Form Dr-312 - Affidavit Of No Florida Estate Tax Due - 2013

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DR-312
Affidavit of No Florida Estate Tax Due
R. 08/13
Rule 12C-3.008
Florida Administrative Code
(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 198.01 or section 731.201, Florida Statutes, as the case
may be, of the estate of _____________________________________________________________________________ .
(print name of decedent)
2.
The decedent referenced above died on _____/_____/_____, and was domiciled (as defined in s. 198.015, F.S.) at
(date of death)
the time of death in the 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) is not required to be filed for the estate.
4.
The estate does not owe Florida estate tax pursuant to Chapter 198, F.S.
5.
I acknowledge personal liability for distribution in whole or in part of any of the estate by having obtained release
of such property from the lien of the Florida estate tax.
Under penalties of perjury, I declare that I have read this Affidavit and the facts stated in it are true. This declaration is
based on all information of which the personal representative has any knowledge
[ss. 92.525(1)(b); 213.37; 837.06, F.S.].
Executed this _______ day of ______________, 20 _____________
Signature ________________________________________________
Print name _______________________________________________
Telephone number _______________________________________
Mailing address ___________________________________________
City/State/ZIP ___________________________________________
State of __________________________________________________
County of _______________________________________________
Sworn to (or affirmed) and subscribed before me by _____________________________________________________________________
On this_____________ day of ______________, 20 ______________
Signature of Notary ________________________________________
(Check one)
❏
Personally known
❏
Or produced identification
Type of identification produced ________________________________
_______________________________________________________________
Print, type, or stamp name of Notary Public
File this form with the appropriate clerk of the court. Do not mail to the Florida Department of Revenue.

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