Ny Et 141 Form PDF Details

When dealing with the aftermath of a loved one's passing, understanding the legal and tax obligations in their home state is paramount. In New York, the Estate Tax Domicile Affidavit, known as Form ET-141, becomes a critical document for estates of individuals who passed away after May 25, 1990, and are claimed not to have been domiciled in New York State at the time of death. This form, provided by the New York State Department of Taxation and Finance, requires detailed information about the decedent's domicile, property ownership, voting registration, and even personal attributes such as church or club memberships. It is intended for use by executors, administrators, surviving spouses, or immediate family members capable of furnishing the necessary details. The form’s completion and submission, alongside appropriate estate tax forms depending on the date of the decedent's death, help assert the non-New York domicile status of the decedent, potentially influencing the estate's tax obligations. Its extensive queries aim to paint a comprehensive picture of the decedent’s ties, or lack thereof, to New York State, underscoring the importance of accurate and thorough responses.

QuestionAnswer
Form NameNy Et 141 Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesnys form et 141 instructions, et 141 form, et 141 ny, et 141

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New York State Department of Taxation and Finance

ET-141

New York State Estate Tax Domicile Afidavit

(1/15)

For estates of decedents dying after May 25, 1990

Complete Form ET-141 if it is claimed that the decedent was not domiciled in New York State at the time of death.

The iduciary (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 afidavit.

Answer all questions completely. Submit this form with Form ET-30; ET-85; ET-90 for dates of death before February 1, 2000; ET-130; ET-133; or ET-706 for dates of death on or after February 1, 2000; as applicable.

Decedent’s last name

First

 

 

 

 

Middle initial

 

Social security number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address of decedent at time of death (number and street)

 

 

 

 

 

 

 

Date of death

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City, village or post ofice

County

 

 

 

State

ZIP code

 

Country of residence

 

 

 

 

 

 

 

 

 

 

 

 

 

Age of death

Date of birth

Place of birth

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1

If born outside the United States, was the decedent a naturalized citizen of the United States?

 

 

 

 

 

If Yes, enter (below) the name and address of the court where the decedent was naturalized.

Yes

No

Name and address of court where naturalized

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Did decedent ever live in New York State? Yes

 

 

 

 

 

 

 

 

2

No

If Yes, list periods.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3

Did decedent ever own, individually or jointly, any

 

 

 

If Yes, list addresses and periods below (submit additional sheets if necessary).

 

interest in real estate located in New York State?

Yes

No

 

Periods of time - from/to

Addresses of property

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4

Did decedent lease a safe deposit box located in New York State at the time of death?

Yes

No

 

 

 

 

If Yes, complete box below. Also, if Yes, has it been inventoried?

Yes

No

If Yes, submit a copy of inventory.

Name and address of bank where box is located

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5Provide the following information regarding the residences of the decedent during the last ive years preceding death (submit additional sheets if necessary).

Period of time

from - to

Address

Residence

owned - rented other - explain

Period of time

from - to

Address

Residence

owned - rented other - explain

6For the ive years prior to death, list (1) the Internal Revenue Service Centers and (2) the states or other municipalities where the decedent iled income tax returns (if no income tax returns were iled, enter NONE).

Year

Internal Revenue Service Center

State, county, or municipality

Privacy notiication

New York State Law requires all government agencies that maintain a system of records to provide notiication of the legal authority for any

request, the principal purpose(s) for which the information is to be collected, and where it will be maintained. To view this information, visit our Web site, or, if you do not have Internet access, call and request Publication 54, Privacy Notiication. See Need help? for the Web address

and telephone number.

ET-141 (1/15) (back)

7List the states where the decedent was registered to vote during the last ive years preceding death (list latest year irst).

Years

 

State

 

 

 

 

From

 

To

 

 

 

 

 

 

 

Date of Death

 

 

 

 

 

 

 

 

 

 

 

 

 

If decedent did not vote in those ive years, when did he or she last vote?

 

Where?

 

 

 

8List employment or business activities (if any) engaged in by the decedent during the ive years preceding the date of death.

 

 

 

In New York State

 

 

 

 

 

Outside New York State

 

Period of time

 

Nature of employment or business activities

Period of time

 

Nature of employment or business activities

 

from - to

 

from - to

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

9

Was decedent a party to any legal proceedings in New York State during the last ive years?

Yes

No

If Yes, list courts, dates,

and types of action.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

10

Did decedent have a license to operate a business, profession, motor vehicle, airplane, or boat?

Yes

No

If Yes, list below.

 

License number

 

Type of license

Date of issuance

 

 

 

Name and location of issuing ofice

 

 

 

 

 

 

 

 

 

11

Did decedent execute any trust indentures, deeds, mortgages, or any other documents

 

 

 

 

 

describing his or her residence during the last ive years preceding death?

 

 

 

Yes

No

If Yes, submit a copy.

12

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

Yes

No

 

 

 

 

If Yes, give name, address, and other details. (Submit additional sheets if necessary.)

13What other information do you wish to submit in support of the contention that the decedent was not domiciled in New York State at the time of death? (Submit additional sheets if necessary.)

Applicant’s last name

First name

Middle initial

Relationship to decedent

 

 

 

 

Address (number and street)

 

 

Connection with estate

 

 

 

 

City, village, or post ofice

State

ZIP code

Country of residence

 

 

 

 

The undersigned states that this afidavit is made to induce the Commissioner of the Department of Taxation and Finance of the State of New York to determine

domicile, and that the answers herein contained to the foregoing questions are each and every one of them true in every particular.

 

 

 

 

 

 

 

Signature of Notary Public, Commissioner of Deeds or Authorized New York State

Signature of applicant

 

 

 

 

 

Department of Taxation and Finance employee (no seal required)

Sworn before me this

 

 

day of

 

20

 

 

 

 

 

 

 

 

 

 

Signature

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Filling out this form requires attentiveness. Ensure that every single field is filled in accurately.

1. Whenever completing the nys tax form et 141, ensure to complete all essential fields within the relevant form section. This will help to speed up the work, enabling your information to be handled promptly and correctly.

How you can complete et 141 ny part 1

2. After completing the previous section, head on to the next step and enter all required details in all these blanks - Period of time, from to, Address, owned rented other explain, Period of time, from to, Address, owned rented other explain, For the ive years prior to death, decedent iled income tax returns, Internal Revenue Service Center, State county or municipality, New York State Law requires all, and Privacy notiication.

Stage # 2 for submitting et 141 ny

3. The following portion is about From, Date of Death, If decedent did not vote in those, Where, List employment or business, In New York State, Period of time, from to, Nature of employment or business, Period of time, from to, Outside New York State Nature of, Was decedent a party to any legal, Yes, and If Yes list courts dates and types - complete each of these fields.

Part number 3 for submitting et 141 ny

4. You're ready to fill out the next part! Here you'll have these Did decedent have a license to, Date of issuance, License number, Type of license, Name and location of issuing ofice, describing his or her residence, Did decedent execute any trust, No If Yes give name address and, Yes, Yes, If Yes submit a copy, What other information do you, time of death Submit additional, Applicants last name, and Address number and street empty form fields to fill in.

Filling out part 4 in et 141 ny

5. To conclude your document, this final section incorporates a number of additional blanks. Entering The undersigned states that this, Signature of applicant, Sworn before me this, Signature of Notary Public, day of, and Signature is going to wrap up everything and you will be done in a snap!

Writing part 5 of et 141 ny

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