Department of Taxation and Finance

       For office use only                            Tentative Payment of Estate Tax                                                                                    ET-130
                                                                                                                                                                                           (6/23)
                                                      For an estate of an individual who died on or after January 1, 2019

                                Decedent’s last name                                   First name                    Middle initial                              Social Security number
                                 
                                Address of decedent at time of death (number and street)                                                                         Date of death Mark an Xif copy of 
                                                                                                                                                                               death certificate is 
                                                                                                                                                                               attached (see inst.)
                                City                                                      State                      ZIP code                                    County of residence

                                If the decedent was a nonresident of New York State on the date of death, mark an  Xin this box and                                   attach a completed 
                                Form ET-141, New York State Estate Tax Domicile Affidavit.
                                Power of Attorney – Mark an  Xin the box if Form ET-14,Estate Tax Power of Attorney, isattached (see instructions)
                                If Form ET-14 was previously provided, indicate which form it was attached to and the date it was submitted:
                                Form                                              Date
                                Executor – If you are submitting Letters Testamentary or Letters of Administration with this form, indicate in this box
                                the type of letters. Enter  Lif 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 (for definition, see instr.) last name                         First name         Middle initial

In care of (firm’s name) 
                                                                                       If more than one executor, mark an  Xin the box                           (see instructions)  ................
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
 
Email address of attorney or authorized representative                                 Email address of executor

                                                      Computation of tentative payment
          1  Estimated value of federal gross estate (see instructions)  .....................................................................                   1.
          2  Estimated value of property with a location outside of New York State .................................................                             2.
 Attach   3  Subtotal (subtract line 2 from line 1)  ..........................................................................................................  3.
 check 
 or       4  Taxable gifts (see instructions)  ................................................................. 4.
 money 
 order    5  Includible QTIP Property (see instructions)  .............................................          5.
 here.
          6  Estimated litigation awards (see instructions)  ..........................................          6.
          7  Amount determined under § 957 relating to Powers of Appointment
            prior to 1930 (see instructions) ..............................................................      7.
          8  Add lines 4 through 7  ............................................................................................................................ 8.
          9  New York estimated gross estate (add lines 3 and 8) ...............................................................................                 9.
          10 Allowable federal deductions for NYS purposes (see instructions)  .........................................................  10.
          11 Estimated New York taxable estate (subtract line 10 from line 9)  ..............................................................                    11.
        12   Tax on taxable estimate (see tax tables on Form ET-706, page 6)  ..............................................................                     12.
        13   Amount previously remitted, if any.........................................................................................................         13.
        14   Amount remitted with this form (make check or money order payable in U.S. funds to Commissioner of  
               Taxation and Finance)  .......................................................................................................................    14.

Certification: Under penalties of perjury, I declare that I am either the duly appointed executor or administrator for the above-named estate or, if no executor 
or administrator has been appointed, a person in actual or constructive possession of any property of the decedent with sufficient knowledge to file an accurate 
return, the attorney or accountant representing such individual, or a person with a power of attorney to act on behalf of the executor, and that, to the best of my 
knowledge and belief, the information contained on this application is true and correct.
 Signature                                                                                                       Date

Mark an  Xin the applicable box:
      Attorney              Court appointed Executor

      Power of attorney     Other (specify role)
             00800106230094