total Amount By Whom Paid? $ 22.13 Reimbursement of items 22.09 – 22.12 by payment to estate from insurance 22.14 Reimbursements by payment to estate from Medicare 22.15 Other reimbursement by payment to estate (List) $ Total 23.0 EXPENSES OF ADMINISTRATION 23.01 Personal Representative's fee (paid/agreed upon/estimated) $ 23. 02 Attorney's fee (paid/agreed upon/estimated) 23. 03 Accountants fee (paid/agreed upon/estimated) TO 23. 04 Appraisal fees (paid/agreed upon/estimated) TO 23. 05 Court Costs Docket fee Certified copies 23.06 Publication Costs 23. 07 Notice to Creditors Other 23. 08 Recording costs 23. 09 Death Certificates 23.10 Telephone expense 23. 11 Photocopy expense 23. 12 Postage 23. 13 Other (Specify) Total $ 24.0 PREVIOUSLY TAXED PROPERTY NOTE: The following is not a worksheet for computation of the Federal applicable credit. See the instructions to the return for the mechanics of computation. 24.01 If D inherited any property within 10 years prior to date of death complete the following: (A) (B) 24.02 Name of person form whom inherited 24.02A Person’s Social Security number 24.03 Date of person’s death 24.04 Residence of that person at time of death 21.04A I.R.S. office where Estate Tax Return filed 24.05 Probate Case No. 24.06 Court 24.08 Property involved 24.08 Value in prior estate 24.09 Reserved 24.10 Amount of credit allowable on D’s Federal Estate Tax Return NOT E: Federal lapse period for credit for property previously held is 10 years. No tracing is required. Amount of credit balance at100% and decreases with passage of years. (I.R.C. § 2013) 25.0 TAXES FOR DECEDENT AND DECEDENT'S ESTATE 25.01 Employer I.D. Number 25. 02 Name, address and phone no. of D's accountant: 25. 03 Is there an audit of D's income tax return now pending? __ Yes __ No 25.04 When was D's income tax return last audited? 25. 05 What are the approximate income tax brackets of D's beneficiaries 25. 06 Did D file the Federal and Hawaii income tax returns (and pay the tax thereon) for each of the preceding 4 years? __ Yes __ No If no, explain 25.07 Did D file a Federal declaration of estimated tax (1040-ES) for the current year? __ Yes __ No 25.08 If yes, how much has D paid on it for the current year? $ 25. 09 Did D file a Hawaii Declaration of estimated tax (N-1) for current year? __ Yes __ No 25.10 If yes, how much has D paid on it for the current year? $ 25.11 Did D work for wages or salary during the current year? __ Yes __ No 25.12 If yes, how much federal income tax was withheld? (See W-2 Form) $ 25. 13 If 25.11 is yes, how much Hawaii income tax was withheld? (See W-2 Form) $ 25.14 If D died between January 1 and April 15, did D file Hawaii and Federal income tax returns (and Due the tax thereon) for the previous year (or obtain extensions)? __ Yes __ No __ NA 25.15 If 25.14 is no, will this firm prepare them? __ Yes __ No 25.16 If no, who will prepare? 25. 17 Will Hawaii and Federal income tax returns be due for the part of the year of D's death? __ Yes __ No 25.18 If yes, who will prepare? 25. 19 Is there a refund(s)? __ Yes __ No 25.20 If yes, state the amount of refund(s). $ 25. 21 End of fiscal year for estate Note: While trusts are calendar year taxpayers (I.R.C. § 645), estates may select a non-calendar fiscal year for the first two years of administration. See I.R.C. §§ 441, 443. 25.22 Will fiduciary income tax be due for the estate? __ Yes __ No If yes, complete the following: First Year Second Year Third Year Fourth Year 25.23 Due Date ____________ ____________ ___________ _____________ 25.24 Who will prepare? ____________ ____________ ___________ _____________ 25.25 Will Federal income (See Special Instruction 39) tax be paid in installments? __ Yes __ No __ Yes __ No __ Yes __ No __ Yes __ No 25.26 Will a Federal Estate Tax Return be filed? __ Yes __ No 25.27 If yes, will this firm prepare it? __ Yes __ No 25.28 If no, who will? 25. 29 What is the alternate valuation date? (6 months from date of death). 25. 30 Will alternate valuation be used? __ Yes __ No 25.31 Will a prompt determination of liability be requested? __ Yes __ No 25.32 Will a Hawaii Estate Tax Report be filed? __ Yes __ No 25.33 If yes, will this firm prepare it? __ Yes __ No 25.34 If no, who will? 25. 35 What is the date the Federal and Hawaii returns must be filed and taxes paid? (9 months from date of death) 25. 36 Will Inheritance Tax Returns be due in other states? __ Yes __ No 25.37 If yes, in which states? 25. 38 If yes, who will prepare? 25.39 Is it necessary to consider any of the following tax returns and taxes? (Circle) A.Federal Gift Taxes-IRS Form 709, year B. Other State Gift Taxes C. Other State Income Taxes: States Years D. Hawaii Unemployment Taxes E.Other State Unemployment Taxes F.Federal Unemployment Taxes/Form 940 G.Federal Excise Taxes H.Federal Employer's Report-IRS Form 941/942 I.Federal Employer's Tax Reports-Form 1096/W-3 J.Federal Employer's Tax Reports-Form 1099/W-2 K.Hawaii General Excise Tax Return-Form G- 45 L. Other State Excise or Use Taxes