Form Tt 141A – Fill Out and Use This PDF

The TT-141A form, provided by the New York State Department of Taxation and Finance, serves as the Estate Tax Domicile Affidavit. It is specifically designated for the estates of individuals who passed away after December 31, 1982, and before May 26, 1990, when there's a claim that the decedent was not a New York State resident at the time of their death. To support such a claim, the form must be thoroughly completed by the fiduciary, surviving spouse, or a member of the decedent's immediate family, ensuring every requested detail is captured. Click the button below to start filling out the form and secure your submission efficiently.

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Form Tt 141A PDF Details

In navigating the complexities of estate taxes, particularly for individuals with ties to New York but who may not have been residents at their time of death, the TT-141A form emerges as a pivotal document. Crafted by the New York State Department of Taxation and Finance, this Estate Tax Domicile Affidavit serves the estates of those who passed away between December 31, 1982, and May 26, 1990. Its primary function is to assert that the deceased was not a resident of New York State at their time of death, a claim that necessitates comprehensive information provided by a fiduciary, surviving spouse, or immediate family member. The form intricately details personal, occupational, and residential histories, alongside affiliations with organizations, voting practices, and the presence of wills or other testamentary documents. Unique to this form is its inclusion of the decedent's property interests, both within and outside New York State, and any related transactions preceding the death that could influence the estate’s tax obligations. Designed to accompany certain other estate tax forms under specified conditions, the TT-141A plays a critical role in estate planning and tax compliance, underscoring its significance in the meticulous process of determining domicile and ultimately facilitating the appropriate administration of an estate’s tax liabilities.

Question	Answer
Form Name	Form Tt 141A
Form Length	4 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	1 min
Other names	tt141a_103 tt 141a form

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	New York State Department of Taxation and Finance	TT-141A
	Estate Tax Domicile Affidavit	TT-141A
	Estate Tax Domicile Affidavit	(1/03)

For the estate of an individual who died after December 31, 1982, and before May 26, 1990

If it is claimed that the decedent was not a New York State resident at the time of death, the fiduciary (executor or administrator), the surviving spouse, or a member of the decedent’s immediate family, who can provide all the information requested below, should complete this affidavit.

Note – If this affidavit is filed with New York State Form TT-86.5, omit questions 28 through 33.

If the estate is filing Form TT-385, New York State Estate Tax Return, or the date of death is on or after May 26, 1990, use Form ET-141, New York State Estate Tax Domicile Affidavit, instead.

If the estate filed a federal estate tax return, Form 706 or 706-NA, attach a copy. Answer all questions completely.

This affidavit must be notarized on page 4.

Decedent’s last name

First name

Initial

Age at

Date of death (attach

Decedent’s social security number

death

death certificate)

Decedent’s domicile

Address

County

State

Country

Attorney for estate (if any)

Name

Address

Telephone number

Applicant’s name

2 Applicant’s address and telephone number

Applicant’s relationship to decedent

or connection with estate

Decedent’s date of birth

Decedent’s place of birth

5a If born outside the U.S., was decedent a naturalized citizen of the United States?

Yes

If 5a is Yes, give court and location where naturalized

If decedent was a U.S. Citizen, did he or she ever apply for a passport? If Yes, give dates of application and

renewals and decedent’s address as it appears on the passport.

Yes

7 Decedent’s occupation (if retired, so state and give former

8 Name and address of employer (if retired, former employer)

occupation)

Was decedent ever married?

9a If Yes, give date and place of marriage

Name and address of spouse

Yes

If Yes, give name, address, and other details. (attach separate sheet if necessary)

11 Was decedent a member of any church, club, or organization?

Yes

Did decedent leave a will?

13 Name and address of executor or administrator of decedent’s estate (attach copy of certificate of appointment).

Yes

If no fiduciary appointed, write none.

(if Yes, attach copy)

14 Name and address of court where will was or is to be probated, or estate administered

15 Did decedent execute any other wills during

the last five years preceding death?

Yes

(if Yes, attach copy)

Did decedent ever live in New York State?

16a

If Yes, for what periods?

17 Provide the following information regarding the residence(s) of the decedent during the last five years preceding death:

In New York State

Outside New York State

Residence

Period of time

owned - rented

Period of time

owned - rented

from – to

Address

other (explain)

from - to

Address

other (explain)

Form Tt 141A – Fill Out and Use This PDF

Form Tt 141A PDF Details

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