Form 454-N - Simplified Nontaxable Affidavit - Oklahoma Tax Commission Page 2

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Form 454-N
Oklahoma Tax Commission
Revised 5-2008
Estate Summary
Estate of:
aka:
Probate Number:
Probate County:
gross estate:
gross estate:
gross estate:
gross estate:
gross estate:
1. Real Estate, oil and gas leases, etc. ............................................................................. $
2. Stocks, bond, etc. .......................................................................................................... $
3. Personal Property .......................................................................................................... $
4. Life Insurance ................................................................................................................ $
5. Transfers during lifetime ................................................................................................ $
6. Total gross estate in Oklahoma (Total lines 1 thru 5) ..................................................... $
7. Property out-of-state ................................................................ $
8. Total gross estate (Total of lines 6 & 7) .................................... $
9. Oklahoma’s % (Line 6 divided by line 8) ..................................
%
10. Less property reportable in Oklahoma passing to surviving spouse ............................. $
11. Adjusted gross estate (Line 6 minus line 10) ................................................................. $
deductions:
deductions:
deductions:
deductions:
deductions:
12. Burial Plot, Crypt, Mausoleum and Monument Expenses ............................................. $
13. Funeral Expenses .......................................................................................................... $
14. Executor and Attorney Fees (court approved and paid) ................................................ $
15. Other deductions (description) ...................................................................................... $
16. Total Deductions (Total of lines 12 thru 15 x % on line 9) .............................................. $
net estate:
net estate:
net estate:
net estate:
net estate:
17. Net Estate in Oklahoma (Line 11 minus line 16)............................................................ $
18. Less exemption allowed (see chart) multiplied by % on line 9 ...................................... $
List Heirs, Devisees and Legatees below:
relationship
value of distribution
name and social security number

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