L-4
                    Affidavit Requesting Preliminary Waivers: Resident Decedents
                                                                                            (12-19)

This form may be used when:
•  A complete Inheritance or Estate Tax return cannot be completed yet; or
•  All beneficiaries are Class A, but estate does not qualify to use Form L-8; or
•  All beneficiaries are Class E, or Class E and Class A.

Use this form to request release of:
•  New Jersey bank accounts; 
•  Stock in New Jersey corporations;
•  Brokerage accounts; 
•  New Jersey investment bonds; and 
•  New Jersey real estate (only when estate does not qualify to use Form L-9).

This form can be completed by the: 
•  Executor;
•  Administrator; 
•  Trustee;
•  Legal Representative of the estate.

For all L-4 filings:
•  Check the appropriate box in Part I to indicate why you are filing this form;
•  Submit complete copies of the decedent’s Will and Codicils and Trust documents;
•  Submit copies of any disclaimer(s) filed;
•  List all beneficiaries and their relationship to the decedent in Part VII;
•  Check the “Request Waiver” box for each asset for which a waiver is requested at this time. The Branch will 
    make final decision on which (if any) waivers are issued;
•  The form must be signed by an estate representative and notarized;
•  Mail form to:  NJ Inheritance Tax Branch, PO Box 249, Trenton, NJ 08695-0249.

For taxable estates: 
•  Report all known New Jersey assets on attached schedules;
•  Submit a complete copy of the decedent’s last full-year federal income tax return (include all schedules) or 
    statement that none was filed;
•  Include estimated payment on attached IT-PMT (recommended);
•  If requesting a real estate waiver, include deed, contract of sale, or closing agreement.

Note: The filing of this form does not guarantee that any waivers will be issued at this time. In addition, the filing 
of this form will not generate a Notice of Assessment or any finding of tax due.

                     Affidavit Requesting Preliminary Waivers: Resident Decedents

                                                           State of New Jersey
                                                           Division of Taxation                                            L-4
                                           Individual Tax Audit Branch                                                     (12-19)
                                          Transfer Inheritance and Estate Tax
                                                           PO Box 249 
                                          Trenton, New Jersey 08695-0249

 Decedent’s Name  
                          (Last)          (First)                   (Middle)

 Decedent’s S.S. No.  /          /        Date of Death (mm/dd/yy)           /     /   County of Residence 

                  Complete and Notarize                       Testate (with will)         Intestate (no will)

                     Name                                                                                Daytime Phone (   ) 
 Mailing Address 
      to send all 
 correspondence      Street 

                     City                                                              State             ZIP Code 
 PART I – Reason for Request (Check the appropriate box):

    I am filing this form to obtain one or more preliminary waivers. The estate is not able to file a full return at this time; however, 
   specific waivers are needed to protect estate assets. I understand that a full return must still be completed and filed.

 Important Note: The Branch will, in every case, keep control of enough liquid assets (i.e., those that can easily be converted to cash) 
 to insure that the tax is covered and that returns will be filed.  This means that we will hold back whichever bank waivers we think are 
 necessary and will avoid relying on real estate being the only waiver withheld (per N.J.A.C. 18:26-9.4).
    I am filing this form to obtain all waivers (Class A only). All beneficiaries are Class A; however, the estate does not qualify to 
   use Form L-8. The estate contends that no tax will be due. I understand that the Branch will evaluate my attached submissions and 
   advise me if a full return is required.

    I am filing this form to obtain all waivers (Class E/Class A). All beneficiaries are Class E only or Class E and Class A. I 
   understand that the Branch will evaluate my submissions and advise me if a full return is required.

 I hereby request the release of the indicated property listed below. I certify that all beneficiaries of the estate are listed in Part VII below 
 and that this form is completed in accordance with its filing requirements.

 State of New Jersey County of                                                     ss.

                                                                     being duly sworn, deposes and says that the foregoing state-
 ments are true to the best of their information or belief.
 Subscribed and sworn before me                                   Signature

 This  day of                    ,        .

                     Notary Public                                Deponent: Executor / Administrator / Joint Tenant / Heir-at-Law

                                                                  Deponent’s Social Security or Federal Identification Number

                                                                  Street Address

                                                                  Town/City, State, Zip

Decedent’s Name:                                                                        Decedent’s S.S. No.:  /                  / 

PART II – Estimated Net Estate
Report estimated value of all NJ reportable assets of the estate:
Gross Estate – Inheritance Tax
(Optional) Deductions (Debts, funeral, legal, etc.)
Net Estate

PART III – Transfers
List all transfers made by the decedent within three years of date of death or to take effect at death (such as POD annuities):
    Date of Transfer          Transferee/Beneficiary             Relationship           Property Transferred DOD Value

                                                   Attach additional sheets if necessary

PART IV – Real Estate 
List all real estate owned wholly or partially by the decedent (except as tenants by the entirety where the spouse is surviving)
                 Description                         Assessed Value                     Market Value         Request Waiver

County
Street
Lot                   Block
Municipality
Interest

                 Description                         Assessed Value                     Market Value         Request Waiver

County
Street
Lot                   Block
Municipality
Interest

                 Description                         Assessed Value                     Market Value         Request Waiver

County
Street
Lot                   Block
Municipality
Interest
                              (Attach additional sheets or riders if necessary)

Decedent’s Name:                                                         Decedent’s S.S. No.:  /  / 

PART V – NJ Financial Institutions (Banks, Brokerage Accts, Mutual Funds)
Name of Bank or Institution Name(s) on Account and how They Were Date of Death Balance        Request Waiver
                                                 Held

                            (Attach additional sheets or riders if necessary)

PART VI – NJ Stocks, Investment Bonds
Name of Stock or Bond       Name(s) of Owner(s)      Shares              Date of Death Value  Request Waiver

                            (Attach additional sheets or riders if necessary)

PART VII – Beneficiaries
                 Name and Address (if available)                         Relationship         Share in Estate

                            (Attach additional sheets or riders if necessary)