Form 454-N
Oklahoma Tax Commission
Revised 5-2008
Simplified Nontaxable Affidavit
Date of Death:
State of
)
County of
)
Attached hereto is a certified copy of the death certificate of
SSN
deceased.
Based upon investigation, Affiant states that, to the best of Affiant’s knowledge, the decedent’s net estate of
$
, as calculated on the reverse, is less than the applicable exemption.
This affidavit is being filed instead of an Oklahoma Estate Tax return for the purpose of obtaining a release from the
Oklahoma Tax Commission, exempting as nontaxable, all property included in the decedent’s estate. Affiant further states
and agrees to be liable for any tax due on the decedents estate subsequently determined by the Oklahoma Tax Commis-
sion after a Release Order is issued.
Under penalty of perjury, I declare that I, the undersigned personal representative, (or other)
,
have examined this affidavit and supporting schedules and to the best of my knowledge and belief it is true.
Affiant (Printed)
Affiant (Signature)
SSN
Address
City
State
Zip
(
)
Telephone
Subscribed and sworn to before me this
day of
20
.
Notary Public
My Commission Expires:
Commission Number:
Attorney (or Preparer):
/
Name (Printed)
Signature
Please Mail To:
Address
Oklahoma Tax Commission
Estate Tax Section
City
State
Zip
2501 North Lincoln Boulevard
Oklahoma City, Oklahoma 73194
(
)
Telephone
affidavit will not be accepted without a death certificate
affidavit will not be accepted without a death certificate
affidavit will not be accepted without a death certificate
affidavit will not be accepted without a death certificate
affidavit will not be accepted without a death certificate