United States Estate (and GenerationSkipping Transfer) Tax Return

Form 706-NA

OMB No. 1545-0531 (Rev. September 2009) Estate of nonresident not a citizen of the United States

Department of the Treasury

Internal Revenue Service © See separate instructions.

Attach supplemental documents and translations. Show amounts in U.S. dollars.

Decedent, Executor, and Attorney

1a b 2

3 4

7a b 8

9a 10a

In

United

States

b b

11a 12a

Outside

United

States

b b

Tax Computation

1 Taxable estate from Schedule B, line 9 1

2 Total taxable gifts of tangible or intangible property located in the U.S., transferred (directly or indirectly)

by the decedent after December 31, 1976, and not included in the gross estate (see section 2511) 2

3 Total. Add lines 1 and 2 3

4 Tentative tax on the amount on line 3 (see instructions) 4

5 Tentative tax on the amount on line 2 (see instructions) 5

6 Gross estate tax. Subtract line 5 from line 4 6

7 Unified credit. Enter smaller of line 6 amount or maximum allowed (see instructions) 7

8 Balance. Subtract line 7 from line 6 8

9

Credit for tax on prior transfers. Attach Schedule Q, Form 706 10

Other credits (see instructions) 

10

11 Total. Add lines 9 and 10 11

12 Net estate tax. Subtract line 11 from line 8 12

13 Total generation-skipping transfer tax. Attach Schedule R, Form 706 13

14 Total transfer taxes. Add lines 12 and 13 14

15 Earlier payments. See instructions and attach explanation 15

16 Balance due. Subtract line 15 from line 14 (see instructions) 16

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. I understand that a complete return requires listing all property constituting the part of the decedent’s gross estate (as defined by

the statute) situated in the United States. Declaration of preparer (other than executor) is based on all information of which preparer has any knowledge.

For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions. Form 706-NA (Rev. 9-2009)

Part I

Part II

Cat. No. 10145K

To be filed for decedents dying after December 31, 2008.

9

5 6

Business or occupation

Name of attorney for estate

Name of attorney for estate

Address

Address

Decedent’s first (given) name and middle initial

Place of death

Date of birth Place of birth

Domicile at time of death

Decedent’s last (family) name

Name of executor

Address

Name of executor

Address

U.S. taxpayer ID number (if any)

Citizenship (nationality) Date of death

Date Preparer’s SSN or PTIN

Preparer’s

signature

Paid

Preparer’s

Use Only Firm’s name (or

yours, if self-employed),

address, and ZIP code Phone no. ( )

©

© EIN

Check

if selfemployed

Date

Sign

Here © Signature of executor ©

© Signature of executor © Date
Form 706-NA (Rev. 9-2009) Page 2

General Information

Yes No Did the decedent make any transfer (of Yes No

property that was located in the United States

at either the time of the transfer or the time

of death) described in sections 2035, 2036,

2037, or 2038 (see the instructions for Form

706, Schedule G)? 

7

1a Did the decedent die testate? 

Were letters testamentary or of administration

granted for the estate? 

b

If granted to persons other than those filing the

return, include names and addresses on page 1. If “Yes,” attach Schedule G, Form 706.

2 Did the decedent, at the time of death, own any: At the date of death, were there any trusts in

existence that were created by the decedent

and that included property located in the

United States either when the trust was

created or when the decedent died? 

8

a Real property located in the United States? 

b U.S. corporate stock? 

Debt obligations of (1) a U.S. person, or (2) the

United States, a state or any political

subdivision, or the District of Columbia? 

c

If “Yes,” attach Schedule G, Form 706.

d Other property located in the United States? 9 At the date of death, did the decedent:

Was the decedent engaged in business in the

United States at the date of death? 

3 Have a general power of appointment over

any property located in the United States? 

a

At the date of death, did the decedent have b Or, at any time, exercise or release the power?

access, personally or through an agent, to a

safe deposit box located in the United States?

4

If “Yes” to either a or b, attach Schedule H, Form 706.

10a Have federal gift tax returns ever been filed?

At the date of death, did the decedent own

any property located in the United States as

a joint tenant with right of survivorship; as a

tenant by the entirety; or, with surviving

spouse, as community property? 

5

b Periods covered ©

c IRS offices where filed ©

11 Does the gross estate in the United States

include any interests in property transferred

to a “skip person” as defined in the

instructions to Schedule R of Form 706? 

If “Yes,” attach Schedule E, Form 706.

Had the decedent ever been a citizen or resident 

of the United States (see instructions)?

6a

If “Yes,” did the decedent lose U.S. citizenship or

residency within 10 years of death? (see instructions)

If “Yes,” attach Schedules R and/or R-1, Form

706.

b

Schedule A. Gross Estate in the United States (see instructions) Yes No

Do you elect to value the decedent’s gross estate at a date or dates after the decedent’s death (as authorized by section 2032)? ©

To make the election, you must check this box ‘‘Yes.’’ If you check ‘‘Yes,’’ complete all columns. If you check ‘‘No,’’ complete

columns (a), (b), and (e); you may leave columns (c) and (d) blank or you may use them to expand your column (b) description.

(a)

Item

no.

(e)

Value at date of

death in U.S. dollars

(d)

Alternate value in

U.S. dollars

(c)

Alternate

valuation date

(b)

Description of property and securities

For securities, give CUSIP number

1

(If you need more space, attach additional sheets of same size.)

Total 

Schedule B. Taxable Estate

Caution. You must document lines 2 and 4 for the deduction on line 5 to be allowed.

1 Gross estate in the United States (Schedule A total) 1

2 Gross estate outside the United States (see instructions) 2

3 Entire gross estate wherever located. Add amounts on lines 1 and 2 3

Amount of funeral expenses, administration expenses, decedent’s debts, mortgages and liens, and

losses during administration. Attach itemized schedule. (see instructions)

4

4

5 Deduction for expenses, claims, etc. Divide line 1 by line 3 and multiply the result by line 4 5

Charitable deduction (attach Schedule O, Form 706) and marital deduction (attach Schedule M, Form

706, and computation) 

6

6

8 Total deductions. Add lines 5, 6, and 7 8

9 Taxable estate. Subtract line 8 from line 1. Enter here and on line 1 of Part II 9

Part III

Form 706-NA (Rev. 9-2009)

7 State death tax deduction (see instructions) 7