California Generation Skipping Transfer Tax Return for Termination

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This return is required to be filed on or before the final filing date for the Federal GenerationSkipping Transfer Tax Return, Form 706GS(T). CALIFORNIA GENERATION-SKIPPING TRANSFER TAX RETURN For Terminations CONTROLLER OF THE STATE OF CALIFORNIA DIVISION OF ACCOUNTING AND REPORTING BUREAU OF TAX ADMINISTRATION P. O. BOX 942850 SACRAMENTO, CA 94250-5880 Calendar Year:______________ DO NOT USE THIS SPACE Name of Trust Employer Identification No. of Trust Name of Trustee Name and Acting Capacity of Person Filing Return Name of Attorney Address Address Address Telephone Number Telephone Number Telephone Number A COPY OF THE FEDERAL GENERATION-SKIPPING TRANSFER TAX RETURN, FORM 706GS(T), MUST BE FILED WITH THIS RETURN 1. 2. Total state generation-skipping transfer tax credit allowable for generation-skipping transfer tax purposes [IRS Form 706GS(T), page 2, Schedule A, line 12] .................................................................... Proration of the state credit for the federal generation-skipping transfer tax (complete only if there is property located in states other than California): a. b. c. Gross value for federal generation-skipping transfer tax purposes of property located in California Gross value of decedent’s property subject to generation-skipping transfer tax for federal purposes [IRS Form 706GS(T), page 2, Schedule A, line 4, of tax computation]............................................. Percent of transfers for federal generation-skipping transfer tax purposes located in California [line 2(a) divided by line 2(b)] ........................................................................................................... 2(a) 2(b) 2(c) 3 4 5 1 PLEASE ATTACH CHECK HERE % 3. 4. 5. Tax payable to California [line 1 multiplied by line 2(c) or amount from line 1 if no entries on line 2] .... Interest due on amount on line 3 (see instructions for line 4 on reverse) .................................................... Total tax and interest due (total of lines 3 and 4) ........................................................................................ MAKE REMITTANCE PAYABLE TO THE CALIFORNIA STATE TREASURER, ATTACH TO THIS RETURN AND MAIL TO THE ADDRESS SHOWN ABOVE Under penalty of perjury, I declare that I have examined this return, including accompanying attachments and statements, and to the best of my knowledge and belief it is true, correct, and complete. (A declaration of a preparer other than the executor is based on all information of which the preparer has any knowledge.) Signature of Person Filing Return/Trustee Form GST(T) (Rev. 10/07) Date Signature of Preparer Other than Trustee Date

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