INHERITANCE TAX RETURN RESIDENT DECEDENTSCHEDULE ODEFERRAL/ELECTION OFSPOUSAL TRUSTSESTATE OF:FILE NUMBER: PART A - DEFERRING STATEMENTFor all trust assets reportable for Pennsylvania inheritance tax purposes for which a deferral of tax is chosen, the personal representativeresponsible for filing the return and the trustee(s) of the trust in question hereby acknowledge the department220s Statement of Policy set forthat 61 Pa. Code 247 94.3 concerning any potential termination of the trust under 20 Pa.C.S. 247 7710.1that occurs after the return was filed. PART B 205 ELECTION TO TAX AMOUNTSComplete this section only if making the election to tax the sole use trust.If the election applies to more than one trust or similar arrangement, a separate form must be filed for each trust. This election applies to theTrust (marital, residual A, B, bypass, unified credit, etc.). Enter the description and value of all interests for which the election is made. DESCRIPTIONVALUE Total REV-1649 EX+ (02-16) If more space is needed, use additional sheets of paper of the same size. American LegalNet, Inc. www.FormsWorkFlow.com