EFTA00598601.pdf

Fonn 709 Crapartmant el the Tree:fay Intone, Revenue Service General Information United States Gift (and Generation-Skipping Transfer) Tax Return ► Information about Form 709 and its separate instructions is at wwwirs.goviforogosi . (Fa gas made Owing calendar year 2012) ► See Instructions. 1 Donor's first name and middle initial BENJAMIN E 4 rtment number) 2 Donor's last name BLACK CVO to 1545.0:O) 2012 3 Ili filial 5 Legal residence (domicile) NEW YORK 7 Citizenship (see instructions) UNITED STATES 6 City, state, and ZIP or postal code NEW YORK, NY 10021 8 If the donor died during the year, check here ► L_I and enter date of death 9 If you extended the time to file this Form 709, check here ►L 10 Enter the total number of donees listed on Schedule A. Count each person only once. ► 1 11a Have you (the donor) previously filed a Form 709 (or 709-A) for any other year? If 'No," skip line 11b b Has your address changed since you last filed Form 709 (or 709-A)? 12 Gifts by husband or wife to third parties. Do you consent to have the gifts (including generation-skipping transfers) made by you and by your spouse to third parties during the calendar year considered as made one-half by each of you? (see instructions.) (If the answer is "Yes; the following information must be furnished and your spouse must sign the consent shown below. If the answer is 'No,' skip lines 13-18.) 13 Name of consenting spouse 15 Were you married to one another during the entire calendar year? (see instructions) 16 17 Will a gift tax return for this year be filed by your spouse? (If 'Yes,' mail both returns in the same envelope.) 18 Yes No X X 1 14 SSN If 15 is 'No,' check whether L_I married L_I divorced or LJ widowed/deceased, and give date ► Consent of Spouse. I consent to have the gifts (and generation-skipping transfers) made by me and by my spouse to third parties d ring the calendar year considered as made one-half by each of us. We are both aware of the joint and several liability for tax created by the execution of this consent Consenting spouse's signature ► Date ► 19 lime you applied a DSUE amowit received Iran a predeceased spouse to a gilt a arts reported en this or a previous Fenn 709? If "Yes.' complete Schedule. C I Ix 1 Enter the amount from Schedule A, Part 4, line 11 2 Enter the amount from Schedule B, line 3 3 Total taxable gifts. Add lines 1 and 2 4 Tax computed on amount on line 3 (see Table for Computing Gift Tax in instructions) 5 Tax computed on amount on line 2 (see Table for Computing Gilt Tax in instructions) 6 Balance. Subtract line 5 from line 4 7 Applicable credit amount If donor has DSUE amount from predeceased spouse(s), enter amount from Schedule C, line 5; otherwise, see instructions 8 Enter the applicable credit against tax allowable for all prior periods (from Sch. B, line 1, col. C) 9 Balance. Subtract line 8 from line 7. Do not enter less than zero 10 Enter 20% (.20) of the amount allowed as a specific exemption for gifts made after September 8, 1976, and before January 1, 1977 (see instructions) 11 Balance. Subtract line 10 from line 9. Do not enter less than zero 12 Applicable credit Enter the smaller of line 6 or line 11 13 Credit for foreign gift taxes (see instructions) 14 Total credits. Add lines 12 and 13 15 Balance. Subtract line 14 from line 6. Do not enter less than zero 16 Generation-skipping transfer taxes (from Schedule D, Part 3, coL H, Total) 17 Total tax. Add lines 15 and 16 18 Gift and generation-skipping transfer taxes prepaid with extension of time to file 19 If line 18 is less than line 17, enter balance due (see instructions) 20 If line 18 is greater than line 17, enter amount to be refunded 1 2 3 4 5 6 5,120,000. 0. 5,120,000. 1,772,800. 0. 1,772,800. 7 8 9 1,772,800. 1,772,800. 10 11 12 13 14 15 16 17 18 19 20 1,772,800. 1,772,800. 1,772,800. 0. 0. 