ESTIMATED FIDUCIARY INCOME TAX PAYMENTS Indiana does not require trusts and estates to make estimated payments. However, fiduciaries electing to make estimated payments must file on this form. Use the worksheet below to compute estimated income tax for each quarter. Extension Payments are due on the fifteenth day of the fourth month following the close of the tax year. Make your check or money order payable to: INDIANA DEPARTMENT OF REVENUE Estimated Fiduciary Income Tax Worksheet A. Total Estimated Fiduciary Income ....................................................................... A. B. Amount Subject to Indiana Income Tax .............................................................. B. C. Total Estimated Income Tax (Line B x .034) ....................................................... C. D. Each Installment (Line C dividedby 4) ................................................................ D. INDIANA DEPARTMENT OF REVENUE FIDUCIARY ESTIMATED TAX AND EXTENSION PAYMENT VOUCHER F I FORM IT-41ES State Form 50217 (R/10-01) D U C Mail this voucher and payment to: Indiana Department of Revenue P.O. Box 6079 Indianapolis, IN 46206-6079 Enter The Amount Of The Estimated Payment Here $ Federal identification Number F DO NOT WRITE ABOVE I Check the boxes to show which payment you are making: D Calendar Year 20___ U Fiscal Year Ending ___/___/___ C I Name of Estate or Trust 1st Quarter Payment I A Name of Fiduciary 2nd Quarter Payment A 3rd Quarter Payment R R Y Street Address 4th Quarter Payment City, State and Zip Code Y Extension Payment American LegalNet, Inc. www.FormsWorkflow.com