This schedule should be used for all single-life, joint or successive life estate and term-certain calculations. For dates of death prior to 5-1-89, actuarial factors for single-life calculations can be obtained from the Department of Revenue.Actuarial factors can be found in IRS Publication 1457, Actuarial Values, Alpha Volume for dates of death from 5-1-89 to 4-30-99,and in Aleph Volume for dates of death from 5-1-99 and thereafter.Indicate below the type of instrument that created the future interest and attach a copy of it to the tax return. 1.Value of fund from which life estate is payable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$ 2.Actuarial factor per appropriate table . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Interest table rate 2050023.5%0026%00210%002Variable Rate% 3.Value of life estate (Line 1 multiplied by Line 2) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$ 1.Value of fund from which annuity is payable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$ 2.Check appropriate block below and enter corresponding number . . . . . . . . . . . . . . . . . . . . . . . . .002Quarterly (4)002Semi-annually (2)002Annually (1)002Other ( ) 3.Amount of payout per period . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$ 4.Aggregate annual payment, Line 2 multiplied by Line 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5.Annuity Factor (see instructions) Interest table rate 2050023.5%0026%00210%002Variable Rate% 6.Adjustment Factor (See instructions.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7.Value of annuity 205If using 3.5, 6, or 10%, or if variable rate and period payout is at end of period, calculation is Line 4 x Line 5 x Line 6 . . . . . . . . . . . . . . . . . . . . . . . .$If using variable rate and period payout is at beginning of period, calculation is (Line 4 x Line 5 x Line 6) + Line 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$ 002Life or 002Term of Years 002Life or 002Term of Years 002Life or002Term of Years 002Life or002Term of Years 002Life or002Term of YearsREV-1514 EX+ (1-15)SCHEDULE KLIFE ESTATE, ANNUITY & TERM CERTAINESTATE OFFILE NUMBER If more space is needed, use additional sheets of the same size. NAME OF LIFE TENANT DATE OF BIRTH NEAREST AGE ATDATE OF DEATH TERM OF YEARS LIFE ESTATE IS PAYABLE LIFE ESTATE INTEREST CALCULATION 002Life or002Term of Years 002Life or002Term of Years 002Life or002Term of Years 002Life or002Term of Years NAME OF LIFE ANNUITANT DATE OF BIRTH NEAREST AGE ATDATE OF DEATH ANNUITY INTEREST CALCULATION 002Will002Intervivos Deed of Trust002OtherNOTE: The values of the funds that create the above future interests must be reported as part of the estate assets on Schedules A through G ofthe tax return. The resulting life or annuity interest should be reported at the appropriate tax rate on Lines 13 and 15 through 18 of the return. BUREAU OF INDIVIDUAL TAXESPO BOX 280601 HARRISBURG PA 17128-0601 American LegalNet, Inc. www.FormsWorkFlow.com