0. Under penalise or pagury. I dotty., that I have azarnmod this return. Including any accompanying schedules and statements. and to the best or my knowledge and belief. a IS true. correct. and corrplse. Oecia-atich of en:peter (other than donor) is bated col all information a/ which emperer has any knowledge Signature of donor Date Islay he PS discuss this return with the caterer shown below (see instructionsY7 Yes ILI No Paid Preparer Use Only Print/Type preparers name THOMAS TURRIN sirm'anerne► RAICH ENDE MALTER & CO., LLP Firm's widens ► 1 375 BROADWAY NEW YORK, NY 10018 Prep...cep signature Date Check 0 if Sell'OmPleYOZI PTIN P00850244 Hews v.* 11 2336434 ftmom212-944-4433 Fenn 709 (20,2) LHA For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see the instructions for this form. 05rA I 2 EFTA00598601 Form 709 (2012) BENJAMIN E BLACK Computation of Taxable Gifts (Including transfers in trust) (see instructions) Page 2 A Does the value of any item listed on Schedule A reflect any valuation discount? If 'Yes," attach explanation Yes 0 No F- 1 B Check here if you elect under section 52 to treat any transfers made this year to a qualified tuition program as made rata Part 1 - Gifts Subject Only to OM Tax. Gifts less political organization, medical, and educational exclusions. (see instructions) A Item number B • it t=i0 ag: adiriry) • oseramon or •a Of Sac...hies. gtva CUSIP no • It the gift was • • It dosely held entity. gsa EIN C D Donor's adjusted basis of gift E Date of gift F Value at date of gift 0 For split gifts, enter 1/2 of column F H Net transfer (subtract col. G from col. F) Gifts made by spouse - complete only if you we splitting gifts with your spouse and he/she also made gifts. inning this year. See instructions. Attach ex lanatio Total of Part 1. Add amounts from Part 1. column H Part 2 Direct Skips. Gifts that are direct skips and are subject to both gift tax and generation-skipping transfer tax. You must list the gift in chronological order. A i'01 i •—t • mrii.,,e• B • Donee's name and achtwfss neenonmio to Wow, 010,10 • Desahtlon of giff • time gift was of secwitles. gnat CUSIP no. • II dewy held entity. give EIN C 2632(b) election out D Donor's adjusted basis of gift E Date of gift F Value at date of gift 0 For split gifts, enter 1/2 of column F H Net transfer (subtract coL G from col F) Gifts made by spouse - complete only if you are splitting gifts with your spouse and he/she also made gifts. Total of Part 2. Add amounts from Part 2, column H Part 3 I direct Skips. Gifts to trusts that are currently subject to gift tax and may later be subject to generation-s loping transfer tax. You must list these gifts A rem MIII::ef B • =.ter;70.2:1 " PA) • Dasottlon of gift • n the gift was of sociNtIoS. gin CUSP no • m closely hold entity. give EIN C 2632(c) election D Donors adjusted basis of gift E Date of gift F Value at date of gift G For split gifts, enter 1/2 of column F H Net transfer (subtract col. G from cot F) SEE CONTINUATION SHEET Gift made by whites - nnmnINta _ _. if Vail ana anlittinn nine with wait gamic% and hakha akn mark nifty DQ II a•der. Total of Part 3. Add amounts from Part 3, column H al more space Is needed, attach additional statements.) 2105511 1-21-12 0.5,120,000. 3 Ecim 7O9 s',2012, EFTA00598602 Form 709 (2012) BENJAMIN E BLACK SCHEDULE A PART 3 CONTINUATION SHEET Part 3 - Indirect Skips. Gifts to trusts that are currently subject to grit tax and may later be subject to generation-skipping transfer lax. You must ist these gifts in chronological order. A Item number B • • Donee's name and address • Relationship to donor (if any) • Description of gift • If the gift was of securities, give CUSIP no. • If closely held entity, give EIN C 2632(c) election Donor's D adjusted basis of gift E Date of gift F Value at date of gift o For split gifts, enter 1/2 of column F H Net transfer (subtract col. C from col. F) 1 THE YGGDRASIL TRUST 102-76-7664 LEON D. BLACK, TRUSTEE 760 PARK AVENUE NEW YORK, NY 10021 TRUST PROMISSORY NOTE DUE TO BENJAMIN E. BLACK FROM THE BEB 2011 TRUST SEE ATTACHED TRUST AGREEMENT [X] 5,120,000. 