Form 700-Sov - Estate Tax Statement Of Value For Lien Discharge For Certain Nontaxable Estates - 2013

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2013
MAINE REVENUE SERVICES
99
ESTATE TAX STATEMENT OF VALUE FOR LIEN DISCHARGE
FOR CERTAIN NONTAXABLE ESTATES
700-SOV
*1311000*
Estate
of:
First Name
M.I.
Last Name
Date of Death:
Social Security Number (SSN)
MM
DD
YYYY
Residency Status:
Resident
Nonresident
State of Residency (abbreviate)
If married/widow/widower, enter spouse’s name:
and SSN:
Personal Representative or Person in Possession of Decedent’s Property:
First Name
M.I.
Last Name
SSN
Telephone Number
Fax Number
Street Address
City/Town
State
ZIP Code
Email Address
Authorized Representative: If you would like to authorize a representative to act on your behalf, complete this section. Otherwise, sign and date this return at the bottom and
mail to Maine Revenue Services.
Authorization is granted to the representative listed below to receive copies of confi dential tax information related to this statement under 36 MRSA § 191 and to act as the estate’s
representative before Maine Revenue Services.
Firm Name (or preparer, if self-employed)
Contact Person: First Name
M.I.
Last Name
Contact Person Mailing Address
City/Town
State
ZIP Code
Telephone Number
Email Address
Fax Number
I declare that the value of the Decedent’s Maine gross estate is $2 million or less. I understand that the Maine gross estate includes all property
ev-
erywhere held by the Decedent that is included in the federal gross estate plus Maine elective property and taxable gifts made within 1 year of death.
Under penalties of perjury, I declare that I have examined this statement and to the best of my knowledge and belief it is true, correct and complete.
Declaration of preparer is based on all information of which preparer has any knowledge.
Signature of Personal Representative
Date
Signature of Preparer other than Personal Representative
Preparer’s SSN or PTIN
Date
Firm name (or preparer if self-employed)
Preparer Address
Preparer Telephone Number

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