Form ET13 "Application for Consent to Transfer the Proceeds of Insurance Contracts, Employer Death Benefits and Retirement Plans for Resident and Nonresident Decedents" - Ohio

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What Is Form ET13?

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 April 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 ET13 by clicking the link below or browse more documents and templates provided by the Ohio Department of Taxation.

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Download Form ET13 "Application for Consent to Transfer the Proceeds of Insurance Contracts, Employer Death Benefits and Retirement Plans for Resident and Nonresident Decedents" - Ohio

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Ohio
I
Department of
Taxation
I
ET 13
Rev. 4/12
Estate Tax Unit
1-(800) 977-7711
Reset Form
tax.ohio.gov
Application for Consent to Transfer the Proceeds of Insurance Contracts,
Employer Death Benefits and Retirement Plans for Resident and
Nonresident Decedents (Ohio Revised Code 5731.39)
For dates of death July 1, 1983 – Dec. 31, 2012
Part I – Identification
Name of decedent
Date of death
Decedent’s Social Security number
Decedent’s address at time of death (number and street, city, state and ZIP code)
County of residence
Case number
The gross value of all property held in the decedent’s name
Is the decedent’s estate in the process of administration?
alone or owned jointly by decedent at death or transferred
•••No
Yes
by the decedent prior to death; including, but not limited to:
real estate; cash; automobiles; household goods; insurance
Name and address of estate representative:
payable to an estate, pension plans and annuities payable
after death including IRA and Keogh plans (check accord-
ing to date of death):
Date of death (DOD) Jan. 1, 2002 – Dec. 31, 2012
More than $338,333
Under $338,333
DOD on or after Jan. 1, 2001 thru Dec. 31, 2001
More than $200,000
Under $200,000
Name and address of attorney representing estate:
DOD on or after June 30, 1983 thru Dec. 31, 2000
More than $25,000
Under $25,000
Note: If the gross estate is less than $338,333, $200,000
or $25,000 on the applicable date of death, no estate tax
return is required to be filed.
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.)
Date submitted
Signature and title of applicant
(executor, administrator, survivor or attorney for same – circle one)
Applicant’s name
Address
City, state, ZIP code
Telephone number
Part II – To Be Completed By Agent of the Tax Commissioner (County Auditor) in the County
of the Decedent’s Residence
The application for consent to transfer is:
Approved
Not approved
Tax commissioner agent
By
Date
Ohio
I
Department of
Taxation
I
ET 13
Rev. 4/12
Estate Tax Unit
1-(800) 977-7711
Reset Form
tax.ohio.gov
Application for Consent to Transfer the Proceeds of Insurance Contracts,
Employer Death Benefits and Retirement Plans for Resident and
Nonresident Decedents (Ohio Revised Code 5731.39)
For dates of death July 1, 1983 – Dec. 31, 2012
Part I – Identification
Name of decedent
Date of death
Decedent’s Social Security number
Decedent’s address at time of death (number and street, city, state and ZIP code)
County of residence
Case number
The gross value of all property held in the decedent’s name
Is the decedent’s estate in the process of administration?
alone or owned jointly by decedent at death or transferred
•••No
Yes
by the decedent prior to death; including, but not limited to:
real estate; cash; automobiles; household goods; insurance
Name and address of estate representative:
payable to an estate, pension plans and annuities payable
after death including IRA and Keogh plans (check accord-
ing to date of death):
Date of death (DOD) Jan. 1, 2002 – Dec. 31, 2012
More than $338,333
Under $338,333
DOD on or after Jan. 1, 2001 thru Dec. 31, 2001
More than $200,000
Under $200,000
Name and address of attorney representing estate:
DOD on or after June 30, 1983 thru Dec. 31, 2000
More than $25,000
Under $25,000
Note: If the gross estate is less than $338,333, $200,000
or $25,000 on the applicable date of death, no estate tax
return is required to be filed.
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.)
Date submitted
Signature and title of applicant
(executor, administrator, survivor or attorney for same – circle one)
Applicant’s name
Address
City, state, ZIP code