12/20/12 5,120,000. 5,120,000. Total of column ft Pio 5,120,000. 05-01-12 Form 709 oom EFTA00598603 Form 709 (2012) BENJAMIN E BLACK Part 4 - Taxable Gift Reconciliation Page 3 I Total value of gifts of donor. Add totals from column H of Parts 1, 2, and 3 2 Total annual exclusions for gifts listed on line 1 (see instructions) 3 Total included amount of gifts. Subtract line 2 from line 1 Deductions (see instructions) 4 Gifts of interests to spouse for which a marital deduction will be claimed, based on item numbers of Schedule A 5 Exclusions attributable to gifts on line 4 8 Marital deduction. Subtract line 5 from ire 4 7 Charitable deduction, based on item nos. less exclusions 8 Total deductions. Add lines 6 and 7 9 Subtract line 8 from line 3 10 Generation-skipping transfer taxes payable with this Form 709 (from Schedule El, Part 3, coL H, Total) 11 Taxable gifts. Add lines 9 and 10. Enter here and on page 1, Part 2 -Tax Computation, line 1 Terminable Interest (GTIP) Marital Deduction. (see instructions for Schedule A, Part 4, line 4.) if a trust (or other property) meets the requirements of qualified terminable interest property under section 2523(f), and: a. The trust (or other property) is listed on Schedule A, and b. The value of the trust (or other property) is entered in whole or in part as a deduction on Schedule A, Part 4, line 4, then the donor shall be deemed to have made an election to have such trust (or other property) treated as qualified terminable interest property under section 2523(f). If less than the entire value of the trust (or other property) that the donor has included in Parts 1 and 3 of Schedule A is entered as a deduction on line 4, the donor shall be considered to have made an election only as to a fraction of the trust (or other property). The numerator of this fraction is equal to the amount of the trust (or other properly) deducted on Schedule A, Part 4, line 6. The denominator is equal to the total value of the trust (or other property) listed in Parts 1 and 3 of Schedule A. 5,120,000. 2 3 0. 5,120,000. 8 9 10 11 5,120,000. 5,120,000. If you make the OTIP election, the terminable interest property involved will be included in your spouse's gross estate upon his or her death (section 2044). See instructions for line 4 of Schedule A. If your spouse disposes (by gift or otherwise) of all or part of the qualifying life income interest, he or she will be considered to have made a transfer of the entire property that is subject to the gift tax. See Transfer of Certain Life Estates Received From Spouse in the instructions. 12 Election Out of QTIP Treatment of Annuities Check here it you elect under section 2523(9(6) not to treat as qualified terminable interest property any joint and survivor annuities that are reported on Schedule A and would otherwise be treated as qualified terminable interest property under section 2523(1). See instructions. Enter the item numbers from Schedule A for the annuities for which you are making this electron Ile• SCHEDULE B1 If you answered 'Yes' on line Ila of page 1, Paft 1, see the instructions for completing Schedule B. If you a swered "No," skip to the Tax Computation on page 1 (or Schedules C or D, if applicable). Complete Schedule A before beginning Schedule B. See instructions for recalculation of the column C amounts. Attach calculations. Gifts From Prior Periods A Calendar year or calendar quarter (see instructions) 2010 B Internal Revenue office where prior return was filed C Arrant of apoocaOte wide (rrialeo crew) agoinea get tax lor panels ai Deoerreer 31. 1976 D Arnowil of specific caerrplion lOr Oiler Wads eating Odour January 1. 