Form 706 - United States Estate (And Generation-Skipping Transfer) Tax Return Page 11
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41Form 706 (Rev. 8-93)
Part 3.—Agreement to Special Valuation Under Section 2032A ( Continued)
Date of Death
Decedent’s Social Security Number
Estate of:
Other acts (specify)
By signing this agreement, the agent agrees to provide the Service with any requested information concerning this property and to notify
the Service of any disposition or cessation of the qualified use of any part of this property.
Name of Agent
Signature
Address
The property to which this agreement relates is listed in Form 706, United States Estate (and Generation-Skipping Transfer) Tax Return,
and in the Notice of Election, along with its fair market value according to section 2031 of the Code and its special use value according
to section 2032A. The name, address, social security number, and interest (including the value) of each of the undersigned in this property
are as set forth in the attached Notice of Election.
,
IN WITNESS WHEREOF, the undersigned have hereunto set their hands at
.
this
day of
SIGNATURES OF EACH OF THE QUALIFIED HEIRS:
Signature of qualified heir
Signature of qualified heir
Signature of qualified heir
Signature of qualified heir
Signature of qualified heir
Signature of qualified heir
Signature of qualified heir
Signature of qualified heir
Signature of qualified heir
Signature of qualified heir
Signature of qualified heir
Signature of qualified heir
Signatures of other interested parties
Signatures of other interested parties
Schedule A-1—Page 11
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