Form Et 12a & 14a - Application For Consent To Transfer Property Or Other Interest Of A Nonresident Decedent

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ET 12A
Rev. 9/07
Reset Form
Estate Tax Division
P.O. Box 183050
Columbus, OH 43218-3050
1-(800) 977-7711
tax.ohio.gov
Application for Consent to Transfer Property or Other Interest
of a Nonresident Decedent (Ohio Revised Code 5731.40)
Name of decedent
Date of death
Address (at time of death)
Social security number
Ohio county and case number
Decedent’s state of domicile
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)
Company and Type of Stock
Denomination of Bonds
1.
2.
3.
Please complete this section in its entirety so that this application may be processed. If needed,
please have the beneficiary or legal representative
complete this section before it is submitted.
Please complete the following. Attach documentation when necessary.
1. Completed tax releases, estate tax form 14A, for each institution.
2. Letters of appointment were issued to
3. For any joint and survivorship property, state the name and relationship of survivor to decedent
4. Did the decedent leave a will? Yes
No
If yes, please attach a copy including all codicils.

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