Form 454-A - Affidavit Of Surviving Spouse


Form 454-A
Revised 11-2004
Oklahoma Tax Commission
Affidavit of Surviving Spouse
State of
County of
The undersigned
, SSN Number
surviving spouse of the below named decedent, of lawful age, being duly sworn, states as follows:
Attached hereto is a certified copy of the death certificate of
SSN Number
deceased, issued by the Department of Health for the State of Oklahoma
) showing that said decedent died on the
day of
, 20
, a
resident of the County of
, State of
at the time of death.
Affiant states that
is the surviving spouse of the above said
decedent. Based upon investigation, Affiant states that, to the best of Affiant’s knowledge, all of said decedent’s property,
both real and personal, passes to Affiant as surviving spouse and therefore, this Affidavit is being filed instead of an
Oklahoma Estate Tax Return for the purpose of the Oklahoma Tax Commission issuing a release exempting as
nontaxable all property included in the decedent’s estate. Affiant further states and agrees to be liable for any Oklahoma
Estate Tax due on decedent’s estate determined by the Oklahoma Tax Commission after a Release Order is issued by the
Oklahoma Tax Commission.
Affiant as Surviving Spouse
SSN Number
City and State
Subscribed and sworn to before me this
day of
, 20
Notary Public
My Commission Expires:


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