It: Aff-1 Affidavit Of Estate Tax - Alabama Department Of Revenue

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Affidavit of Estate Tax
IT: AFF-1 (7/02)
(To be recorded in the county of residence of the decedent)
(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)
1. I am the Personal Representative as defined in Section 8-6-140(5), Code of Alabama 1975, as the case may
be, of the Estate of _________________________________________________________________________.
(print name of decedent)
2. The decedent referenced above, whose Social Security Number is ________________________________ died
on ________ /_________ /________, and was domiciled, as defined in Caheen vs. Caheen, 233 Ala. 494, 172
So. 618 (1937), at the time of death, at ___________________________________________________________
in the county of ____________________________ and state 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) (check one):
is not required
is required to be filed for the Estate.
Under penalties of perjury, I declare that I have read this Affidavit and that the facts stated are true. This form is
being filed in accordance with Section 40-15-13, Code of Alabama 1975.
Executed this __________ day of ______________________, 20______.
Signature: ________________________________________________
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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