Affidavit To Waive Filing Of Tennessee Inheritance Tax Return {007}

IN THE CHANCERY COURT OF HAMILTON COUNTY, TENNESSEE * IN THE MATTER OF THE ESTATE OF * N0. _________________ * ____________________________________, * PART 2, PROBATE DIVISION DECEASED * AFFIDAVIT TO WAIVE FILING OF TENNESSEE INHERITANCE TAX RETURN The undersigned, being duly sworn, deposes and says: 1. I am the duly qualified personraelpr esentative of the estate of ___________________________ [hereinafter "Decedent]". 2. This affidavit is submitted in support of a waiver of filing the Tennessee Inheritance Tax Return as prescribed in T.C.A. 67-8-409(g). 3. Decedents Gross Estate for Tennessee Ihenritance Tax purposes is valued at $_______________ [not to exceed $100,000] . 4. Decedents Gross Estate for Tennessee Inheritance Tax purposes consists of the following assets: ASSETS VALUE _____________________________________________________________________ _____________ _____________________________________________________________________ _____________ _____________________________________________________________________ _____________ _____________________________________________________________________ _____________ _____________________________________________________________________ _____________ 5. Decedent made no gifts during life to any donee in an amount exceeding the maximum single exemption allowable free of tax under T.C.A. 67-8-104. UNDER PENALTIES OF PERJURY, I DECLARE THE FACTS STATED IN THIS AFFIDAVIT ARE TRUE, CORRECT, AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND BELIEF. THIS ____ DAY OF __________________, 20___. ___________________________________________ AFFIANT STATE OF TENNESSEE ) COUNTY OF ___________________ ) Sworn to and subscribed before me this ____ day of __________________, 20___. ____________________________________ N OTARY PUBLIC My commission expires:___________________ [Form 007, Rev. 2001.01.19]