ET 36
Rev. 4/12
Reset Form
Estate Tax Unit
1st annual report
P.O. Box 183050
2nd annual report
Columbus, OH 43218-3050
1-(800) 977-7711
Final annual report
tax.ohio.gov
Qualifi ed Farm Property Annual Report
for Estate Tax Valuation (Ohio Revised Code Section 5731.011)
For dates of death prior to Jan. 1, 2013
Estate of: Decedent’s last name
Decedent’s fi rst name and initial
Estate tax fi le number
County in Ohio
Case number
Decedent’s Social Security number
Date of death
Part I – Identifi cation
Date Received by
Ohio Department of Taxation
Name of preparer
Address
City, state and ZIP code
Telephone number of preparer
Designation (please check one):
Attorney
Executor
Administrator(s)
Part II – General Farm Property Information
1. Farm property location. Please provide only the street address, parcel(s) number(s), county and township.
2. Current farm owner(s) name(s)
3. Has the farm property been devoted exclusively for agricultural use, within the meaning of Ohio Revised Code section
5713.30(A) since the date of the decedent’s death?
Yes
No
4. Has any farm property, valued at current agricultural use value (CAUV) in the return, been sold or split off in the last
year?
Yes
No If yes, please provide the following information:
Date of sale or transfer
Sales price $
Total acreage
Sold to
Is this a qualifi ed heir?
Yes
No
If no, please also provide a copy of the most current county auditor’s property tax record card showing the CAUV cal-
culation, parcel number, total acreage and current owner’s name.
Part III – Signature and Verifi cation
Under penalties of perjury, I declare that to the best of my knowledge and belief, the statements made herein are true and correct.
Signature of preparer
Date