Estate Tax Waiver Notice {ET-99}

Department of Taxation and FinanceEstate Tax Waiver NoticeET-99(12/17) þ (see instructions), insurance, or annuity company holding assets of the decedent þ Decedent222s last name þ First name þ Middle initial þ Date of deathNot valid until stampedInstructionsNote: Form ET-99 must be attached to and submitted with a completed Form ET-85, , Form ET-90, New York State Estate Tax Return, Form TT-385, New York State Estate Tax Return, Form TT-102, New York , Form TT-141-A, Estate Tax Domicile , or Form ET-141, New York State Estate Tax Domicile . Estate tax waivers are not required for property of the estate of an individual whose date of death is on or after February 1, 2000.You must complete all applicable areas. 226 If an entire investment portfolio account is decedent information in the areas provided above. Attach to this form a copy of the portfolio showing the itemized assets on the date of death. If your broker requires Tax Department validation on the listing request that validation when you submit the waiver notice. The department will return your validated listing sheet with the waiver notice.Bonds 226 Enter the quantity and denomination of bonds.Stock 226 Enter the number of shares of common and/or preferred stock.Description 226 Enter a description of the annuity, stock, bond, life insurance policy, bank account (e.g. savings, checking, CD), or brokerage account being transferred, and include its corresponding account or policy number.Amount 226 Enter the date þ - of þ - death value of the stock or bonds, bank account, brokerage account, life insurance, or annuity.Name of or payable to 226 If a bank account, bond, stock, or brokerage account is held jointly, enter the names of the joint tenants. If it is in the name of the decedent only, enter decedent. StockAs authorized by the Tax Law, the Commissioner of Taxation and Finance hereby waives notice of the time and place of delivery or transfer by you or your transfer agent of the property described above and consents to the transfer without retention by you or your transfer agent of any tax and interest that may be assessed against this estate pursuant to the Tax Law.BondsNumber of shares of:QuantityDenominationCommonPreferredName of or payable to (see instructions)Description of each asset andaccount numberAmountestate of decedent.If you are requesting a waiver for the estate of an individual whose date of death was before May þ / 26, 1990, submit this form and attachments in duplicate.New York State Law requires all government agencies that authority for any request for personal information, the principal purpose(s) for which the information is to be collected, and where it will be maintained. To view this information, visit our website, or, if you do not have Internet access, call and request Publication 54, . See Need help? for the Web address and telephone number.For estates of individuals whose date of death is before February 1, 2000Telephone assistanceNeed help? Visit our website at www.tax.ny.gov þ get information and manage your taxes online þ check for new online services and features Estate Tax Information Center: þ 518-457-5387To order forms and publications: þ 518-457-5431Text Telephone (TTY) or TDD þ Dial 7-1-1 for the þ equipment users þ New York Relay Service American LegalNet, Inc. www.FormsWorkFlow.com Need help? Persons with disabilities: In compliance with the Americans with Disabilities Act, we will ensure other facilities are accessible to persons with Telephone assistanceEstate Tax Information Center: þ (518) 457-5387 þ Text Telephone (TTY) Hotline (for persons with Visit our Web site at www.tax.ny.gov þ þ TP-38(10/15)Change in Mailing Address and AssistanceInformation for Certain Estate Tax FormsPrivate delivery services below):NYS ESTATE TAXPROCESSING CENTERPO BOX 15167ALBANY NY 12212-5167NYS TAX DEPARTMENTTDAB/ESTATE TAXW A HARRIMAN CAMPUSALBANY NY 12227-2994Note: Private delivery servicesunless Designated Private Delivery Services. Need help? below for information American LegalNet, Inc. www.FormsWorkFlow.com