Form Et-99 - Estate Tax Waiver Notice

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New York State Department of Taxation and Finance
ET-99
Estate Tax Waiver Notice
(10/08)
For estates of individuals whose date of death is before February 1, 2000
Name of bank, corporation, association, governmental entity, brokerage firm
, insurance, or annuity company holding assets of the decedent
(see instructions)
Decedent’s last name
First name
Middle initial
Date of death
Bonds
Stock
Number of shares of:
Description of each asset and
Name of or payable to
Quantity
Denomination
Common
Preferred
account number
Amount
(see instructions)
Not valid until stamped
As authorized by the Tax Law, the Commissioner of Taxation and Finance hereby waives notice of the time
and place of delivery or transfer by you or your transfer agent of the property described above and consents to the
transfer without retention by you or your transfer agent of any tax and interest that may be assessed against this
estate pursuant to the Tax Law.
Instructions
If you are requesting a waiver for the estate of an individual
Note: Form ET-99 must be attached to and submitted with a
whose date of death was before May 26, 1990, submit this form
completed Form ET-85, New York State Estate Tax Certification,
and attachments in duplicate.
Form ET-90, New York State Estate Tax Return, Form TT-385,
New York State Estate Tax Return, Form TT-102, New York
Privacy notification — The Commissioner of Taxation and Finance may
State Resident Affidavit, or Form TT-141-A, Estate Tax Domicile
collect and maintain personal information pursuant to the New York State
Affidavit.
Tax Law, including but not limited to, sections 5-a, 171, 171-a, 287, 308,
Estate tax waivers are not required for property of the
429, 475, 505, 697, 1096, 1142, and 1415 of that Law; and may require
estate of an individual whose date of death is on or after
disclosure of social security numbers pursuant to 42 USC 405(c)(2)(C)(i).
February 1, 2000.
This information will be used to determine and administer tax liabilities
and, when authorized by law, for certain tax offset and exchange of tax
You must complete all applicable areas.
information programs as well as for any other lawful purpose.
Brokerage firm — If an entire investment portfolio account is
Information concerning quarterly wages paid to employees is provided
to be transferred, enter the name of the brokerage firm and the
to certain state agencies for purposes of fraud prevention, support
decedent information in the areas provided above. Attach to this
enforcement, evaluation of the effectiveness of certain employment and
form a copy of the portfolio showing the itemized assets on the
training programs and other purposes authorized by law.
date of death.
Failure to provide the required information may subject you to civil or
If your broker requires Tax Department validation on the listing
criminal penalties, or both, under the Tax Law.
sheet that identifies the securities in the portfolio, you must
This information is maintained by the Director of Records Management
request that validation when you submit the waiver notice. The
and Data Entry, NYS Tax Department, W A Harriman Campus,
department will return your validated listing sheet with the waiver
notice.
Albany NY 12227; telephone 1 800 225-5829. From areas outside the
United States and outside Canada, call (518) 485-6800.
Bonds — Enter the quantity and denomination of bonds.
Stock — Enter the number of shares of common and/or
preferred stock.
Need help?
Description — Enter a description of the annuity, stock, bond,
Internet access:
life insurance policy, bank account (e.g. savings, checking,
(for information, forms, and publications)
CD), or brokerage account being transferred, and include its
corresponding account or policy number.
Fax-on-demand forms:
1 800 748-3676
Amount — Enter the date-of-death value of the stock or bonds,
To order forms and publications:
1 800 462-8100
bank account, brokerage account, life insurance, or annuity.
Estate Tax Information Center:
1 800 641-0004
Name of or payable to — If a bank account, bond, stock, or
From areas outside the U.S. and
brokerage account is held jointly, enter the names of the joint
outside Canada:
(518) 485-6800
tenants. If it is in the name of the decedent only, enter decedent.
Text Telephone (TTY) Hotline
If there is a beneficiary or annuitant listed, enter his or her name.
(for persons with hearing and
speech disabilities using a TTY):
1 800 634-2110
If the beneficiary or annuitant is the estate, enter estate of
decedent.

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