The New York State Department of Taxation and Finance provides the ET-95 form, known as the "Claim for Refund of New York State Estate Tax," for executors or authorized representatives seeking a refund of estate tax paid. This crucial document, updated in April 2009, allows for the submission of refund claims under various circumstances, including protests against denied or adjusted refunds, filing protective claims to preserve rights for a potential refund when an issue is unresolved, or protests of paid bills based on certain tax documents. Executors must provide detailed information, including the decedent's name, social security number, and the date of death, along with their own details and that of any attorney or authorized representative. The form also requires a comprehensive explanation for the refund claim, supported by all relevant facts and figures. Additionally, it emphasizes the importance of deadlines for filing claims, highlighting that claims must be filed within specific periods depending on the date of death and when the tax was paid. This document must be signed by the executor and, if applicable, the attorney or authorized representative, certifying the truthfulness and accuracy of the information provided. The ET-95 form serves as a vital tool for individuals navigating the complexities of estate tax refunds in New York State, underscoring the Tax Department’s procedures for handling such claims and offering a pathway for those seeking adjustments to their estate tax liabilities.
| Question | Answer |
|---|---|
| Form Name | New York Form Et 95 |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | SSN, ET-14, ET-95, New_York |
|
New York State Department of Taxation and Finance |
|
||
|
Claim for Refund of New York State Estate Tax |
|||
|
|
|
|
(4/09) |
|
|
|
|
|
Decedent’s last name |
|
First name |
Middle initial |
|
|
|
|
|
|
Social security number ( SSN ) |
|
Date of death |
Employer identiication number ( EIN ) of estate |
|
|
|
|
|
|
Executor – If there has been a change of executor and you are submitting Letters Testamentary or Letters of Administration with this form,
indicate in this box the type of letters. Enter L if regular, LL if limited letters. If you are not submitting letters with this form, enter N..............................
Attorney’s or authorized representative’s last name |
First name |
MI |
Executor’s last name |
|
First name |
MI |
|||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
In care of ( firm’s name ) |
|
|
|
Mark an X |
|
|
If more than one executor, mark an X |
||||||||
|
|
|
|
if POA is |
|
|
in the box ( see instructions ) |
|
|
|
|
|
|
||
|
|
|
|
attached |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Address of attorney or authorized representative |
|
|
|
|
Address of executor |
|
|
|
|
||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
City |
State |
ZIP code |
|
|
City |
State |
|
ZIP code |
|||||||
|
|
|
|
|
|
|
|
|
|
|
|
||||
SSN or PTIN of attorney or authorized rep. |
Telephone number |
|
|
Social security number of executor |
|
Telephone number |
|||||||||
|
|
( |
) |
|
|
|
|
|
|
|
|
|
( |
) |
|
|
|
|
|
|
|
|
|
|
|
|
|
||||
1 Are you requesting a refund? ( see instructions ) |
|
Yes |
A If No, you may ile this form as a protective claim to preserve your rights to a possible refund when there |
|
|
is an unresolved issue and the statute of limitations is due to expire before the matter is settled. ( see instr. ) |
|
|
B If Yes, are you protesting either a denied or reduced refund, or a paid bill? |
|
Yes |
|
No
No
1) If Yes, enter the amount of refund claimed $ |
|
, the amount of total |
estate tax paid $ |
|
|
, and if protesting a paid bill, the assessment |
|
|
|
ID L- |
|
|
. Complete the rest of this form. |
|
|
|
2) If No, is the refund request the result of a federal audit? |
|
Yes |
||||
|
||||||
aIf Yes, ile Form
Do not file this form.
b If No, ile an amended Form
No
2Reason for claim. Print or type a detailed explanation of all facts and igures on which your claim is based. Attach additional sheets if necessary.
If an attorney or authorized representative is listed above, he or she must complete the following declaration.
I declare that I have agreed to represent the executor(s) for the above estate, that I am authorized to receive tax information regarding the
estate, and I am ( mark an X in all that apply ): an attorney a certiied public accountant an enrolled agent a public accountant enrolled with the New York State Education Department
Signature of attorney or authorized representative |
Date |
|
|
|
|
Certification. I certify that this claim and any attachments are to the best of my knowledge and belief true, correct, and complete.
