COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Estate Tax Division : 1 (800) 977-7711 www.ohio.gov/tax Estate Tax Form 4 Revised 7/03 Index No. Calendar No. : JUDICIAL 5731.19) Ohio Nonresident Estate Plaintiff(s) Tax Return (O.R.C. SectionSUBPOENA -against: This form must accompany Estate Tax Form 2 File in duplicate with the County Probate Court in Ohio :Nontaxable Check one: Taxable Estate of: Decedent’s last name Decedent’s first name and initial : County.in .Ohio .where . . . . . . . located . . . . . . . . . . property . . . . . Defendant(s) : . . . .State. of. domicile . . . . . . . . . . . . . ... . ...... Did decedent ever reside in Ohio? No Yes Date of death Decedent’s social security number If “yes,” state place, dates and duration of residence. THE PEOPLE OF THE STATE OF NEW YORK Computation TO (A) 1. Total Ohio tax on property in all jurisdictions ................................................................................... $ (from page 1, line 6 of Estate Tax Form 2) (B) 2. Total gross value of all property having a taxable situs in Ohio ...................................................... $ GREETINGS: (real property and tangible personal property) (C) WE of property in YOU, that all business and excuses being laid aside, you $ 3. Total gross value COMMANDall jurisdictions ..............................................................................and each of you attend before the page 1, line 1 of Estate Tax Form 2) Honorable at the Court (from located at County of (B) X , 20 4. Ohio room tax due (A) the in estate , on day of , at o'clock in= the $ noon, and at any recessed (C) or adjourned date, to testify and give evidence as a witness in this action on the part of the 5. Less: Previous payments (exclude any interest and penalty paid) ................................................. $ 6. Balance due (if amount on line 5 is less than amount on line 4, enter difference as balance due) .............. $ 7. Overpayment (if amount on linecomply with this subpoenaline punishable as a as a refund) ......... $ Your failure to 5 is greater than tax amount on is 4, enter difference contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply. Declaration Witness, Honorable , one of the Justices of the Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and Court of County, day of , complete. Declaration of preparer other than decedent’s to the best in my knowledge and belief, it is true, correct and20 personal 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) Telephone number (Attorney must sign above and type name below) Name of executor/administrator(s) Address (number and street, city, state and ZIP code) Signature of executor/administrator(s) Date Filed with Probate Court Date Attorney(s) for Signature of preparer Distribution of Subdivisions’ Share of Tax Office and (O.R.C. Section 5731.48 and 5731.50) P.O. Percentage Telephone number Date 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. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : General Information When Nonresident Filing Is Required (O.R.C. Section 5731.19) Index No. Estate Tax Form 4 Revised 7/03 Page 2 Calendar No. : The estate of aPlaintiff(s) decedent mustJUDICIALForms 2 and 4 if the decedent nonresident file Estate Tax SUBPOENA owned the following types of property: real property situated in Ohio, tangible personal -against: property having an actual situs in Ohio, and intangible personal property employed in carrying on a business within Ohio (unless exempted under O.R.C. Section 5731.34) : The filing requirements are the same as for a resident decedent, except the return may be filed directly with the county probate court where the Ohio property is located. : When completing Estate Tax Form 2, real estate and other assets, such as bank acIncludible Assets Defendant(s) : and .Deductions. . . . . . . . . . . . .counts situated.outside. of.Ohio, .should also be reported. Accordingly, when completing . ........... ........... ..... . .... ... the Estate Tax Form 2, describe and itemize all proper debts, expenses of administration and deductions. These deductions may include, but are not limited to, real estate taxes, mortgages and utilities located in and outside of Ohio. THE PEOPLE OF THE STATE OF NEW YORK Computation of Tax TO (O.R.C. Section 5731.19) The nonresident tax base is determined by multiplying the tax due (as computed on the Estate Tax Form 2) by a fraction, the numerator of which is the gross value of all property having a taxable situs in this state, and the denominator of which is the value of the gross estate wherever situated (line 1 of the Estate Tax Form 2, page 1). When and Where to Returns are required to be filed within nine months from decedent’s date of death (see GREETINGS: Extension of Time to File, below). All filings must be made in duplicate in the county File (O.R.C. Section where all business and excuses property having taxable situs of you attend 5731.21) WE COMMAND YOU, thatthe principal portion of the being laid aside,ayou and each is located. before , the Honorable at the Court located at are paid at the county auditor’s office, with the check drawn to the order County ofWhere to Tax and interest When and in room , on the day county treasurer. Interest begins to accruein the , 20 , at o'clock at variable noon,nine monthsrecessed of theof rates and at any from the Pay (Tax and Interest) or adjourned date, to testify anddecedent’s date ofadeath regardless of theon the partduethe The county auditor will give evidence as witness in this action extended of date. (O.R.C. Section 5731.23) calculate any interest owing. For dates of death is or after January 1, 2002, 80% of the will make you liable to Distribution of Tax to comply with this subpoenaon punishable as a contempt of court and tax is distributed to the Your failure municipal corporation, village or township in which the tax all damages sustained the the party on whose (O.R.C. Sections behalf this subpoena was issued for a maximum penalty of $50 and originates, and 20% to as a state of Ohio. For dates of death between January 1, 2001 through December 31, result and 5731.50) 5731.48 of your failure to comply.2001, 70% of the tax is distributed to the municipal corporation, village or township in which the tax originates, and 30% to the state of Ohio. For dates of death before Witness, Honorable January 1, 2001, 64% of the tax is distributed, to the municipal corporation, village or one of the Justices of the Court in County, township of which the tax originates, and 36% to the state of Ohio. day in , 20 Extension of Time to File (O.R.C. Section 5731.21) Estates of decedents with a date of death on or after January 1, 2000 are granted an automatic six-month extension, allowing them a total of 15 months to file the estate tax (Attorney must sign above and type return. Any additional six-month extension must be requested name below) in writing directly to the Estate Tax Division on Estate Tax Form 24 before the due date of the return. Interest on any estate tax due Attorney(s) for will be calculated from nine months from date of death regardless if the estate uses the automatic or additional extensions. To stop the accrual of interest, an estimated payment of tax may be made. Any inquiries may be directed to: Ohio Department of Taxation, Estate Tax Division, 800 Freeway Drive North,Office and P.O. Address Columbus, OH 43229-5404. You may also call 1(800) 977-7711 or visit our Web site at www.ohio.gov/tax. For information regarding extensions of time to pay, estimated payments and penalties, Telephone this please refer to Estate Tax Form 2 or contactNo.: office. Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com