Form 541-Qft - California Income Tax Return For Qualified Funeral Trusts - 2001

California Income Tax Return for

TAXABLE YEAR

FORM

2001

Qualified Funeral Trusts

541-QFT

For calendar year 2001 or short year beginning month ______day______year 2001, and ending month______day______2001.

P

Name of estate or trust

Federal employer identification no.

-

Name and title of trustee

AC

Address of Fiduciary (number and street, including rural route, or PO box)

Suite no.

PMB no.

A

R

City

State

ZIP code

-

RP

Check Applicable Boxes:

Initial tax return

Amended tax return

Final tax return

Change in fiduciary’s name or address

1 Interest income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1

__________________

2 Dividends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2

__________________

3 Capital gain or (loss). Attach Schedule D (541) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3

__________________

4 Other income. State nature of income ___________________________________________________ . . . . . . . . . . . .

4

__________________

5 Total income. Combine line 1 through line 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

5

__________________

6 Taxes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6

__________________

7 Trustee fees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

7

__________________

8 Attorney, accountant, and preparer fees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

8 __________________

9 Other deductions NOT subject to the 2% floor _______________________________________________ . . . . . .

9 __________________

10 Allowable miscellaneous itemized deductions subject to the 2% floor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

10 __________________

11 Total deductions. Add line 6 through line 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

11

__________________

12 Taxable income. Subtract line 11 from line 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12

__________________

13 Tax from:

Tax Rate Schedule (see instructions)

Composite Return

Number of QFTs included on this tax return __________ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

13 __________________

14 Credits. Attach worksheet. If one credit, enter code. ________ If more than one credit, attach a detailed list . . . . . .

14 __________________

•

27 Tax liability. Subtract line 14 from line 13. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

27 __________________

28 California income tax withheld . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

28 ___________________

29 California income tax previously paid _______________________________________________ . . . . . . . . . . . .

29 ___________________

30 2001 CA estimated tax, amount applied from 2000 tax return, and payment with form FTB 3563 . . . . . . . . . . . . . . . .

30 ___________________

31 Total Payments. Add line 28, line 29, and line 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

31 ___________________

32 Tax due. If line 27 is larger than line 31, subtract line 31 from line 27

and enter the amount owed. Mail Form 541-QFT and the check or money order to:

. . . . .

, , , , ,

, , , , ,

FRANCHISE TAX BOARD, PO BOX 942867, SACRAMENTO CA 94267-0001 . . . . . . . . . . .

32

33 Overpaid tax. If line 27 is less than line 31, subtract line 27 from line 31

and enter the amount overpaid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

33 ___________________

34 Amount of line 33 to be credited to 2002 estimated tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

34 ___________________

35 Amount of line 33 to be refunded. Mail Form 541-QFT to:

. . . . .

, , , , ,

, , , , ,

FRANCHISE TAX BOARD, PO BOX 942840, SACRAMENTO CA 94240-0000 . . . . . . . . . . .

35

39 Underpayment of estimated tax. Fill in circle: FTB 5805

FTB 5805F

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

39 ___________________

Under penalties of perjury, I declare that I have examined this tax return, including accompanying schedules and statements, and to the best of my knowledge

Please

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

Date

Here

Signature of trustee or office representing fiduciary

Paid preparer’s SSN/PTIN

Preparer’s signature

Date

Check if self-

employed

Paid

FEIN

-

Preparer’s

Firm’s name (or yours,

Use Only

if self-employed) and

Telephone

address.

(

)

Form 541-QFT

2001

541QF01104

C1

For Privacy Act Notice, get form FTB 1131.