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New York State Estate Tax Certification ET-85 - New York
| New York State Estate Tax Certification Form. This is a New York form and can be used in Dept Of Taxation And Finance Statewide . |
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New York State Department of Taxation and Finance For office use only New York State Estate Tax Certification Decedent's last name First name Middle initial ET-85 (1/12) Mark an X if copy of death certificate is attached (see instr.) For an estate of an individual whose date of death is on or after January 1, 2011 Social security number (SSN) Date of death Address of decedent at time of death (number and street) City State ZIP code County of residence If the decedent was a nonresident of New York State on the date of death, mark an X in this box and attach a completed Form ET-141, New York State Estate Tax Domicile Affidavit. Executor - If you are submitting Letters Testamentary or Letters of Administration with this form, indicate in this box the type of letters. Enter L if regular, LL if limited letters. If you are not submitting letters with this form, enter N. Attorney's or authorized representative's last name First name MI Executor's last name First name In care of (firm's name) Address of attorney or authorized representative City State ZIP code Mark an X if POA is attached MI If more than one executor, mark an X in the box (see instr.) Address of executor City Social security number of executor E-mail address of executor State ZIP code SSN or PTIN of attorney or authorized rep. Telephone number Telephone number ( ) ( ) If an attorney or authorized representative is listed above, he or she must complete the following declaration. I declare that I have agreed to represent the executor(s) for the above estate, that I am authorized to receive tax information regarding the estate, and I am (mark an X in all boxes that apply): an attorney a certified public accountant an enrolled agent a public accountant enrolled with the New York State Education Department Signature of attorney or authorized representative Date E-mail address of attorney or authorized representative Did decedent make any New York gifts or transfers in excess of $10,000 in any calendar year after December 31, 1982 and before January 1, 2000?.. If Yes, enter amount ......................................... Also, if Yes, were gift tax returns filed? Yes No Yes No Estimated net estate (including jointly held assets) Real property ..................................... 1 Bank deposits, mortgages, notes and cash 2 Stocks and bonds ............................. 3 Life insurance .................................... 4 Annuities ............................................ 5 Retirement benefits ........................... 6 Miscellaneous assets (cars, boats, coin collections, etc.) ...... 7 8 Add lines 1 through 7 ........................ 8 9 Estimated deductions ....................... 9 10 Estimated net estate (subtract line 9 from line 8) 10 1 2 3 4 5 6 7 Were releases of lien previously issued? .............. If Yes, give date of issuance (mm-dd-yyyy). Was the decedent a member of a partnership?.... Did the decedent have a surviving spouse? ......... If the decedent was a nonresident of New York State, does the estate include real property or tangible personal property having an actual situs in New York State? ....................................... Yes No Yes Yes No No Yes No Mark an X in the box below if a release of lien is requested. Releases of lien are requested -- Submit a separate Form ET-117, Release of Lien of Estate Tax, for each county, cooperative housing corporation, and purchaser (see instructions). A release of lien is not required if the property was held jointly by the decedent and the surviving spouse as the only joint tenants. There is no fee for a release of lien. If releases of lien are required, enter the total number of counties here.................... Certification: The undersigned states that he or she is the duly appointed executor or administrator, or a beneficiary or person having an interest in the above named estate for which no executor or administrator has been appointed. The undersigned further states that he or she has a thorough knowledge of the decedent's assets. This certification estimates the assets of the decedent's estate, and the answers to the above questions are each and every one of them true in every particular. The certification is made to induce the Commissioner of Taxation and Finance to give a release of lien required by the Tax Law. Signature of executor/applicant State of New York, County of Qualified in of Co., Commission expires day , Sworn to before me this , Signature of Notary Public, Commissioner of Deeds, or authorized New York State Department of Taxation and Finance employee (affix stamp below) Mail to: NYS ESTATE TAX, PROCESSING CENTER, PO BOX 15167, ALBANY NY 12212-5167. American LegalNet, Inc. www.FormsWorkFlow.com
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