Signature of executor |
Date |
Signature of |
|
|
Date |
|
|
|
|
|
|
Print name of preparer other than executor |
|
Signature of preparer other than executor |
|
Date |
|
|
|
|
|
|
|
Address of preparer |
City |
State |
ZIP code |
||
|
|
|
|
|
|
Instructions
Use this form to claim a refund of New York State estate tax only for the following types of claims:
Protest of denied refund — If the Tax Department has denied or adjusted your refund for any reason other than offsets to amounts owed to other agencies or tax liabilities, you may immediately ile a formal claim for refund.
Protective claim * — A protective claim is a refund claim that is based on an unresolved issue(s) that involves the Tax Department or another taxing jurisdiction that may affect your New York State estate tax. The purpose of iling a protective claim is to protect any potential overpayment when the statute of limitations is due to expire.
Protest of paid bill * — If the bill was based on Form
*Note: Your protective claim or protest must be iled within three years from the time the return was iled or within two years from the time the tax was paid, whichever is later.
File all other claims, for dates of death after May 25, 1990, and before February 1, 2000, on Form
Executor information
Enter the name (last name irst) and other information for the executor of the estate. The term executor includes executrix, administrator, administratrix, or personal representative of the decedent’s estate; if no executor, executrix, administrator, administratrix, or personal representative is appointed, qualiied, and acting within the United States, executor means any person in actual or constructive possession of any property of the decedent.
If an executor has not been appointed, this form may be signed and iled by a person having knowledge of all the assets in the 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.
If the estate has more than one executor, mark an X in the box, enter the name and other information for the primary 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 previously submitted. Submit Letters Testamentary or Letters of Administration with this form if not previously submitted. It is suficient to have one of the coexecutors sign this form.
Attorney/representative information
If you, as the executor of the estate, have authorized a person to represent you regarding the estate, and you would like the department to contact him or her regarding the estate, enter the name (last name irst) of the attorney, accountant, or enrolled agent who is representing you. Also enter the irm’s name, address, and telephone number in the areas provided, and have the representative sign in the area provided on the front of this form.
Note: If you are giving a person power of attorney to represent you, attach a completed Form
Sign this claim and mail to:
NYS TAX DEPARTMENT
TDAB - ESTATE TAX AUDIT
W A HARRIMAN CAMPUS
ALBANY NY 12227
Privacy notification
The Commissioner of Taxation and Finance may collect and maintain personal information pursuant to the New York State Tax Law, including but not limited to, sections
This information will be used to determine and administer tax liabilities and, when authorized by law, for certain tax offset and exchange of tax information programs as well as for any other lawful purpose.
Information concerning quarterly wages paid to employees is provided to certain state agencies for purposes of fraud prevention, support enforcement, evaluation of the effectiveness of certain employment and training programs and other purposes authorized by law.
Failure to provide the required information may subject you to civil or criminal penalties, or both, under the Tax Law.
This information is maintained by the Manager of Document Management, NYS Tax Department, W A Harriman Campus, Albany NY 12227; telephone (518)
Need help?
Internet access: www.nystax.gov
(for information, forms, and publications)
|
|
available 24 hours a day, |
|
7 days a week. |
1 800 |
Telephone assistance is available from 8:00 A.M. to 5:00 P.M. (eastern time), Monday through Friday.
Estate Tax Information Center: |
(518) |
|
1 800 |
||
To order forms and publications: |
(518) |
|
1 800 |
Text Telephone (TTY) Hotline (for persons with hearing and speech disabilities using a TTY): If you have access to a TTY, contact us at 1 800
If you do not own a TTY, check with independent living centers or community action programs to ind out where machines are available for public use.
Persons with disabilities: In compliance with the Americans with Disabilities Act, we will ensure that our lobbies, ofices, meeting rooms, and other facilities are accessible to persons with disabilities. If you have questions about special accommodations for persons with disabilities, call the information center.