Form ET12a "Application for Consent to Transfer Property or Other Interest of a Nonresident Decedent" - Ohio

What Is Form ET12a?

This is a legal form that was released by the Ohio Department of Taxation - a government authority operating within Ohio. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on May 1, 2012;
  • The latest edition provided by the Ohio Department of Taxation;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form ET12a by clicking the link below or browse more documents and templates provided by the Ohio Department of Taxation.

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Download Form ET12a "Application for Consent to Transfer Property or Other Interest of a Nonresident Decedent" - Ohio

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Ohio
I
Department of
Taxation
ET 12A
Rev. 5/12
Reset Form
Estate Tax Unit
P.O. Box 183050
Columbus, OH 43218-3050
1-(800) 977-7711
tax.ohio.gov
Application for Consent to Transfer Property or Other Interest
of a Nonresident Decedent (Ohio Revised Code 5731.40)
For dates of death July 1, 1983 – Dec. 31, 2012
Name of decedent
Date of death
Address (at time of death)
Social Security number
Ohio county and case number
Decedent’s state of domicile
The description and approximate value of the property to be transferred:
Type of Account and Number
Value as of Date of Death
(Accounts) Bank
or
(Including Interest)
(Stocks) No. of Shares
Denomination of Bonds
Company and Type of Stock
1.
2.
3.
Please complete this section in its entirety so that this application may be processed. If needed,
please have the beneficiary or legal representative
complete this section before it is submitted.
Please complete the following. Attach documentation when necessary.
1. Completed tax releases, estate tax form 14A, for each institution.
2. Letters of appointment were issued to
3. For any joint and survivorship property, state the name and relationship of survivor to decedent
4. Did the decedent leave a will? Yes
No
If yes, please attach a copy including all codicils.
Ohio
I
Department of
Taxation
ET 12A
Rev. 5/12
Reset Form
Estate Tax Unit
P.O. Box 183050
Columbus, OH 43218-3050
1-(800) 977-7711
tax.ohio.gov
Application for Consent to Transfer Property or Other Interest
of a Nonresident Decedent (Ohio Revised Code 5731.40)
For dates of death July 1, 1983 – Dec. 31, 2012
Name of decedent
Date of death
Address (at time of death)
Social Security number
Ohio county and case number
Decedent’s state of domicile
The description and approximate value of the property to be transferred:
Type of Account and Number
Value as of Date of Death
(Accounts) Bank
or
(Including Interest)
(Stocks) No. of Shares
Denomination of Bonds
Company and Type of Stock
1.
2.
3.
Please complete this section in its entirety so that this application may be processed. If needed,
please have the beneficiary or legal representative
complete this section before it is submitted.
Please complete the following. Attach documentation when necessary.
1. Completed tax releases, estate tax form 14A, for each institution.
2. Letters of appointment were issued to
3. For any joint and survivorship property, state the name and relationship of survivor to decedent
4. Did the decedent leave a will? Yes
No
If yes, please attach a copy including all codicils.
ET 12A
Rev. 5/12
Page 2
5. Was the decedent engaged in a business in Ohio during the last five years prior to death? Yes
No
If yes, did the decedent own the business? Yes
No
Describe the decedent’s participation in the business
6. Where was the decedent registered to vote during the last five years prior to death?
7. Other information available to support place of domicile (i.e., place of car registration and driver’s license)
I hereby certify that all statements made are correct to the best of my knowledge and belief.
(Please provide name, address and telephone number of person filing this application.)
Signature and title of applicant
(executor, administrator, survivor or attorney for same)
Address
City, state and ZIP code
Telephone number
Date submitted
Instructions for Completing Estate Tax Form 12A
Note: A consent to transfer is not required for funds on
Give an exact description of the property for which a consent
to transfer is requested.
deposit if the only beneficiary is the surviving spouse. Ef-
fective Jan. 1, 2001, pursuant to the tax commissioner’s
A. Bank accounts and funds on deposit, including IRAs and
authorization, a consent to transfer is not required for
Keogh plans, in a savings and loan association or other
funds on deposit if the amount is $25,000 or less per
banking institution – provide the following:
account.
1. Name of institution
2. Amount on deposit as per last entry prior to death and
ET forms 12 and 14 will become obsolete for
date of last entry
dates of death after Dec. 31, 2012. H.B. 508,
3. Type of account
129th General Assembly, revised R.C. section
4. Identifying number and the manner in which the fund
5731.39. A tax release or consent to transfer
is registered
is not required for individuals with a date of
death after Dec. 31, 2012.
B. Stocks/bonds – provide the following:
1. Total number of shares or denomination of bonds
If a release is required, please complete this form and
2. Rate of interest and due date
mail to the address listed on the front.
3. Type and the manner in which they are registered, if
registered other than solely in name of decedent
Questions regarding domicile should be directed to the
same address and toll-free number.
It shall be assumed that all stocks are common unless oth-
erwise indicated.
General Information
The fact that a consent to transfer may or may not be issued
The tax release estate tax form 14A must accompany this
does not in itself establish tax liability nor does it relieve
form to obtain a release. Since the tax release will reflect
tax liability. An estate tax return may be required to be filed
only the last entry balance posted prior to death, this entry
pursuant to Ohio Revised Code (R.C.) sections 5731.19
may or may not reflect the entire date of death value with the
and 5731.21. Tax liability on any property transferred will
accrued interest due.
be determined by the tax commissioner upon audit of the
estate tax return. Failure to timely file a return may subject
the taxpayer to a penalty pursuant to R.C. section 5731.22.
Ohio
I
Department of
Taxation
ET 14A
Reset Form
Rev. 5/12
Estate Tax Unit
P.O. Box 183050
Columbus, OH 43218-3050
1-(800) 977-7711
tax.ohio.gov
Nonresident Tax Release
Date
To
(Name of company whose stocks or bonds are to be transferred or institution where deposit or other property is located.)
The tax commissioner of Ohio consents to the immediate transfer of the following property now in your possession, control
or custody:
(Accounts) Bank
Type of Account and Number
(Stocks) No. of Shares
or
Value as of Date of Death
Denomination of Bonds
Company and Type of Stock
(Including Interest)
belonging to or standing in the name or joint name of
, deceased;
date of death
,
, resided in
, state of
.
Month
Day
Year
County
Tax commissioner agent
By
Instructions
This form must accompany estate tax form 12A. The
Stocks – Copy and describe each company stock as it is
attorney for the estate or the applicant should complete
described on the application (estate tax form 12A), except
this form.
do not carry the value over to this form as the value will
vary from date of death to date of actual transfer. Please
To obtain a release, forward completed estate tax forms
direct this release to the company or institution where
12A and 14A to the Estate Tax Unit at the address above.
the property is located and not to the individual receiv-
ing the property.
The following is required for completion:
Bank Accounts – Copy and describe each account
exactly as it is described on the application (estate tax
form 12A).
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