Estate Tax Form 22 - Certificate Of Estate Tax Payment And Real Property Disclosure For Dates Of Death On Or After November 8, 1990 Page 2

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Estate Tax Form 22
Page 3
Certificate of Estate Tax Payment and Real Property Disclosure
for Dates of Death on or after November 8, 1990
(Section 5731.21 O.R.C.)
Part II
A.
This section is to be completed by the Estate Representative.
Estate of _______________________________________ Case No. __________________
Date of Death ___________________________________ County ____________________
B.
This section is to be completed by the County Auditor.
I hereby verify that the estate taxes shown due on the estate tax return filed on ____________
have been paid in full.
Date Tax Paid to
County Auditor
___________________________________________
County Auditor
By: _______________________________________
Deputy
C.
This section is to be completed by the Probate Judge.
The verification of this certificate by the County Auditor was filed in this Court on the date
stamped hereon.
Date Filed in
Probate Court
___________________________________________
Probate Judge
By: _______________________________________
Deputy

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