SCHEDULE K-1 (Form 1041) Beneficiary's Share of Income, Deductions, Credits, etc 2021 SCHEDULE K-1 (Form 1041) Beneficiary's Share of Income, Deductions, Credits, etc 2021 Summary: This is an example of Schedule K-1 (Form 1041) 2020. The following items are completed. "A. Estate's or trust's employer identification number" field contains 10–0123456 "B. Estate's or trust's name" field contains Estate of John R. Smith "C. Fiduciary's name, address, city, state and ZIP code" field contains Charles R. Smith, Executor, 6406 Mayflower Street, Juneville, ME 00000 "F. Beneficiary's identifying number" field contains 123-00-6789 "G. Beneficiary's name, address, city, state, and ZIP code" field contains James Smith, 6407 Mayflower Street, Juneville, ME 00000 "H. Checkbox Domestic beneficiary" checkbox checked "1. Interest income" field contains 300 "2a. Ordinary dividends" field contains 100 "2b. Qualified dividends" field contains 100 "5. Other portfolio and nonbusiness income" field contains 1,600
