Form Et-85 - New York State Estate Tax Certification
ADVERTISEMENT
1ET-85
New York State Department of Taxation and Finance
New York State Estate Tax Certification
For office use only
(4/14)
For an estate of an individual who died on or after April 1, 2014
Decedent’s last name
First name
Middle initial
Social security number (SSN)
Mark an X if
Address of decedent at time of death
Date of death
(number and street)
copy of death
certificate is
attached
(see instr.)
City
State
ZIP code
County of residence
If the decedent was a nonresident of New York State on the date of death, mark an X in this box and attach a
completed Form ET-141, New York State Estate Tax Domicile Affidavit.
Executor - If you are submitting Letters Testamentary or Letters of Administration with this form, indicate in this box
the type of letters. Enter L if regular, LL if limited letters. If you are not submitting letters with this form, enter N. ..........
Attorney’s or authorized representative’s last name
First name
MI
Executor’s last name
First name
MI
In care of
If more than one executor,
E-mail address of executor
(firm’s name)
Mark an X
if POA is
mark an X in the box
(see instr.)
attached
Address of attorney or authorized representative
Address of executor
City
State
ZIP code
City
State
ZIP code
SSN or PTIN of attorney or authorized rep.
Telephone number
Social security number of executor
Telephone number
(
)
(
)
If an attorney or authorized representative is listed above, he or she must complete the following declaration.
I declare that I have agreed to represent the executor(s) for the above estate, that I am authorized to receive tax information regarding the estate, and I am
(mark an X in all boxes that apply):
an attorney
a certified public accountant
an enrolled agent
a public accountant enrolled with the New York State Education Department
Signature of attorney or authorized representative
Date
E-mail address of attorney or authorized representative
Estimated net estate
(including jointly held assets)
Were releases of lien previously issued? ..............
Yes
No
1 Real property .....................................
1
2 Bank deposits, mortgages, notes and cash
2
If Yes, give date of issuance
.
(mm-dd-yyyy)
3 Stocks and bonds .............................
3
Was the decedent a member of a partnership? ....
Yes
No
4 Life insurance ....................................
4
5 Annuities ............................................
5
Did the decedent have a surviving spouse? .........
Yes
No
6 Retirement benefits ...........................
6
If the decedent was a nonresident of New York
7 Miscellaneous assets
State, does the estate include real property or
......
7
(cars, boats, coin collections, etc.)
tangible personal property having an actual
8 Taxable gifts
8
.............
(see instructions)
situs in New York State? .......................................
Yes
No
9 Add lines 1 through 8 ........................
9
10 Estimated deductions ....................... 10
11 Estimated net estate
11
(subtract line 10 from line 9)
Mark an X in the box below if a release of lien is requested.
Releases of lien are requested — Submit a separate Form ET-117, Release of Lien of Estate Tax, for each county, cooperative housing corporation,
and purchaser (see instructions). A release of lien is not required if the property was held jointly by the decedent and the surviving spouse as the only
joint tenants. There is no fee for a release of lien.
If releases of lien are required, enter the total number of counties here ....................
State of
, County of
,
Certification: The undersigned states that he or she is the duly appointed executor or administrator, or a
beneficiary or person having an interest in the above named estate for which no executor or administrator has
Sworn to before me this
day
been appointed. The undersigned further states that he or she has a thorough knowledge of the decedent’s
of
,
assets. This certification estimates the assets of the decedent’s estate, and the answers to the above
questions are each and every one of them true in every particular. The certification is made to induce the
Commissioner of Taxation and Finance to give a release of lien required by the Tax Law.
Signature of Notary Public, Commissioner of Deeds,
or authorized New York State Department of Taxation
Signature of executor/applicant
and Finance employee (affix stamp below)
Mail to: NYS ESTATE TAX, PROCESSING CENTER, PO BOX 15167, ALBANY NY 12212-5167.
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial