Blank Arizona 74 PDF Template Modify Form Now

Blank Arizona 74 PDF Template

The Arizona 74 form, officially known as the Report of Personal Representative of Decedent, is a crucial document for estate administration in Arizona. It provides a comprehensive summary of the decedent's estate, including assets and liabilities, and must be submitted to the Arizona Department of Revenue. Completing this form accurately is essential for ensuring compliance with state tax regulations and facilitating the probate process.

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Overview

The Arizona Form 74, officially known as the Report of Personal Representative of Decedent, is a crucial document that must be completed and submitted to the Estate Tax Unit of the Arizona Department of Revenue. This form serves to provide a comprehensive overview of a decedent's estate, including vital information such as the decedent's name, social security number, date of death, and residence. It is essential to indicate whether the submission is an original or amended report. The form requires the personal representative to detail the estate's federal identification number and probate number, if applicable. Additionally, it outlines the total value of the estate, broken down into categories such as real estate, bank deposits, securities, and other assets. A copy of the death certificate must accompany the original report. The form also includes a section for requesting estate tax waivers and emphasizes the importance of accuracy by requiring a declaration under penalty of perjury. Completing this form correctly is vital for ensuring compliance with Arizona tax laws and facilitating the smooth administration of the decedent's estate.

Form Example

ARIZONA FORM

Report of Personal Representative of Decedent

 

 

74

 

 

This report must be completed and returned to:

 

 

 

 

 

 

Estate Tax Unit, Arizona Department of Revenue,1600 W Monroe, Room 610, Phoenix AZ 85007-2650

 

 

 

 

 

For assistance call: (602) 542-4643 or (800) 352-4090 (nationwide toll free)

 

 

 

 

 

 

 

You may also visit our web site at: www.revenue.state.az.us

 

 

CHECK ONE

 

 

 

 

 

 

Original

Amended

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Please Print or Type

 

 

 

Estate's federal identification number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name of decedent (last, first, middle initial)

 

 

 

 

 

 

Decedent's social security number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date of death

 

 

 

 

 

 

 

 

 

 

 

 

 

Residence of decedent (city or town, state, and ZIP code)

 

 

 

 

Probate number (if any)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

County of Probate Court

 

 

 

 

 

 

 

 

 

 

 

 

 

Personal representative

Address

City

 

State

 

 

 

ZIP code

 

 

 

 

 

 

 

 

 

 

 

 

 

Attorney

Address

City

 

State

 

 

 

ZIP code

 

 

 

 

 

 

 

 

 

 

 

 

Attach a copy of the death certificate if this is an original report.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Section I

 

 

Summary of Estate

 

 

 

 

 

 

 

 

 

Complete Section III first. Enter values below. (See instructions)

 

 

 

 

 

 

 

 

 

Arizona

 

 

Other Than Arizona

 

 

 

A. Real estate

$

 

 

$

 

 

 

 

 

 

 

B. Bank deposits

$

 

 

$

 

 

 

 

 

 

 

C. Securities

$

 

 

$

 

 

 

 

 

 

 

D. Other assets (household furnishings,

 

 

 

 

 

 

 

 

 

 

 

automobiles, other personal property)

$

 

 

$

 

 

 

 

 

 

 

E. Insurance

$

 

 

$

 

 

 

 

 

 

 

Total value of the estate

 

 

 

 

 

 

 

 

 

 

 

(Add A through E)

$

 

 

$

 

 

 

 

 

 

Is a federal estate tax return (Form 706 or 706NA) being filed?

NO

YES

Section II

Documents Requested

Indicate the type of waiver(s) you are requesting

Estate tax waiver (Real Estate)

Estate tax waiver (Probate)

Section III

Estate Assets

 

Use a continuation sheet if more space is needed

A. Real Estate - Market value at date of death of all real estate in Arizona. $ _______________________.

List legal description(s) of real estate in Arizona. Indicate county and if held as separate or joint tenancy. This can be found on the deed to the property or on the notice of valuation from the county assessor's

office. NOTE, BE SURE TO INCLUDE THE LOT NUMBER AND SUBDIVISION NAME.

ADOR 06-0034 (99)

Complete page 2

Form 74 Page 2

B. Bank Deposits - List accounts in financial institutions.

Name of bank or other institution

Type of account

Balance at date of death

 

 

 

Total Value

$ __________________

 

 

 

 

C. Securities - List all stocks, bonds, and other securities that were owned by the decedent.

 

 

Name of company

Number of shares

Value at date of death

Total Value

$ __________________

D. Other Assets - List other assets (household furnishings, motor vehicles, and other personal property).

Total Value

$ __________________

E. Insurance - Insurance on decedent's life (owned by the decedent).

Total Value $ __________________

Under penalty of perjury, I declare that I have examined this report, including any accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete.

Personal Representative / Surviving Joint Tenant / Attorney

Name (typed or printed)

 

Social security number or federal employer identification number

 

 

 

Address

 

 

 

 

 

City

State

ZIP code

 

 

 

Signature of representative

Date

Phone number

ADOR 06-0034 (99)

Document Characteristics

Fact Name Description
Purpose of the Form The Arizona Form 74 serves as a report for the personal representative of a decedent's estate. It provides necessary information regarding the estate's assets and liabilities for tax purposes.
Filing Requirements This form must be completed and submitted to the Estate Tax Unit of the Arizona Department of Revenue. It is crucial to include a copy of the death certificate when submitting the original report.
Governing Laws The form is governed by Arizona Revised Statutes, specifically Title 42, which pertains to taxation and estate tax regulations in the state.
Contact Information For assistance with the form, individuals may contact the Arizona Department of Revenue at (602) 542-4643 or (800) 352-4090. More information is also available on their official website.
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