COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Estate Tax Division : 1 (800) 977-7711 www.ohio.gov/tax Estate Tax Form 2-X Revised 7/03 Index No. Calendar No. : JUDICIAL Amended Ohio Plaintiff(s)Tax Resident Return SUBPOENA Estate -against-in duplicate with the Probate Court. : File This form is to be used to report an increase in : tax liability, claim a refund or disclose a change with no tax consequences. : Check one: Refund Supplemental Tax Nontaxable Disclosure Pay supplemental tax Defendant(s) County Auditor’s Office. through the : ...................................................... Estate of: Decedent’s last name Decedent’s first name and initial Date of death Address of decedent at time of death (number and street, city, state and ZIP code) Decedent’s social security number County in Ohio, in which Probate Court located, where will probated or estate administered TO Case number THE PEOPLE OF THE STATE OF NEW YORK Date estate tax return filed Was it (check one): Taxable Nontaxable GREETINGS: If an Estate Tax Form 10, Certificate of Determination of Final Ohio Estate Tax Liability, WE COMMAND YOU, that all business and copy thereof to this return. and each of you attend before has been received, attach a excuses being laid aside, you the Honorable at the in room , on the day of , 20 , Court located at County of Net taxable estate as previously reported ......................................................... , at 1 $ o'clock in the noon, and at any recessed Plus additional or increase testify and give evidence as a witness in this action on the part of the or adjourned date, to (or less a decrease) in value of assets (describe on reverse side) ....................................................................................... 2 $ Total ........................................................................... 3 $ Less additionalYour failure(or comply with this in amount of deductions as a contempt of court and will make you liable to or increase to plus a reduction) subpoena is punishable (describeparty on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a on reverse side) ....................................................................................... 4 $ the result of your failure to comply. New net taxable estate ............................................. 5 $ Tentative tax due on new Honorable estate (use table on reverse side) .................. , one of the Justices of the 6 $ Witness, net taxable County, day of , 20 Less Court in credit (see reverse side) ................................................................. estate tax 7 $ Tax due (subtract line 7 from line 6; if line 7 is more than line 6, enter 0) .......................... 8 $ (Attorney must 9 Less tax previously assessed or paid (exclude any interest and penalty paid) ............. sign above and type name below) ( If line 9 is less than line 8, subtract line 9 from line 8 and enter the amount of supplemental tax now due ................................................................................ 10 ) $ Attorney(s) for If line 9 is greater than line 8, subtract line 8 from line 9 and enter the amount of refund now due .................................................................................................. 11 Date Filed with Probate Court Distribution of Subdivisions’ Share of Tax (O.R.C. Section 5731.48 and Office and 5731.50) Percentage ( P.O. Address ) Date Received by Ohio Department of Taxation City, Village or Township Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : Explanation of Changes Estate Tax Form 2-X Revised 1/03 Page 2 Index No. Calendar No. If addtional space is needed, please use attachments. : Plaintiff(s) -against- JUDICIAL SUBPOENA : : : Defendant(s) : ...................................................... THE PEOPLE OF THE STATE OF NEW YORK TO Line 6 – Tax Rates If the net taxable estate is: Not more than $40,000 The tax shall be: 2% of the net taxable estate GREETINGS: More than $40,000 but not more than $100,000 $800 plus 3% of the excess more than $40,000 More than $100,000 but not more than $200,000 and excuses being laid aside, you and each of you attend before WE COMMAND YOU, that all business $2,600 plus 4% of the excess more than $100,000 , the More than $200,000 but not more than $300,000 at$6,600 plus 5% of Court Honorable the the excess more than $200,000 located at County of $300,000 but not more than $500,000 $11,600 plus 6% of the excess more than $300,000 More than in room than $500,000 the , on day of , 20 , at o'clock in the noon, and at any recessed More $23,600 plus 7% of the excess more than $500,000 or adjourned date, to testify and give evidence as a witness in this action on the part of the Line 7 – Credits Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to Applicable Estate the party on whose behalf this subpoena of Death for a maximum penalty of $50 and all damages sustained as a Date was issued Tax Credit result of your failure to comply. Dates of death on or before 06/30/83 Dates of death on or after 07/01/83 but before 01/01/01 Witness, Honorable Dates of death on or after 01/01/01 but before 01/01/02 Court in County, day of , 20 0 $500.00 , one of the Justices of the Dates of death on or after 01/01/02 $6,600.00 $13,900.00 Print or type to expedite audit and finalization Declaration (Attorney must sign above and type name below) Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the deceased’s personal Attorney(s) for representative or person in possession of property is based on all information of which preparer has any knowledge. Name of attorney representing the estate Address (number and street, city, state and ZIP code) Name of executor/administrator(s) Address (number and street, city, state and ZIP code) Signature of executor/administrator(s) Office and P.O. Address No.: Facsimile No.: E-Mail Address: Mobile Tel. File in Duplicate in Probate Court.No.: Date Signature Telephone of preparer Telephone number Telephone number Date American LegalNet, Inc. www.USCourtForms.com