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Get Form 706 Rev August 2011

State of a citizen or resident of the United States (see instructions). To be filed for decedents dying after December 31, 2010, and before January 1, 2012. Form Part 1 Decedent and Executor 1a Decedent s first name and middle initial (and maiden name, if any) 1b Decedent s last name 3a County, state, and ZIP code, or foreign country, of legal residence (domicile) at time of death 3b Year domicile established 2 Decedent s social security no. 4 Date of birth 5 Date of death 6b.

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