Affidavit Of Transferee Of Trust Property That No Indiana Inheritance Or Estate Tax Is Due On The Transfer
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Affidavit Of Transferee Of Trust Property That No Indiana Inheritance Or Estate Tax Is Due On The Transfer Form. This is a Indiana form and can be use in Department Of Revenue Statewide.
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Tags: Affidavit Of Transferee Of Trust Property That No Indiana Inheritance Or Estate Tax Is Due On The Transfer, IH-TA, Indiana Statewide, Department Of Revenue
Form IH-TA
SF# 48832
(R2/04-07)
STATE OF INDIANA
)
)SS:
COUNTY OF _______________________ )
IN THE MATTER OF THE ESTATE OF
)
)
_____________________________, DECEASED. )
Social Security Number ______ - ___ - ______
AFFIDAVIT OF TRANSFEREE OF TRUST PROPERTY THAT NO
INDIANA INHERITANCE OR ESTATE TAX IS DUE ON THE TRANSFER
Comes now ___________________, being first duly sworn upon his/her oath, says that:
1. Transferee, ___________________________________________________, is a trust beneficiary, successor
trustee (strike inappropriate terms) of the _____________________________________ Trust, under agreement
dated and signed on the ____ day of _______________, 20______ and last amended on the ____ day of
(month)
(year)
______________, 20______.
(month)
(year)
2. That the original grantor_____________________, of the trust died on the ____ day of ______________,
(month)
20______, a resident of ___________________, County, Indiana.
(year)
3. Transferee (a) is domiciled in Indiana, or (b) is a representative of _________________________, a corporation
doing business in Indiana. (Strike either (a) or (b), whichever is not pertinent.)
4. That the following personal property sought to be transferred is held by the trust:
Holding Institution
Account Number
Description of Property
Date of Death Value
5. That the transfer of the trust personal property is not subject to Indiana inheritance or estate tax for the following reason:
6. Transferee, by making this affidavit, says that the above trust personal property will be transferred to him/
her and is not subject to Indiana inheritance or estate tax and further says, under the penalties for perjury, that
the statements herein are true and correct to the best of such person’s knowledge and belief.
Signature of transferee
Name (typed or printed)
Address
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STATE OF INDIANA
)
) SS:
COUNTY OF _________________ )
Before me, a Notary Public in and for _____________________ County, State of _________________, personally appeared ____________________________, who acknowledged execution of the foregoing document and
who, being duly sworn, stated the representations contained herein to be true.
WITNESS my hand and Notarial Seal this _________ day of ________________, ___________.
(Signature) _________________________________
(Printed) _________________________________
Notary Public
SEAL
My commission expires: ______________________
NOTE: This affidavit must immediately be filed with the Indiana Department of Revenue, Inheritance Tax Division,
100 N. Senate Avenue, Room N248, Indianapolis, Indiana 46204-2253.
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