ET 2X 
           Department of                              Reset Form                                                                                          Rev. 5/12 
Ohio I     Taxation 
           Estate Tax Unit 
           1-(800) 977-7711 
           tax.ohio.gov 

                                Amended Ohio Estate Tax Resident Return 
                                   File in duplicate with the Probate Court. 
                         For estates with a date of death of July 1, 1983 – Dec. 31, 2012 
                                This form is to be used to report an increase in tax liability, 
                         claim a refund or disclose a change with no tax consequences.

            Check one:          Refund   Supplemental Tax                          Nontaxable Disclosure 
                                Pay supplemental tax through the county auditor’s Office. 

 Estate of: Decedent’s last name          Decedent’s fi rst name and initial                                                Date of death 

 Address of decedent at time of death (number and street, city, state and ZIP code)                                        Decedent’s Social Security number 

 County in Ohio, in which Probate Court located, where will probated or estate administered                                Case number 

 Date estate tax return fi led                         Was it (check one):                Taxable                         Nontaxable 

           If an estate tax form 10, Certifi cate of Determination of Final Ohio Estate Tax Liability, 
                                 has been received, attach a copy thereof to this return. 

                                                                                                                       1  $
 Net taxable estate as previously reported ..........................................................     

 Plus additional or increase (or less a decrease) in value of assets                                                    2  $
 (describe on reverse side) .......................................................................................  
                                                                                                                        3  $
     Total ............................................................................                   

 Less additional or increase (or plus a reduction) in amount of deductions 
                                                                                                                       4  $
 (describe on reverse side) .......................................................................................  
                                                                                                                        5  $
                                New net taxable estate ..............................................     
                                                                                                                        6  $
 Tentative tax due on new net taxable estate (use table on reverse side)................  
                                                                                                                        7  $
 Less estate tax credit (see reverse side) .................................................................                   
                                                                                                                        8  $ 
 Tax due (subtract line 7 from line 6; if line 7 is more than line 6, enter 0) .........................  
                                                                                                                        9  (                                    ) 
 Less tax previously assessed or paid (exclude any interest and penalty paid) .............               

 If line 9 is less than line 8, subtract line 9 from line 8 and enter the amount 
 of supplemental tax now due .................................................................................         10 $ 

 If line 9 is greater than line 8, subtract line 8 from line 9 and enter the amount 
 of refund now due ...................................................................................................  11 (                                    ) 

  Date Filed with Probate Court        Distribution of Subdivisions’ Share of Tax                                                        Date Received by 
                                   (Ohio Revised Code Section 5731.48 and 5731.50)                                             Ohio Department of Taxation 
                                       Percentage                                       City, Village or Township 

                                                                                                                      ET 2X 
                                                                                                                      Rev. 5/12 
                                                                                                                      Page 2 

                                         Explanation of Changes 
                                       If addtional space is needed, please use attachments. 

                                                Line 6 – Tax Rates 

If the net taxable estate is:                          The tax shall be: 
Not more than $40,000                                  2% of the net taxable estate 
More than $40,000, but not more than $100,000  $800 plus 3% of the excess more than $40,000 
More than $100,000, but not more than $200,000  $2,600 plus 4% of the excess more than $100,000 
More than $200,000, but not more than $300,000  $6,600 plus 5% of the excess more than $200,000 
More than $300,000, but not more than $500,000  $11,600 plus 6% of the excess more than $300,000 
More than $500,000                                     $23,600 plus 7% of the excess more than $500,000 

                                                Line 7 – Credits 

                                                                               Applicable Estate
                                         Date of Death                                            Tax Credit 
 
Dates of death on or before 06/30/83                                                                 0 
Dates of death 07/01/83, but before 01/01/01                                                         $500 
Dates of death 01/01/01, but before 01/01/02                                                         $6,600 
Dates of death 01/01/02, but before 01/01/13                                                   $13,900 

Print or type to expedite audit and finalization 

                                                Declaration 

Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best 
of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the deceased’s personal representative 
or person in possession of property is based on all information of which preparer has any knowledge. 
Name of attorney representing the estate Address (number and street, city, state and ZIP code)       Telephone number 

Name of executor/administrator(s)        Address (number and street, city, state and ZIP code)       Telephone number 

Signature of executor/administrator(s)   Date          Signature of preparer                                 Date 

                                         File in Duplicate in probate court.