OMB No. 1545-1593
Form 1041-QFT                                         U.S. Income Tax Return for Qualified Funeral Trusts

Department of the Treasury                              Go to www.irs.gov/Form1041QFT for instructions and the latest information.                               2023
Internal Revenue Service 
For calendar year 2023 or short year beginning                                                            , 2023, and ending                                              , 2023. 
Part I                                General Information 
1    Name of trust or other entity filing return                                                                                             2  Employer identification number (EIN)

3a  Name and title of trustee 

3b  Number, street, and room or suite no. (If a P.O. box, see the instructions.) 

3c  City or town, state, and ZIP code                                                                                                        4  Number of QFTs included on this return 

5    Check applicable boxes: 
                                  Initial return Amended return        Final return            Change in the fiduciary or fiduciary’s name        Change in fiduciary’s address
Part II                               Tax Computation

                                  1a  Interest income  .  .      . . . . . . .             . . . .  . . . .  . . .        . . .            . .  .   .  1a 
                                  b   Tax-exempt interest. Don’t include on line 1a  .         . .  . . . .  . .   1b 
                                  2 a Total ordinary dividends  .    . . . . .             . . . .  . . . .  . . .        . . .            . .  .   .  2a 
                                  b   Qualified dividends  .     . . . . . . .             . . . .  . . . .  . .   2b 
                 Income           3   Capital gain or (loss) (attach Schedule D (Form 1041))        . . . .  . . .        . . .            . .  .   .  3 
                                  4   Other income. List type and amount                                                                               4 

                                  5   Total income. Combine lines 1a, 2a, 3, and 4  .          . .  . . . .  . . .        . . .            . .  .   .  5 

                                  6   Taxes  .   .    . . .      . . . . . . .             . . . .  . . . .  . . .        . . .            . .  .   .  6 
                                  7   Trustee fees  .   . .      . . . . . . .             . . . .  . . . .  . . .        . . .            . .  .   .  7 
                                  8   Attorney, accountant, and return preparer fees .         . .  . . . .  . . .        . . .            . .  .   .  8 
                                  9   Other deductions    .      . . . . . . .             . . . .  . . . .  . . .        . . .            . .  .   .  9 
                 Deductions
                                  10  Total deductions. Add lines 6 through 9  .           . . . .  . . . .  . . .        . . .            . .  .   .  10 

                                  11  Taxable income. Subtract line 10 from line 5  .          . .  . . . .  . . .        . . .            . .  .   .  11 

                                  12  Tax. (If this is a composite return, check here          )  . . . . .  . . .        . . .            . .  .   .  12 
                                  13  Credits (see instructions). Specify the credits claimed                                                          13 

                                  14  Subtract line 13 from line 12  . . . . .             . . . .  . . . .  . . .        . . .            . .  .   .  14 
                                  15  Net Investment Income Tax from Form 8960, line 21  .          . . . .  . . .        . . .            . .  .   .  15
                                  16  Total tax. Add lines 14 and 15  .  . . .             . . . .  . . . .  . . .        . . .            . .  .   .  16 
                                  17  Payments (see instructions)  .   . . . .             . . . .  . . . .  . . .        . . .            . .  .   .  17
                 Tax and Payments 18  Elective payment election amount from Form 3800  .            . . . .  . . .        . . .            . .  .   .  18
                                  19  Tax due. If the total of lines 17 and 18 is smaller than line 16, enter amount owed  .               . .  .   .  19 
                                  20  Overpayment. If the total of lines 17 and 18 is larger than line 16, enter amount overpaid                .   .  20

                                  21  Amount of line 20 to be: a Credited to 2024 estimated tax                                 b Refunded             21
                                      Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge
                                      and belief, it is true, correct, and complete. Declaration of preparer (other than trustee) is based on all information of which preparer has any knowledge.
Sign 
                                                                                                                                                       May the IRS discuss this return 
Here                                                                                                                                                   with the preparer shown below? 
                                      Signature of trustee or officer representing trustee              Date                                           See instr.    Yes  No 
                                      Print/Type preparer’s name           Preparer’s signature                    Date
Paid                                                                                                                                            Check         if PTIN
                                                                                                                                                self-employed
Preparer 
                                      Firm’s name                                                                                          Firm’s EIN 
Use Only                              Firm’s address                                                                                       Phone no.
For Paperwork Reduction Act Notice, see instructions.                                                     Cat. No. 25368F                              Form 1041-QFT (2023)