Form 706-GS(T) Generation-Skipping Transfer Tax Return For Terminations
                                              ▶ Use for terminations made after December 31, 2012.                                OMB No. 1545-1145
(Rev. November 2013)                                  ▶ For calendar year                     .   
Department of the Treasury     ▶ Information about Form 706-GS(T) and its separate instructions is at www.irs.gov/form706gst.  
Internal Revenue Service 
Part I    General Information 
1a  Name of trust                                                                               1b  Trust’s employer identification number (see instructions) 

2a  Name of trustee 

2b  Trustee’s address (number and street or P.O. box; apt. or suite no.; city, town or post office; state and ZIP code) If you have a foreign address, also complete the spaces 
    below (see instructions).  

    Foreign country name                          Foreign province/county                                 Foreign postal code

Part II   Trust Information (see the instructions) 
                                                                                                                                           Sch. A  
                                                                                                                      Yes  No 
3    Has  any  exemption  been  allocated  to  this  trust  by  reason  of  the  deemed  allocation  rules  of                             number(s) 
     section  2632?  If  “Yes,”  describe  the  allocation  on  the  line  7,  Schedule  A,  attachment  showing 
     how the inclusion ratio was calculated  .      . . .                     . . . . . . . . . .       . .  . . .  .

4    Has  property  been  contributed  to  this  trust  since  the  last  Form  706-GS(T)  or  706-GS(D-1)  was 
     filed? If “Yes,” attach a schedule showing how the inclusion ratio was calculated  .                 .  . . .  .

5    Have any terminations occurred that are not reported on this return because of the exceptions
     in section 2611(b)(1) or (2) relating to medical and educational exclusions and prior payment of 
     Generation-Skipping Transfer (GST) tax? If “Yes,” attach a statement describing the termination  .

6    Have any contributions been made to this trust that were not included in calculating the trust’s 
     inclusion ratio? If “Yes,” attach a statement explaining why the contribution was not included  .              .

7    Has the special QTIP election in section 2652(a)(3) been made for this trust?              .       . .  . . .  .
8    If this is not an explicit trust (see the instructions under Who Must File), check here and attach a statement  describing the 
     trust arrangement that makes its effect substantially similar to an explicit trust  .              . .  . . .  . .      .  . .    .   . .  ▶

Part III  Tax Computation 

9a   Summary of attached Schedules A (see instructions for line 9b)                                                                        GST tax 
Schedule A No.                                                                                                                    (from Sch. A, line 10) 
1       . .        . .      .  . . . .    . . . . . . . .                     . . . . . . . . . .       . .  . . .    9a1
2       . .        . .      .  . . . .    . . . . . . . .                     . . . . . . . . . .       . .  . . .    9a2
3       . .        . .      .  . . . .    . . . . . . . .                     . . . . . . . . . .       . .  . . .    9a3
4       . .        . .      .  . . . .    . . . . . . . .                     . . . . . . . . . .       . .  . . .    9a4
5       . .        . .      .  . . . .    . . . . . . . .                     . . . . . . . . . .       . .  . . .    9a5
6       . .        . .      .  . . . .    . . . . . . . .                     . . . . . . . . . .       . .  . . .    9a6

9b   Total from all additional Schedules A, in excess of six, attached to this form .           .       . .  . . .  ▶   9b 
10   Total GST tax (add lines 9a1 through 9b)  .      . .                     . . . . . . . . . .       . .  . . .  .   10 
11   Payment, if any, made with Form 7004  .        . . .                     . . . . . . . . . .       . .  . . .  .   11 
12   Tax due. If line 10 is larger than line 11, enter the amount owed  .               . . . . .       . .  . . .  .   12 
13   Overpayment. If line 11 is larger than line 10, enter amount to be refunded  .             .       . .  . . .  .   13 
                   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 fiduciary is based on all information of which preparer has any 
Sign              ▲knowledge.
Here 
                     Signature of fiduciary or officer representing fiduciary                                         Date 
               Print/Type preparer’s name             Preparer's signature                              Date                           PTIN
Paid                                                                                                                  Check         if 
                                                                                                                      self-employed
Preparer 
Use Only       Firm’s name      ▶                                                                                  Firm's EIN  ▶
               Firm's address  ▶                                                                                   Phone no.
For Paperwork Reduction Act Notice, see separate instructions.                          Cat. No. 10329M               Form 706-GS(T) (Rev. 11-2013) 

