PDF document

- 1 -

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

Application for Consent to Transfer Property or Other Interest
of a Resident Decedent (Ohio Revised Code 5731.39)
For dates of death July 1, 1983 – Dec. 31, 2012
File this form with the county auditor together with completed tax release(s) (estate tax form 14).

Name of decedent Date of death

Address County of residence

Social Security number Case number

The description and approximate value of the property to be transferred:
(Accounts) Bank Type of Account and Number Value as of Date of Death
(Stocks) No. of Shares or (Including Interest)
Denomination of Bonds Company and Type of Stock
1.

This application will not be processed unless sections A through E are completed in their entirety. The
beneﬁ ciary or legal representative should complete these sections before it is submitted to the county auditor.

Necessary Accompanying Documents

1. Completed tax releases (estate tax form 14) for each 4. For joint and survivorship property, give name and relation-
institution. ship of survivor to decedent.
2. Exhibit letters of probate court appointment upon ﬁ rst ap- 5. For payable on death (P.O.D.) accounts, present passbook
plication. and letter from bank giving name of undisclosed beneﬁ-
ciary and relationship to decedent.
3. Savings passbooks and certiﬁ cates must be presented
with this application.

- 2 -

ET 12
Rev. 5/12
Page 2

A. Is the decedent’s estate in the process of administra- D. The gross value of all property held in the decedent’s
tion? name alone or owned jointly by decedent at death or
Yes NoF• F transferred by the decedent prior to death; including, but
not limited to: real estate; cash; automobiles; household
B. Name and address of estate representative: goods; insurance payable to an estate, pension plans and
annuities payable after death including IRA and Keogh
plans (check according to date of death):

Date of death (DOD) Jan. 1, 2002 – Dec. 31, 2012
• F More than $338,333 F Under $338,333
DOD on or after Jan. 1, 2001 thru Dec. 31, 2001
• F More than $200,000 F Under $200,000
C. Name and address of attorney representing estate:
DOD on or after June 30, 1983 thru Dec. 31, 2000
• F More than $25,000 F Under $25,000

Note: If the gross taxable estate is less than $25,000,
$200,000 or $338,333 on the applicable date of death, no
estate tax return is required to be ﬁled.

E.
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 ﬁ ling this application.)

Signature and title of applicant
(executor, administrator, survivor or attorney for same)

Address City, state, ZIP code Telephone number

Date submitted

Instructions for Completing Estate Tax Form 12

Note: A consent to transfer is not required for funds on deposit if the only beneﬁ ciary is the surviving spouse. Effec-
tive Jan. 1, 2001, pursuant to the tax commissioner’s authorization, a consent to transfer is not required for funds
on deposit if the amount is $25,000 or less per account.

ET forms 12 and 14 will become obsolete for dates of death after Dec. 31, 2012.
◄ H.B. 508, 129th General Assembly, revised R.C. section 5731.39. A tax release or consent ►
to transfer is not required for individuals with a date of death after Dec. 31, 2012.

If a release is required, follow these instructions.
A. Bank accounts and funds on deposit, including IRAs and Keogh plans, in a savings and loan association or other banking
institution – provide the following:
1. Name of institution
2. Amount on deposit as per last entry prior to death and date of last entry
3. Type of account
4. Identifying number and the manner in which the fund is registered
Bank books and certiﬁcates of deposit must accompany this application.

- 3 -

ET 12
Rev. 5/12
Page 3
In the case of commercial accounts, the ﬁ duciary should present the bookkeeping statement of the bank showing the balance
on date of death less honored checks drawn by decedent prior to death. In the case of P.O.D. accounts, when the passbook
fails to disclose the name of the beneﬁ ciary, a letter from the bank should accompany the passbook giving this date.

B. Stocks/bonds – provide the following:

1. Total number of shares or denomination of bonds
2. Rate of interest and due date
3. Type and the manner in which they are registered, if registered other than solely in name of decedent

It shall be assumed that all stocks are common unless otherwise indicated.

General Information
File this form with the county auditor together with completed tax release(s) (estate tax form 14).

Ohio Revised Code section (R.C.) 5731.39 provides a penalty liability on any property transferred will be determined by
of the amount of the tax and up to $5,000 if a corporation, the tax commissioner upon audit of the estate tax return.
safe-deposit box company, bank, savings and loan associa- An estate tax return may be required to be ﬁ led pursuant to
tion, trust company or similar institution transfers more than R.C. section 5731.21. Failure to timely ﬁ le may subject the
a three-fourths interest in property belonging to or standing taxpayer to a penalty pursuant to R.C. section 5731.22.
in the name or joint name of a decedent or in trust for a
decedent without obtaining a consent to transfer from the The tax release estate tax form 14 must accompany this
tax commissioner. It is necessary for such institutions to form to obtain a release. Since the tax release, estate tax
request a consent to transfer for the entire amount of any form 14, will reﬂ ect only the last entry balance posted prior
such interest prior to ﬁ nal transfer from the decedent’s name. to death, this entry may or may not reﬂ ect the entire date of
The county auditor is the tax commissioner’s agent for these death value with the accrued interest due.
purposes.

The fact that a consent to transfer is issued does not in itself
establish tax liability nor does it relieve from tax liability. Tax

- 4 -

                                                                                                                                       ET 14 
              Department of                                                                                                            Rev. 5/12 
Ohio I        Taxation 
              Estate Tax Unit 
              1-(800) 977-7711 
              tax.ohio.gov 

                                           Resident Tax Release 
                                   (Ohio Revised Code 5731.39) 

                                                                                Date 

To 
              (Name of company whose stocks or bonds are to be transferred or institution where deposit or other property is located.) 

The tax commissioner of Ohio consents to the immediate transfer of the following property now in your possession, control 
or custody: 

   (Accounts) Bank                         Type of Account and Number 
 (Stocks) No. of Shares                               or                                 Value as of Date of Death 
 Denomination of Bonds                     Company and Type of Stock                     (Including Interest) 

belonging to or standing in the name or joint name of                                               , deceased; 

date of death                      ,                  , resided in                       , state of                                            . 
              Month            Day         Year                       County 

                                                                   Tax commissioner agent

 By  

                                                Instructions 
 This form must accompany estate tax form 12. The attorney   Stocks – Copy and describe each company stock as it is 
 for the estate or the applicant should complete this form.  described on the application (estate tax form 12), except do 
                                                             not carry the value over to this form as the value will vary
 To obtain a release, take the completed estate tax forms    from date of death to date of actual transfer. Please direct 
 12 and 14 to the county auditor’s ofﬁce.                    this release to the company or institution where the property  
                                                             is located and not to the individual receiving the property. 
 The following is required for completion: 

 Bank Accounts – Copy and describe each account exactly  
 as it is described on the application (estate tax form 12).

PDF file checksum: 3332105978

(Plugin #1/8.13/12.0)