Reset Form                                                                                         ET 2X
                                                                                                                                                         Rev. 5/12
          Estate Tax Unit
          1-(800) 977-7711
          tax.ohio.gov

                                Amended Ohio Estate Tax Resident Return
                                 File in duplicate with the Probate Court.
                For estates with a date of death of July 1, 1983 – Dec. 31, 2012
                                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 through the county auditor’s Offi ce.

 Estate of: Decedent’s last name       Decedent’s fi rst 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                                 Case number

 Date estate tax return fi led                         Was it (check one):            Taxable                              Nontaxable

          If an estate tax form 10, Certifi cate of Determination of Final Ohio Estate Tax Liability,
                                 has been received, attach a copy thereof to this return.

                                                                                                                      1     $
 Net taxable estate as previously reported ..........................................................  

 Plus additional or increase (or less a decrease) in value of assets                                                  2     $
 (describe on reverse side) .......................................................................................  
                                                                                                                      3     $
                                Total ............................................................................  

 Less additional or increase (or plus a reduction) in amount of deductions
                                                                                                                      4     $
 (describe on reverse side) .......................................................................................  
                                                                                                                      5     $
                                New net taxable estate ..............................................  
                                                                                                                      6     $
 Tentative tax due on new net taxable estate (use table on reverse side)................  
                                                                                                                      7     $
 Less estate tax credit (see reverse side) .................................................................                   
                                                                                                                      8     $
 Tax due (subtract line 7 from line 6; if line 7 is more than line 6, enter 0) .........................  
                                                                                                                       9    (                                               )
 Less tax previously assessed or paid (exclude any interest and penalty paid) .............  

 If line 9 is less than line 8, subtract line 9 from line 8 and enter the amount
 of supplemental tax now due .................................................................................       10     $

 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                                                        Date Received by
                                 (Ohio Revised Code Section 5731.48 and 5731.50)                                               Ohio Department of Taxation
                                       Percentage                             City, Village or Township

                                                                                                                    ET 2X
                                                                                                                    Rev. 5/12
                                                                                                                    Page 2

                                         Explanation of Changes
                                       If addtional space is needed, please use attachments.

                                                Line 6 – Tax Rates

If the net taxable estate is:                          The tax shall be:
Not more than $40,000                                  2% of the net taxable estate
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  $2,600 plus 4% of the excess more than $100,000
More than $200,000, but not more than $300,000  $6,600 plus 5% of the excess more than $200,000
More than $300,000, but not more than $500,000  $11,600 plus 6% of the excess more than $300,000
More than $500,000                                     $23,600 plus 7% of the excess more than $500,000

                                                Line 7 – Credits

                                                                               Applicable Estate
                                         Date of Death                                            Tax Credit
 
Dates of death on or before 06/30/83                                                                0
Dates of death 07/01/83, but before 01/01/01                                                        $500
Dates of death 01/01/01, but before 01/01/02                                                        $6,600
Dates of death 01/01/02, but before 01/01/13                                                        $13,900

Print or type to expedite audit and fi nalization

                                                Declaration

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 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

Name of executor/administrator(s)        Address (number and street, city, state and ZIP code)      Telephone number

Signature of executor/administrator(s)   Date          Signature of preparer                                Date

                                         File in Duplicate in probate court.