Oklahoma Real Estate Commission - Non-Foreign Affidavit Form
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1OKLAHOMA REAL ESTATE COMMISSION
NON-FOREIGN AFFIDAVIT
STATE OF OKLAHOMA
NON-FOREIGN AFFIDAVIT
COUNTY OF ___________________________________________
(FIRPTA AFFIDAVIT)
THE UNDERSIGNED, BEING FIRST DULY SWORN, DEPOSES AND SAYS THAT:
1. This Non-Foreign Affidavit is given by Seller (Transferor) pursuant to Section 1445(b) (2) of the Internal Revenue Code of 1954,
as amended, (the “Code”) in order to induce ___________________________________________ the Buyer (Transferee)
to refrain from deducting and withholding any required tax on the amount realized by Seller (Transferor) upon the sale to Buyer
(Transferee) of the property briefly described as follows:
__________________________________________________________________________________________________
__________________________________________________________________________________________________
2. Seller (Transferor) is NOT a foreign person, nonresident alien, foreign corporation, foreign partnership, foreign trust, or foreign
estate (as those terms are defined in the Internal Revenue Code and Income Tax Regulations), and Seller (Transferor) is either:
• A citizen or resident of the United States,
• A domestic partnership, or
• A domestic corporation, or
• An estate or trust (other than a foreign estate of foreign trust as those terms are defined in Section 7701 (a) (31) of the
Code.
3. Seller’s (Transferor’s) Taxpayer Identification Number (TIN) or Social Security Number (SSN), as those terms are defined in
Sections 7701(a) (41) and 6109 of the Code is:
Seller’s (Transferor’s) TIN or SSN: ___________________________________
4. Seller’s (Transferor’s) address is: _____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
5. The undersigned Seller (Transferor) acknowledges that this certification may be disclosed to the Internal Revenue Service
and declares under penalties of perjury that the foregoing information is true, correct, and complete. Section 7206 of the Code
provides substantial fines and/or imprisonment for violation(s).
IN WITNESS WHEREOF, this Non-Foreign Affidavit is given this the ________ day of ___________________ , 20________.
SELLER:
______________________________________________
_________________________________________ (SEAL)
By: ___________________________________________
_________________________________________ (SEAL)
Sworn to and subscribed by _____________________ before me this _______ day of__________________, 20________.
_______________________________________ (Notary Seal)
Notary Public
My commission expires: _______________________________________________
This form was created by the Oklahoma Real Estate Contract Form Committee and approved by the Oklahoma Real Estate Commission.
OREC NON-FOREIGN AFFIDAVIT (11-2010)
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