Telephone number
Part II – To Be Completed By Agent of the Tax Commissioner (County Auditor) in the County
of the Decedent’s Residence
The application for consent to transfer is:
Approved
Not approved
Tax commissioner agent
By
Date
ET 13
Rev. 4/12
Page 2
Part III – Benefits Payable by an Insurance Company (to be completed by insurer)
1. A consent is not necessary for straight life insurance payable to a named beneficiary other than the estate.
2. Please complete Part V – listing all benefi ciaries’ information
3. A separate application consent form is not required for each beneficiary. Please complete only one consent applica-
tion form for each policy or contract.
Name of insured
Owner of policy or contract
Name and address of insurance company
Type of policy or contract
Number of policy or contract
Value at date of death
If annuity, yearly payment
Part IV – Employment-Related Benefits (to be completed by employer)
1. A separate application consent form is not required for each beneficiary. Please complete only one consent applica-
tion form for each death benefit.
2. Please complete Part V – listing all benefi ciaries’ information
This form is not for IRAs and Keogh plans
Name and address of employer
held in a banking institution.
Use estate tax forms 12 and 14.
•
•
•
•
Date of death value $
Check one:
IRA
Keogh
Other
Lump sum $
Annually $
Monthly $
Other
Part V – Benefi ciary Information
Please complete the beneficiary information as it applies to Part III and Part IV above.
Benefi ciary’s Name
Address
Relationship to Decedent
1.
2.
3.
4.
5.
6.
ET 13
Rev. 4/12
Page 3
General Information
All county auditors have been appointed agents of the tax commissioner for the purpose of issuing con-
sents to transfer (R.C. section 5731.41)
How to obtain
Submit this completed application to the county auditor in the county of the
decedent’s residence. The county auditor will review the application and return a
a release
copy to the applicant. If the name and address of the county auditor are needed,
please call the Ohio Department of Taxation, Estate Tax Unit, at 1-800-977-7711.
1. Complete a separate application for each benefit.
2. Application will not be processed unless completed in its entirety and signed by the
applicant.
3. The approval of a consent to transfer does not determine a tax liability.
4. The county auditor will forward a copy of the approved application to the tax com-
missioner.
For nonresident decedents, submit this completed application to the Ohio Depart-
ment of Taxation, Estate Tax Unit, P.O. Box 183050, Columbus, OH 43218-3050. This
unit will review the application and return a copy to the applicant.
A consent must be obtained for the following:
When a consent to
1. Annuities payable to a named beneficiary or the estate.
transfer is required
2. Matured endowments payable to a named beneficiary or the estate.
(R.C. section 5731.09(A)
3. Supplemental contracts payable to a named beneficiary or the estate.
and (B) and R.C. section
4. Straight life insurance payable to the estate.
5731.39 (C) and (D)
5. Life insurance owned by decedent on the life of another person.
6. Employer-related death benefits in excess of $2,000, including:
a. retirement benefits payable to a named beneficiary or the estate;
b. pension or profit-sharing plans payable to a named beneficiary or the estate;
c. IRAs payable to a named beneficiary or the estate;
d. Keoghs payable to a named beneficiary or the estate;
e. corporate plans, whether qualified or unqualified, payable to a named beneficiary
or the estate;
f. any deferred compensation program; and
g. bonus plans.
A consent is not required for the following:
When a consent
1. Date of death is after Dec. 31, 2012. H.B. 508, 129th General Assembly, revised R.C.
to transfer is not
section 5731.39. A tax release or consent to transfer is not required for individuals
required
with a date of death after Dec. 31, 2012.
(R.C. section 5731.09)
2. Straight life insurance benefits payable to a named beneficiary other than the estate;
or
3. When any of the above-listed assets are payable to the surviving spouse and the
date of death is on or after 10/01/96; or
4. Any of the above-listed assets are $25,000 or less, regardless of benefi ciary; or
5. The Federal Coal Mine and Safety Act annuity payable under Title IV of 1969 (black
lung benefits).
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