Form Et-92 - New York Application For Release Of Safe Deposit Box
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ET-92
New York State Department of Taxation and Finance
Application for Release of Safe Deposit Box
(6/99)
For estates of decedents dying before February 1, 2000
Decedent information
Decedent’s last name
First
Middle Initial
Social security number
Address of decedent at time of death (number and street)
Date of death
Attach a copy
of the
death certificate
City, village or post office
State
ZIP code
County of residence
On the date of death, decedent was a:
Resident of New York State
Nonresident of New York State
Applicant information
Name of applicant
(last, first, middle initial)
Relationship to decedent
Address of applicant
City, village or post office
State
ZIP code
Social security number of applicant
Telephone number
(
)
Bank information
Name and address of bank where safe deposit box is located
Safe deposit box number(s)
If the box was held jointly in the name of the decedent and another, or a deputy was
named, check the appropriate box and enter the name of the other joint tenant or the
deputy.
Joint tenant
Deputy
Name
Sign below
Signature of applicant
Date
Instructions
Note: Estates of individuals dying on or after February 1,
Privacy notification
2000, are not required to obtain a release of the safe deposit
The right of the Commissioner of Taxation and Finance and the
box from the Tax Department.
Department of Taxation and Finance to collect and maintain
personal information, including mandatory disclosure of social
This form may be filed by an executor, administrator, joint
security numbers in the manner required by tax regulations,
tenant, deputy, the attorney for the estate, the decedent’s next
instructions, and forms, is found in Articles 22, 26, 26-A, 26-B, 30,
of kin, or any person having an interest in the estate who has
30-A, and 30-B of the Tax Law; Article 2-E of the General City
knowledge of the decedent’s assets.
Law; and 42 USC 405(c)(2)(C)(i).
The Tax Department will use this information primarily to
Since other laws may apply to the release of safe deposit
determine and administer tax liabilities due the state and city of
boxes, check with your bank or safe deposit company for any
New York and the city of Yonkers. We will also use this information
additional requirements.
for certain tax offset and exchange of tax information programs
authorized by law, and for any other purpose authorized by law.
The term executor includes executor, executrix, administrator,
administratrix, or personal representative of the decedent’s
Information concerning quarterly wages paid to employees and
estate. If no executor, executrix, administrator, administratrix, or
identified by unique random identifying code numbers to preserve
personal representative is appointed, qualified, and acting
the privacy of the employees’ names and social security numbers
within the United States, any person acting in the capacity of
will be provided to certain state agencies for research purposes to
executor (by virtue of the fact that that person is in actual or
evaluate the effectiveness of certain employment and training
constructive possession of any property of the decedent) may
programs.
apply for the release of the safe deposit box.
Failure to provide the required information may result in civil or
criminal penalties, or both, under the Tax Law.
Mail the completed application form to:
This information will be maintained by the Director of the
NYS TAX DEPARTMENT
Registration and Data Services Bureau, NYS Tax Department,
TTTB - ESTATE TAX AUDIT - 855
Building 8 Room 924, W A Harriman Campus, Albany NY 12227;
W A HARRIMAN CAMPUS
telephone 1 800 225-5829. From areas outside the U.S. and
ALBANY NY 12227
outside Canada, call (518) 485-6800.
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