Form Et 4 - Ohio Nonresident Estate Tax Return (Ohio Revised Code Section 5731.19)
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1
2ET 4
Rev. 4/12
Estate Tax Unit
1-(800) 977-7711
Reset Form
tax.ohio.gov
Ohio Nonresident Estate Tax Return (Ohio Revised Code Section 5731.19)
Estates with a date of death July 1, 1983 – Dec. 31, 2012
This form must accompany estate tax form 2
File in duplicate with the County Probate Court in Ohio
Taxable
Nontaxable
Check one:
Estate of: Decedent’s last name
Decedent’s fi rst name and initial
Date of death
County in Ohio where property located
State of domicile
Decedent’s Social Security number
No
Yes
Did decedent ever reside in Ohio?
If “yes,” state place, dates and duration of residence.
Computation
(A)
1. Total Ohio tax on property in all jurisdictions ......................................................................................$
(from page 1, line 6 of estate tax form 2)
(B)
2. Total gross value of all property having a taxable situs in Ohio ..........................................................$
(real property and tangible personal property)
(C)
3. Total gross value of property in all jurisdictions ..................................................................................$
(from page 1, line 1 of estate tax form 2)
(B)
(A)
X
=
4. Ohio estate tax due
$
(C)
5. Less: Previous payments (exclude any interest and penalty paid).....................................................$
6. Balance due (
) ..................$
if amount on line 5 is less than amount on line 4, enter difference as balance due
7. Overpayment (
).............$
if amount on line 5 is greater than tax amount on line 4, enter difference as a refund
Declaration
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and
to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than decedent’s personal
representative or person in possession of property is based on all information of which preparer has any knowledge.
Name of attorney representing the estate
Address (number and street, city, state and ZIP code)
Telephone number
Name of executor/administrator(s)
Address (number and street, city, state and ZIP code)
Telephone number
Signature of executor/administrator(s)
Date
Signature of preparer
Date
Date Filed with Probate Court
Distribution of Subdivisions’ Share of Tax
Date Received by
Ohio Department of Taxation
(R.C. Section 5731.48 and 5731.50)
Percentage
City, Village or Township
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