L-9
L-9
RESIDENT DECEDENTS ONLY
Decedent’s Name:
_____________________________________________________________________________________________
(Last)
(First)
(MI)
Decedent’s SS No.
_______________________________
Date of Death
________________________________________County of Residence ___________________________________
(mm/dd/yy)
1.Submit a copy of Letters Testamentary or of Administration
Testate
2.If the decedent died testate, submit a copy of his/her will and any codicils thereto.
Intestate
3.Submit a copy of any trust agreements.
For decedent’s dying after December 31, 2001, will the decedent’s gross estate for Federal estate tax
purposes under the provisions of the Internal Revenue Code in effect on December 31, 2001 exceed
Yes
$675,000 or will a NJ Estate Tax be payable? If Yes, this form may NOT be used.
No
(Gross estate $ _____________ Deductions $ _____________ Adjusted taxable gifts $ _____________)
Full Market Value
Full Assessed Value
Description of New Jersey Real Estate
at Date of Death
for Year of Death
Street and Number
Municipality
Lot
Block:
County:
Owner(s) of Record:
(If decedent owned a fractional interest state how held and fractional value thereof).
Amount of Mortgage Balance (if any)
$____________________________________
Street and Number
Municipality
Lot
Block:
County:
Owner(s) of Record:
(If decedent owned a fractional interest state how held and fractional value thereof).
Amount of Mortgage Balance (if any)
$____________________________________
RIDERS MAY BE ATTACHED WHERE NECESSARY