Form Dr-312 - Affidavit Of No Florida Estate Tax Due With Instructions - 2000


Affidavit of No Florida Estate Tax Due
N. 01/00
(for decedents dying on or after January 1, 2000)
(this space available for case style of estate probate proceeding)
(for official use only)
STATE OF _____________________________
COUNTY OF ___________________________
I, the undersigned, ________________________________________________________________ , do hereby state:
(print name of personal representative)
I am the Personal Representative as defined in s. 198.01 or s. 731.201, Florida Statutes (F.S.), as the case may be,
of the Estate of _____________________________________________________________________________ .
(print name of decedent)
The decedent referenced above, whose Social Security Number is _________________________________, died
on _____/_____/_____, and was domiciled, as defined in s. 198.015, F.S., at the time of death in the state
(date of death)
of _______________________.
On date of death, the decedent was (check one):
a U.S. citizen
not a U.S. citizen
3. A federal estate tax return (federal Form 706 or 706-NA) is not required to be filed for the Estate.
4. The Estate does not owe Florida estate tax pursuant to Chapter 198, F.S.
5. I acknowledge personal liability for distribution in whole or in part of any of the Estate by having obtained release of
such property from the lien of the Florida estate tax.
Under penalties of perjury, I declare that I have read this Affidavit and that the facts stated are true.
Executed this ______ day of ______________________, 20 _______ .
Print Name:________________________________________________
Mailing Address:____________________________________________
Telephone: ____________________
STATE OF __________________
COUNTY OF ________________
Sworn to (or affirmed) and subscribed before me by ___________________________________________________________
on this _____________ day of _______________________, 20______.
Signature of Notary: _______________________________
Personally known ______
Or Produced Identification ______
Type of Identification Produced_________________________
(Print, Type, or Stamp Name of Notary)


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