1977 E Amount of taxable gifts CINCINNATI, OH 0. 0. 1 Totals for prior periods 1 0. 0. 2 Amount, if any, by which total specific exemption, ire 1, column El is more tha $30,000 3 Total amount of taxable gifts for prior periods. Add amount on line 1, column E and amount, if any, on line 2. Enter here and on page 1, Part 2 - Tax Computation, line 2 (If more space Is needed, attach additional statements.) 205521 11-21-12 2 3 0. (-cn 709 120121 5 EFTA00598604 Form 709 (2012) BENJAMIN E BLACK Page 4 Deceased pousal Unused Exclusion (DSUE) Amount Provide the following information to determine the DSUE amount and applicable credit received from prior spouses. Complete Schedule A before beginning Schedule C. A Name of Deceased Spouse (dates of death after December 31.2010 only) B Date of Death C Portability Election Made? D If 'Yes; DSUE Amount Received from Spouse E DSUE Amount Applied by Donor to Lifetime Gifts (current and prior gifts) F Date of Gift(s) (enter as mmiddiyy for Part 1 and as yyyy for Part 2) a RESERVED Yes I No Part 1 - DSUE RECEIVED FROM LAST DECEASED SPOUSE I Part 2 - DSUE RECEIVED FROM PREDECEASED SPOUSEIS1 TOTAL (for all DSUE amounts applied for Part 1 and Part 2) I Donor's basic exclusion amount (see in tractions) 2 Total from column E, Parts 1 and 2 3 Reserved 4 Add lines 1 and 2 5 Applicable credit on amount in ine 4 (See Table for Computing Gift Tax in the instructions). Enter here and on line 7, Part 2 - Tax Computation 6 Reserved 7 Reserved 8 Reserved 9 Reserved 10 Reserved SCHEDULE DI Computation of Generation-Skipping Transfer Tax Note. Inter vivos direct skips that are completely excluded by the GST exemption must still be fully reported (including value and exem lions laimed) on Schedule D. Part 1 - Generation-Skipping Transfers A Item No. (from Part 2, Schedule A, col. A) B Value (from Schedule A. Part 2. col. H) C Nontaxable Portion of Transfer D Net Transfer (subtract col. C from col. B) 1 2 3 4 5 6 7 8 9 10 Gifts made by spouse (fo gift splitting only) (If more space is needed, attach additional statements.) Form 709 (2012) 203531 11-21-12 6 EFTA00598605 Form 709 (2012) BENJAMIN E BLACK Part 2 - GST Exemption Reconciliation (Section 2631) and Section 2652(a)(3) Election Page 5 Check here PP. I l if you are making a section 2652(aX3) (special °TIP) election (see instructions) Enter the item numbers from Schedule A of the gifts for which you are making this election IP. 1 Maximum allowable exemption (see instructions) 2 Total exemption used for periods before filing this return 3 Exemption available for this return. Subtract line 2 from line 1 4 Exemption claimed on this return from Part 3, column C total, below 5 Automatic allocation of exemption to transfers reported on Schedule A, Part 3 (see instructions) 6 Exemption allocated to transfers not shown on line 4 or 5, above. You must attach a "Notice of Allocation? (see instructions) 7 Add tines 4, 5, and 6 8 Exemption available for future transfers. Subtract line 7 from line 3 Part 3 -Tax Computation Item No. (from Schedule D, Part 1) 8 Net Transfer (from Sated* D, Part 1, col 0) C GST Exemption Allocated D Divide col. C by col. 8 E Inclusion Ratio (Subtract col. D from 1.000) F Maximum Estate Tax Rate e Applicable Rate (multiply col. E by col. F) li Generation-Skipping Transfer Tax (multiply col. 8 by col. G) 35% (.35) 35% (.35) 35% (.35) 35% (.35) 35% (.35) 35% (.35) 1 5,120,000. 2 3 5,120,000. 4 5 6 5,120,000. 7 5,120,000. 8 0. Gifts mane by spouse (for gift spitting only) 35% (.35) 35% (.35) 35% (.35) 35% (.35) 35% (.35) 35%4;35) Total exemption claimed. Enter here and on Part 2, lin 4, above. May not exceed Part 2, line 3, above Total generation-skipping transfe tax. Enter he e; on page 3, Schedule A, Part 4, line 10; and on page 1. Pan 2 - Tax Computation, line 16 (If more space is needed, attach additional statements.) F am 709 (201z 205532 11-21-12 7 EFTA00598606