rom 2O6—A United States Additional Estate Tax Return

(Rev. June 1985) (To report dispositions or cessations of qualified use under

Department of the Treasury section 2032A of the Internal Revenue Code)
Internal Revenue Service

OMB No. 1545-0016
Expires 6/30/88

Name of qualified heir or heiress

Heir's or heiress’ social security number

Address of qualified heir or heiress (number and street including apartment number or rural route)

Commencement date (See instructions)

City, town or post office, State and ZIP code

Decedent's name reported on Form 706 Decedent's social security number Date of death
Tax Computation
1 Value at date of death (or alternate valuation date) of all specially valued property which passed from
decedent to qualified heir or heiress:
a Without section 2032A election. . . . . 2... . .. . .{ da
b With section 2032Aelection . . . re ao)
¢ Balance (subtract line 1b from line la) . rs le
2 Value at date of death (or alternate valuation date) of all specially valued property i in decedent's estate:
a Without section 2032A election. . . . . . 1... .. . . [2a
b With section 2032A election. . . re 2)
¢ Balance (subtract line 2b from line 2a) . 2c
3 Decedent's estate tax:
a Recomputed without section 2032A election (attach computation) . . . [3a
b Reported on Form 706 with section 2032Aelection. . . . . . . .L3b
c Balance (subtract line 3b from line 3a) on 3c
4 Divide line 1c by line 2c and enter the result as a percentage . 4 %
5 Multiply line 3c by percentage on line 4 . . 5
6 Value, without section 2032A election, at date of death (or: alternate
valuation date) of specially valued property shownonScheduleA . . . .| 6
7 Divide line 6 by line 1(a) and enter the result as a percentage . 7 %
8 Multiply line 5 by percentage on line 7 (see instructions) woe ee 8
9 Enter the total of column (d),ScheduleA,page2. . 2. 2. 2. 2 2. 9
10 Enter the total of column (e),ScheduleA,page2. . . . . . . . . .L10
11 Balance (subtract line 10 fromline9) 11
12 Additional estate tax. Enter the lesser of line 8 orline 11 we 12
GEG Involuntary Conversions or Exchanges. Checkiffor: L] involuntary conversion [_] Exchange
13 Qualified replacement (or exchange) property
(a) Item (b) Description (©) Cost (or FMV)
Total cost (or FMV). . . . . . 13
14 Enter the total of column (d), Schedule A, page 2. 14
15 Divide line 13 by line 14 and enter the result as a percentage (Do! not enter more ‘than 2 100%) 15 %
16 Multiply line 12 by percentage on line 15 . 16
17 Additional tax, subtract line 16 from line 12 (Do not enter less than zero) 17

Under penalties of perjury, | declare that | have examined this return, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer
other than taxpayer 1s based on all information of which preparer has any knowledge.

Address (and ZIP code)

For Paperwork Reduction Act Notice, see page 1 of the separate instructions.

Form 706—A (Rev. 6-85)


Form 706-A (Rev. 6-85)

Page

Schedule A.— Disposition of Specially Valued Property or Cessation of Qualified Use

‘Amount received (or fair

ttem Description of specially valued property and schedule and item Date of disposition Special use value
number number where reported on the decedent's Form 706 (or date qualified use ceased) | TM@rkgt value if applicable) See Instructions
See Instructions
() ) © @ ©
1

Enter total of column (d) on line 9, page 1, and total of column (e) on line 10, page 1