Form Et-14 - Estate Tax Power Of Attorney (Page 2 of 2) in pdf

ET-14 (1/00) (back)

8. Declaration of representative (to be completed by representative)

I agree to represent the above-named executor in accordance with this power of attorney.

I affirm that my representation will not violate the provisions of the Ethics in Government Act restricting appearances by former Tax

Department employees. I have read a summary of these restrictions reproduced in the instructions to this form.

I am (indicate all that apply):

1 an attorney-at-law licensed to practice in New York State

2 a certified public accountant duly qualified to practice in New York State

3 a public accountant enrolled with the New York State Education Department

4 an agent enrolled to practice before the Internal Revenue Service

5 Other

Designation

Preparer’s tax identification number

(insert appropriate number

(PTIN) or representative’s

Signature

Date

from above list)

social security number

Instructions

copies of notices to be sent to a different representative named in section 2, or a

General instructions

representative on a previously filed power of attorney, enter the name of the

Purpose of form. Use Form ET-14, Estate Tax Power of Attorney, as evidence

representative you want to receive copies of notices. If you do not want copies of

that the individual(s) named as representative(s) have the authority to obligate,

notices to go to any of your representatives, write none.

bind, or appear on your behalf before the New York State Department of Taxation

6. Executor signature

and Finance’s Division of Taxation (the Department). The individual(s) named as

representative(s) may receive confidential information concerning estate tax.

Form ET-14 must be signed and dated by the executor. The Department may

Unless you indicate otherwise, he or she may also perform any and all acts you

require the executor, or his or her representative, to provide identification and

can perform, such as consenting to extending the time to assess tax or executing

evidence of his or her authority to execute this power of attorney.

consents agreeing to a tax adjustment. However, authorizing someone to

The term executor includes executrix, administrator, administratix, or personal

represent you by a power of attorney does not relieve you of your tax obligations.

representative of the decedent’s estate; if no executor, executrix, administrator,

A photocopy or facsimile transmission (fax) is acceptable.

administratix, or personal representative is appointed, qualified, and acting within

the United States, executor means any person in actual or constructive

2. Representative information

possession of any property of the decedent.

Enter your representative’s name, mailing address (including firm name if

8. Declaration of representative

applicable), and telephone number. Also include an e-mail address and fax

number, if applicable. Only individuals may be named as representatives. You

Your representative(s) must sign and date this declaration. The representative(s)

may not appoint a firm to represent you.

must also insert the appropriate number designation in the box to indicate his or

her profession or capacity to represent you before the Department.

All representatives appointed will be deemed to be acting severally, unless

Representation for former government employees

Form ET-14 clearly indicates that all representatives are required to act

jointly.

The Ethics in Government Act bars a government employee from appearing or

practicing before his or her former agency for two years after leaving public

3. Estate information

service, and prohibits for life his or her participation in any matter that he or she

Limitations. This power of attorney authorizes the representative(s) you

was directly and personally involved with while a government employee.

appointed to act for you without any restrictions for the estate indicated. If you

Need help?

intend to limit the authority, check the box. Attach a complete explanation (signed

Telephone assistance is available from 8:30 a.m. to 4:25 p.m. (eastern time), Monday through Friday. For tax

and dated), stating the specific restrictions.

information, call toll free 1 800 641-0004. If busy, call 1 800 225-5829. To order forms and publications, call

toll free 1 800 462-8100. From areas outside the U.S. and outside Canada, call (518) 485-6800.

4. Retention/revocation of prior Power(s) of Attorney

Fax-on-demand forms ordering system - Most forms are available by fax 24 hours a day, 7 days a week. Call

toll free from the U.S. and Canada 1 800 748-3676. You must use a Touch-Tone phone to order by fax. A fax

The filing of this power of attorney automatically revokes all earlier power(s) of

code is used to identify each form.

attorney on file with the Tax Department for the estate covered by this form. If

Internet access -

there is an existing power(s) of attorney that you do not want to revoke, check the

Access our website for forms, publications, and information.

box on this line and attach a signed and dated copy of the power(s) of attorney

Hotline for the hearing and speech impaired - If you have access to a telecommunications device for the

you want to remain in effect.

deaf (TDD), you can get answers to your New York State tax questions by calling toll free from the U.S. and

Canada 1 800 634-2110. Assistance is available from 8:30 a.m. to 4:25 p.m. (eastern time), Monday through

You may not partially revoke a previously filed power of attorney. If a previously

Friday. If you do not own a TDD, check with independent living centers or community action programs to find

out where machines are available for public use.

filed power of attorney has more than one representative and you do not want to

Persons with disabilities - In compliance with the Americans with Disabilities Act, we will ensure that our

retain all the representatives on that previously filed power of attorney, you must

lobbies, offices, meeting rooms, and other facilities are accessible to persons with disabilities. If you have

indicate on the new power of attorney the representative(s) that you want to

questions about special accommodations for persons with disabilities, please call the information numbers listed

retain.

above.

Mailing address - If you need to write, address your letter to: NYS Tax Department, Taxpayer Assistance

If you want to revoke an existing power of attorney and do not want to name a

Bureau, W A Harriman Campus, Albany NY 12227.

new representative, send a copy of the previously executed power of attorney to

the Department. Write revoke across the copy of the power of attorney, and sign

Privacy notification

and date the form. If you do not have a copy of the power of attorney you want to

The right of the Commissioner of Taxation and Finance and the Department of Taxation and Finance to collect

revoke, send a statement to the Department office where you filed the power of

and maintain personal information, including mandatory disclosure of social security numbers in the manner

required by tax regulations, instructions, and forms, is found in Articles 22, 26, 26-A, 26-B, 30, 30-A, and 30-B of

attorney. The statement of revocation must indicate that the authority of the

the Tax Law; Article 2-E of the General City Law; and 42 USC 405(c)(2)(C)(i).

power of attorney is revoked, and must be signed and dated by the taxpayer.

The Tax Department uses this information primarily to determine and administer tax liabilities due the state and

Also, the name and address of each recognized representative whose authority

city of New York and the city of Yonkers. We also use this information for certain tax offset and exchange of tax

is revoked must be listed.

information programs authorized by law, and for any other purpose authorized by law.

Information concerning quarterly wages paid to employees and identified by unique random identifying code

A representative can withdraw from representation by filing a statement with the

numbers to preserve the privacy of the employees’ names and social security numbers is provided to certain

Department. The statement must be signed and dated by the representative and

state agencies, for research purposes to evaluate the effectiveness of certain employment and training

programs.

must identify the name and address of the executor and estate from which the

representative is withdrawing.

Failure to provide the required information may subject you to civil or criminal penalties, or both, under the Tax

Law.

5. Notices and decisions

This information is maintained by the Director of the Registration and Data Services Bureau, NYS Tax

Department, Building 8 Room 924, W A Harriman Campus, Albany NY 12227; telephone 1 800 225-5829. From

Only one representative may receive copies of statutory notices. Notices will

areas outside the U.S. and outside Canada, call (518) 485-6800.

automatically be sent to the first representative listed. However, if you want

Form Et-14 - Estate Tax Power Of Attorney Page 2

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