Form Et-95 - Claim For Refund Of New York State Estate Tax Page 2
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3ET-95 (10/10) (back)
Instructions
Use this form to claim a refund of New York State estate tax only
Note: If you are giving a person power of attorney to represent
for the following types of claims:
you, attach a completed Form ET-14, Estate Tax Power of Attorney,
if one was not submitted previously. Refer to the instructions on
Protest of denied refund — If the Tax Department has denied or
Form ET-14 for additional information.
adjusted your refund for any reason other than offsets to amounts
owed to other agencies or tax liabilities, you may immediately file a
Preparer information
formal claim for refund.
If you prepared Form ET-95 for the estate and you are not the
Protective claim * — A protective claim is a refund claim that is
executor, fill in the information requested in the preparer section
based on an unresolved issue(s) that involves the Tax Department
on the front of this form and sign where indicated. Include your
or another taxing jurisdiction that may affect your New York State
federal preparer tax identification number (PTIN) or your social
estate tax. The purpose of filing a protective claim is to protect
security number (SSN), and your New York tax preparer registration
any potential overpayment when the statute of limitations is due to
identification number (NYTPRIN) if you are required to have one.
expire.
Paid preparers can be subject to a penalty for failure to conform
Protest of paid bill * — If the bill was based on Form DTF-960,
to certain requirements. See TSB-M-09(10)M, Tax Preparer
Statement of Proposed Audit Changes; Form DTF-966.1, Notice
Registration Program, and TSB-M-10(8)M, Enrolled Agents
and Demand for Payment of Tax Due; or Form DTF-961, Notice of
Excluded from the Definition of Tax Return Preparer for the Tax
Additional Tax Due, enter your 10-digit assessment ID in the space
Preparer Registration Program, for more information.
provided on line 1.
Sign this claim and mail to:
* Note: Your protective claim or protest must be filed within
NYS TAX DEPARTMENT
three years from the time the return was filed or within two years
TDAB — ESTATE TAX AUDIT
from the time the tax was paid, whichever is later.
W A HARRIMAN CAMPUS
If you are requesting a refund as the result of a federal audit
ALBANY NY 12227
change, do not file this form. Instead, for dates of death after
Privacy notification
May 25, 1990, and before February 1, 2000, file Form ET-115, New
The Commissioner of Taxation and Finance may collect and
York State Estate Tax Report of Federal Audit Changes. For dates
maintain personal information pursuant to the New York State Tax
of death on or after February 1, 2000, file Form ET-115.1, New York
Law, including but not limited to, sections 5-a, 171, 171-a, 287,
State Estate Tax Report of Federal Audit Changes.
308, 429, 475, 505, 697, 1096, 1142, and 1415 of that Law; and
For all other claims, for dates of death after May 25, 1990, and
may require disclosure of social security numbers pursuant to
before February 1, 2000, file Form ET-90, New York State Estate
42 USC 405(c)(2)(C)(i).
Tax Return, and write Amended at the top of the return. For dates
This information will be used to determine and administer tax
of death on or after February 1, 2000, file Form ET-706, New York
liabilities and, when authorized by law, for certain tax offset and
State Estate Tax Return, and mark an X in the box on the top of the
exchange of tax information programs as well as for any other
front page of the return.
lawful purpose.
Executor information
Information concerning quarterly wages paid to employees
Enter the name (last name first) and other information for the
is provided to certain state agencies for purposes of fraud
executor of the estate. The term executor includes executrix,
prevention, support enforcement, evaluation of the effectiveness
administrator, administratrix, or personal representative of the
of certain employment and training programs and other purposes
decedent’s estate; if no executor, executrix, administrator,
authorized by law.
administratrix, or personal representative is appointed, qualified,
Failure to provide the required information may subject you to civil
and acting within the United States, executor means any person in
or criminal penalties, or both, under the Tax Law.
actual or constructive possession of any property of the decedent.
This information is maintained by the Manager of Document
If an executor has not been appointed, this form may be signed
Management, NYS Tax Department, W A Harriman Campus,
and filed by a person having knowledge of all the assets in the
Albany NY 12227; telephone (518) 457-5181.
decedent’s estate. This person must also enter his or her name,
address, and social security number in the area provided for the
executor on the front of this form.
Need help?
If the estate has more than one executor, mark an X in the
Internet access:
box, enter the name and other information for the primary
(for information, forms, and publications)
executor (preferably a person residing in New York State) in the
area provided, and attach a list of each of the other executors
with their mailing address and social security number if not
Telephone assistance is available from 8:30
to
A.M.
previously submitted. Submit Letters Testamentary or Letters
4:30
(eastern time), Monday through Friday.
P.M.
of Administration with this form if not previously submitted. It is
Estate Tax Information Center:
(518) 457-5387
sufficient to have one of the coexecutors sign this form.
To order forms and publications:
(518) 457-5431
Attorney/representative information
Text Telephone (TTY) Hotline (for persons with
If you, as the executor of the estate, have authorized a person
hearing and speech disabilities using a TTY):
(518) 485-5082
to represent you regarding the estate, and you would like the
department to contact him or her regarding the estate, enter the
Persons with disabilities: In compliance with the
name (last name first) of the attorney, accountant, or enrolled agent
Americans with Disabilities Act, we will ensure that our
who is representing you. Also enter the firm’s name, address,
lobbies, offices, meeting rooms, and other facilities are
and telephone number in the areas provided, and have the
accessible to persons with disabilities. If you have questions
representative sign in the area provided on the front of this form.
about special accommodations for persons with disabilities, call
the information center.
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