Schedule Cc Form – Fill Out and Use This PDF

Schedule Cc Form – Fill Out and Use This PDF

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CAUTION:

The 2021 Schedule CC may not be filed prior to January 18, 02

Schedule

Request for a Closing Certificate

for Fiduciaries

2021

Use BLACK INK

Wisconsin Department of Revenue

ESTATES ONLY – Decedent’s last name

Decedent’s first name

M.I.

Decedent’s social security number

STAPLENOT

TRUSTS ONLY – Legal name

Estate’s/Trust’s federal EIN

Individual or firm to whom the closing certificate should be mailed

Attention or c/o

County of jurisdiction (Name Only)

Address

Probate case number

City

State

Zip code

Date of decedent’s death (MM DD YYYY)

PART I Information Required When Requesting a Closing Certificate for Estates

DO NOT ATTACH SCHEDULE CC TO FORM 2 (see instructions)

Complete lines 1 through 11 and sign on page 2.

1.	Is a certificate required by the court?												Yes					No			See instructions.
	If No, DO NOT submit Schedule CC. The department only issues a Closing Certificate if a court requires it to close a proceeding.
2.	Does the decedent have a will?												Yes					No			(If Yes, enclose a copy)
3.	Type of probate			Formal				Informal					Other
4.	If the decedent did not file tax returns for the 4 years prior to death, enter the year and the decedent’s approximate income:
	20		$		, 20				$			,				20				$		, 20				$				.

5.	Was the decedent contacted by the IRS and/or Wis. Dept. of Revenue in the last 3 years?																							Yes				No
	If Yes, explain:
6.	Is the gross income of the estate
	less than $600?												Yes					No
7.	Will a final Form 2 be filed at a l					ter d			te?				Yes					No
8.	Was the decedent a resident of Wisconsin
	at the time of death?												Yes					No
9.	Did the decedent own an interest in any
	partnership, S corporation, LLC, or LLP?												Yes					No
10.	Enter the totals of each of the assets listed below.

	Probate Assets (Enclose a copy of the inventory)																				NO COMMAS; NO CENTS
	. . . . . . . . . . . . .a. Real Estate						. .	. . . . . . . . . .		. . .			. . . . .	.		. .	. .		.10a			.00
	b. Stocks and Bonds
	b. Stocks and Bonds			. . .	. . . . .		. .	. . . . . . . . . .		. . .			. . . . .	.		. .	. .		.10b			.00
	c. Mortgages, Notes, and Cash																		10c			.00
	c. Mortgages, Notes, and Cash								. . .		. . . . .	.	. .			. .			10c			.00			NOTE
	d. Land Contracts and Installment Sales																		.10d			.00			NOTE
	d. Land Contracts and Installment Sales											.	. .			. .			.10d			.00			Where any line
	e. Insurance Payable to Estate																		.10e			.	00				from	10a		through
	e. Insurance Payable to Estate						. .	. . . . . . . . . .		. . .			. . . . .	.	. .		. .		.10e			.					10L	is	left blank,
																											10L	is	left blank,
	f.	Annuities and Employee Death Benefits Payable to Estate . . .10f																				.00					it will		be	deemed
	g. Other Miscellaneous Property																		.10g			.00					that	NONE is the
	g. Other Miscellaneous Property								. . .		. . . . .	.	. .			. .			.10g			.00			DECLAR ATION
	Nonprobate Assets																										for that line by the
	Nonprobate Assets																										person(s)			signing
	h. Jointly Owned Survivorship – Decedent’s share of property . . 10h																					.00					person(s)			signing
																						.00					Schedule CC.
	i. Decedent’s Share of Survivorship Marital Property																		. 10i			.00
	i. Decedent’s Share of Survivorship Marital Property															. .			. 10i			.00
	. . . . . . . . .j. Insurance Payable to Named Beneficiaries													.	. .		. .		. 10j			.00
	. . . . . . . .k. Transfers During Decedent’s Life (gifts, etc.)													.	. .		. .		. 10k			.00
	. . . . . . . . . . . .L. Other Assets						. .	. . . . . . . . . .		. . .			. . . . .	.		. .	. .		. 10L			.00
	m. Wisconsin GROSS Estate (add lines 10a through 10L)															.	. .		. . . .	.	. . . . . . . . . . . . . .	10m								.00
11.	Fiduciary fees paid or payable to the personal representative or trustee																				. . . . . . . . . . . . . .	11								.00

I-030 (R. 7-21)

2021 Schedule CC	Page 2

PART II Information Required When Requesting a Closing Certificate for Trusts

Complete lines 1 through 10 and sign below.
1. Is a certificate required by the court?	Yes	No

If Yes, enclose a statement from the court verifying that a Closing Certificate is required to close a proceeding.

If No, DO NOT submit Schedule CC. The department only issues a Closing Certificate if a court requires it to close a proceeding.

2.Enclose a copy of the trust instrument with amendments (will/codicils).

3.a. Name(s) of grantor(s)


	Social security number(s)
	b. Name(s) of grantee(s)
	Social security number(s)
4.	On what date was the trust funded?
5.	Was the trust contacted by the IRS and/or Wis. Dept. of Revenue in the last 3 years?	Yes	No If Yes, explain:

6.State reason for closing the trust. If death of beneficiary, provide name of beneficiary, social security number, last address, and date of death.

7. Have you petitioned the court to close the trust?

Yes

If Yes, enclose a copy of the petition. If No, explain why no petition has been filed:

for that line by the person(s) signing Schedule CC.)

Real Estate

.00

Stocks and Bonds

.00

Mortgages, Notes, and Cash

.00

Annuities and Life Insurance

.00

Interest in Partnerships, LLCs, and S Corporations . . .

.00

Other Miscellaneous Property

.00

Total Assets (add lines 9a through 9f)

. . . . .

. . . .

. . . . . . . . . . . .

. . .

10. Fiduciary fees paid or payable to the personal representative or trustee

. . . . . . . . . . . .

. . . 10

Third

Do you want to allow another person to discuss this return with the department (see instructions)?

Yes Complete the following.

Party

Designee’s

Phone

Personal

(

)

identification

Designee name

no.

number (PIN)

.00

I, as fiduciary, declare under penalties of law that I have examined this schedule (including accompanying documents and state-

ments) and to the best of my knowledge and belief it is true, correct, and complete.

Your signature			Date		Daytime phone
					(	)

Fiduciary’s address		City		State		Zip code

PERSON PREPARING FORM if other than the preceding signer	Signature of preparer		Date		Daytime phone
					(	)

Mail to: Wisconsin Department of Revenue • PO Box 8918 • Madison WI 53708-8918

Question	Answer
Form Name	Schedule Cc Form
Form Length	3 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	45 sec
Other names	Request for a Closing Certificate for Fiduciaries, 2021 I-030 Wisconsin Schedule CC

Has the trust filed fiduciary income tax returns wi h Wisconsin in any of the last four years?

If No, provide either a) copies of informal or ormal annual accountings for the past four years, or b) annual schedules show-

ing the trust’s income and expenses for each of he past four years.

Enter the total fair market value of e

ch of the ssets listed below that are held by the trust at the end of the year preceding the

final year of the trust. ( NOTE Where

ny line from 9a through 9f is left blank, it will be deemed that NONE is the DECLARATION