New York Estate Tax Affidavit

NEW YORK ESTATE TAX AFFIDAVIT

State of New York                                                                 Title No._______________
                                        ss:                                                   
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 $1,000,000.00 and therefore said estate is not subject to any New York 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