Form 706-GS(T) (Rev. 11-2013)                                                                                               Page  2 
Name of trust                                                                                 EIN of trust 

                                        Note. Make  copies  of  this  schedule  before  completing  it  if  you  will  need  more  than  one 
Schedule A No.                          Schedule A. 
                                            Schedule A—Taxable Terminations 
                                      (See the instructions before completing this schedule.) 
                                  a                                           b                 c Item no. from line 4 below in  
                  Name of skip persons                           SSN or EIN of skip person          which interest held 
1 

2  Describe the terminating power or interest. If you need more space, attach an additional sheet. 

3  If you elect alternate valuation, check here (see the instructions)  . . . . .      . . .  . . . .       . . .  . . . .  ▶
4  Describe each taxable termination below (see the instructions) 
   a                                  b                                     c                   d                      e 
  Item no.      Description of property subject to termination   Date of termination       Valuation date            Value 
   1

   Total  .   . . . .         . . . . . . .   .   . . . . .    . .    .   . . . .      . . .  . . . .       ▶   4 
5  Total deductions applicable to this Schedule A (from attached Schedule B, line 5)  .    .  . . . .       .   5 
6  Taxable amount (subtract line 5 from line 4)     . . . .    . .    .   . . . .      . . .  . . . .       .   6 
7  Inclusion ratio (attach separate schedule showing computation)  .      . . . .      . . .  . . . .       .   7 
8  Maximum federal estate tax rate (see Table in the instructions)  .     . . . .      . . .  . . . .       .   8                %
9  Applicable rate (multiply line 7 by line 8)  . . . . . .    . .    .   . . . .      . . .  . . . .       .   9 
10 GST tax (multiply line 6 by line 9) (enter here and on page 1, Part III, line 9)  . . . .  . . . .       .   10 
                                                                                                Schedule A (Form 706-GS(T)) (Rev. 11-2013) 

Form 706-GS(T) (Rev. 11-2013)                                                                                                           Page  3 
Name of trust                                                                                  Schedule A No. ▶
                                                                                               EIN of trust 

Note. Make copies of this schedule before completing it if you will need more than one Schedule B. 
                              Schedule B(1)—General Trust Debts, Expenses, and Taxes 
                              (Section 2622(b)) (Enter only items related to the entire trust; see the instructions.) 
      a                                                      b                                                          c 
  Item no.                                               Description                                                    Amount 
      1

1     Total of Schedule B(1)  . . . . . .          . . . . . . . .   . . . . . . .           . .   . . .              1 

2     Percentage allocated to corresponding Schedule A  .  . . . .   . . . . . . .           . .   . . .              2                 % 

3     Net deduction (multiply line 1 by line 2)  . . . . . . . . .   . . . . . . .           . .   . . .              3 
              Schedule B(2)—Specific Termination-Related Debts, Expenses, and Taxes 
       (Section 2622(b)) (Enter only items related solely to terminations appearing on corresponding Schedule A; see the instructions.) 
      a                                                      b                                                          c 
  Item no.                                               Description                                                    Amount 
      1

4     Total of Schedule B(2)  . . . . . .          . . . . . . . .   . . . . . . .           . .   . . .              4 

5     Total. Add lines 3 and 4 (enter here and on line 5 of the corresponding Schedule A)  . . .   . . .              5 
                                                                               Schedules B(1) and B(2) (Form 706-GS(T)) (Rev. 11-2013)