Fs Form 5336 - Disposition Of Treasury Securities Belonging To A Decedent'S Estate Being Settled Without Administration - U.s. Department Of The Treasury Page 6
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10INSTRUCTIONS
ALL securities belonging to the decedent’s estate must be included in this transaction. If the redemption and/or par value of all
securities and/or related payments owned by the decedent as of the date of death exceeds $100,000, Treasury regulations
require that the estate be administered through the court; in this event, this form may not be used. We will recognize only ONE
voluntary representative to act at any time on behalf of the decedent's estate.
USE OF FORM – A voluntary representative is a person qualified by the Department of the Treasury to request disposition of United
States Treasury Securities (Treasury Bills, Notes, Bonds, TIPS, Floating Rate Notes, Savings Bonds, and Savings Notes) and/or related
payments (not exceeding $100,000) that belong to a decedent’s estate if the estate is not being administered through the court. A
voluntary representative of the decedent’s estate must complete this form to request:
•
Payment on behalf of persons entitled to the estate according to the law of the jurisdiction in which the decedent was domiciled
at the date of death.
•
Transfer of unmatured marketable securities to a financial institution, broker, or dealer account in MY name to be sold on behalf
of all persons entitled.
•
Distribution of the securities to the persons entitled to the estate according to the law of the jurisdiction in which the decedent
was domiciled at the date of death.
If you need more space for any item, use a plain sheet of paper or make a photocopy of the relevant section, and attach to the form.
PART A – ESTATE INFORMATION
Provide the requested information regarding the decedent. If more than one deceased person is named on the securities, provide the
information for the person who died last. Submit certified copies of the death certificates for all deceased registrants.
Insert the following information:
•
Decedent’s name.
•
Decedent’s Social Security Number.
•
Jurisdiction (state, district, or territory) of decedent’s last legal residence.
By signing this form you certify that the decedent’s estate has not been and will not be administered through a court or settled in
accordance with the law of the decedent’s domicile (such as Summary Administration, Small Estates Act, Texas Muniment of Title,
Louisiana Judgment of Possession, etc.). If a legal representative has been appointed by the court, if the estate has been
administered and is now closed, or if you have a document establishing entitlement to the estate (other than an unprobated
will), do not complete this form. Instead, send the securities and all evidence and/or documentation concerning the estate to
the appropriate address in “WHERE TO SEND,” near the end of this form. Upon review of the submission, we will provide
additional instructions, if necessary.
PART B – PERSON QUALIFIED TO ACT AS VOLUNTARY REPRESENTATIVE
Title 31, Code of Federal Regulations (CFR), provides that disposition of a decedent’s estate that is not being administered through the
court will be made upon the request of a person qualified to act as voluntary representative. To act as voluntary representative, you must
be competent and eighteen years of age or older and be eligible according to the Order of Precedence for Voluntary Representative.
Starting at the top, read down the Order of Precedence until you find the situation that applies to you. Mark the box that represents your
eligibility to act as voluntary representative. (If the last box is marked, show your relationship to the decedent.) For example, if the
decedent leaves a competent surviving spouse and children (over the age of eighteen), the competent surviving spouse must complete
this form. If there is no competent surviving spouse, one of the children (over the age of eighteen) must complete this form.
NOTE: Only a blood relative or surviving spouse of the decedent can complete and submit this form. This restriction applies even to a
person acting as an attorney-in-fact. The estate may need to be settled in accordance with the laws of the decedent’s domicile (such as
Summary Administration, Small Estates Act, Texas Muniment of Title, Louisiana Judgment of Possession, etc.)
NOTE: This form cannot be used to distribute bonds or to make payment to a trust.
PART C – TYPE OF DISPOSITION
Title 31, Code of Federal Regulations (CFR), provides that a voluntary representative may request one of the following:
•
Payment to the voluntary representative on behalf of all persons entitled to share in the decedent’s estate (except for
unmatured marketable securities).
•
Transfer of unmatured marketable securities to a financial institution, broker, or dealer account in MY name to be sold on
behalf of all persons entitled. (Continue to Part E.)
•
Distribution of securities and/or related payments to the persons entitled according to the law of the jurisdiction in which the
decedent was domiciled at the date of death.
Mark the appropriate box. If you are requesting payment, continue to Part D. If you are requesting distribution, skip Part D and continue
to Part E.
FS Form 5336
Department of the Treasury | Bureau of the Fiscal Service
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