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Form 712 Page 3 InstructionsStatement of insurer. This statement must be made,

on behalf of the insurance company that issued the

policy, by an officer of the company having access to

the records of the company.

IRS form 712 is the Life Insurance Statement

Part l Decedent---Insured (To be filed by the executor with Form 706, United States Estate (and Generation-Skipping Transfer) Tax Return, or

Form 706-NA, United States Estate (and Generation-Skipping Transfer) Tax Return, Estate of nonresident not a citizen of the United States.)

Page 2 of the FORM 712

Part ll Living Insured (File with Form 709, United States Gift (and Generation-Skipping Transfer) Tax Return. May also be filed with Form 706, United

States Estate (and Generation-Skipping Transfer) Tax Return, or Form 706-NA, United States Estate (and Generation-Skipping

Transfer) Tax Return, Estate of nonresident not a citizen of the United States, where decedent owned insurance on life of another.)

Go to the IRS.gov web site and use the search box for FORM 712

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