NY Federal Estate Tax Affidavit

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  • New York
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NY Federal Estate Tax Affidavit

Form Document
V 1


State of New York                                                                 Title No._______________
County of ________                                                              

I, ______________________________, being duly sworn, depose and state the following to be true under the penalty of perjury:

1.  I reside at __________________________________________________.

2.  I am the Executor/Administrator of the Estate of _____________________ who died a resident of ___________________ County, on the ______ day of ___________________, in the year ________.

3.  If neither the Executor nor Administrator, state relationship to decedent: ___________________.

4.  I am fully familiar with the assets of which the decedent died seized, which comprise the gross estate as hereinafter defined, and said gross estate is less than $________________________ and therefore said estate is not subject to any Federal Estate Tax. 

5.  I make this statement knowing full well that ________________________, as policy issuing agents for Stewart Title Insurance Company relies on the accuracy thereof for the purposes of issuing title insurance in the captioned matter.


Sworn to before me this______
day of _____________, 20____.

            Notary Public

No guidelines are available for this form at this time.