7/07

              L-9 NR

    AFFIDAVIT OF NON-RESIDENT DECEDENT

    REQUESTING REAL PROPERTY TAX WAIVER(S)

              STATE OF NEW JERSEY
              DEPARTMENT OF THE TREASURY
              INDIVIDUAL TAX AUDIT BRANCH
              TRANSFER INHERITANCE & ESTATE TAX
              PO BOX 249
              TRENTON, NEW JERSEY 08695-0249

              (609) 292-5033

Do not file this form if you are a surviving spouse or a surviving civil union
partner, and the New Jersey real property was owned by you and the decedent
as tenants by the entirety.  An Inheritance tax waiver is not necessary and will
not be issued.

                                     INSTRUCTIONS

Form L-9 NR is an affidavit executed by the executor, administrator, or joint tenant (when an executor or administrator has
not been appointed). This form is used to request an inheritance tax waiver for real property located in New Jersey which
was held by a non-resident decedent. This form can be used only when all beneficiaries of the entire estate, no matter
where the assets of the estate are located, are Class "A" beneficiaries or charities (N.J.S.A. 54:34-4d).  Class "A"
beneficiaries include spouse/ civil union partner on or after 2/19/07, children, grandchildren, legally adopted
children and their children, step-children (not step-grandchildren), parents, grandparents, and domestic partner on
or after 7/10/04.

If this form is not fully and properly completed and/or it does not have the required attachments, it will be returned. 

 Answer all questions.

 Attach a copy of the decedent's death certificate.

 Attach a copy of letters testamentary or letters of administration.

 Attach a copy of the decedent's will, codicils, and any trust agreements.

 Attach a copy of the first two pages of the decedent's last full year's Federal income tax return. 

 Attach a copy of the deed for the NJ realty and provide the assessed and market values on the decedent's date of
  death.  If the realty was held by multiple owners, state the names of the owners and their relationship to the
  decedent.  

 List all beneficiaries who shared in the estate either by will, intestacy, trust, or operation of law.   Also list all
  beneficiaries who were recipients of transfers intended to take effect at the decedent's death and transfers made
  within three years of the decedent's death.  State their relationship to the decedent and their interest in the estate.

 In the case of a surviving spouse/civil union partner or domestic partner, submit a copy of the appropriate certificate
  establishing the relationship.

                 This form is not a tax waiver and is not to be filed with the County Clerk.

This complete form and attachments should be forwarded to the NJ Division of Taxation, Inheritance and Estate Tax,
PO Box 249, Trenton, NJ 08695-0249.

Additional information pertaining to the use of Form L-9 NR may be obtained by calling the Inheritance and Estate Tax
section at 609-292-5033.

                        THIS FORM MAY BE REPRODUCED IN ITS ENTIRETY

L-9 NR                                  NON RESIDENT DECEDENTS ONLY                                                   L-9 NR
                                                                                                                          2/07

Decedent’s Name: ___________________________________________________________________________________________________________
                       (Last)                                         (First)                                         (MI)
Decedent’s SS No. _____________________________  Date of Death (mm/dd/yy)  ____________________   State of Domicile: ___________________

                                      THE FOLLOWING QUESTIONS MUST BE ANSWERED:

1. The decedent died           Testate               Intestate

at _________________________________________________________________________________________________________ 
                                                             (Address)
_________________________________   _________________                 on __________________________________________________
                   (City)                            (State)                                       (Date)

A. The decedent’s actual place of residence was: ____________________________________________________________________
                                                                                      (Address)

Where he/she lived from _________________________________ to _________________________________

B. The decedent’s voting address was ____________________________________________________________________________ 

and he/she last voted in _________________________________
                                        (Year)

C. The decedent’s last Income Tax Return listed his/her address as: _____________________________________________________

D. The decedent formerly lived in New Jersey at: ____________________________________________________________________

but moved to ______________________________________________________________ on _____________________________
                                        (Address)                                                               (Date)
2. Does the value of the decedent’s entire estate, wherever located, exceed $675,000?  Yes     No
                                                                      Approximate value:  $____________________________

3. Did the decedent own any assets, located anywhere, that were jointly owned with someone other than a 
Class “A” beneficiary?             Yes           No

4. Did the decedent transfer any assets, located anywhere, to someone other than a Class “A” beneficiary during the 3 year period prior 

to death?         Yes     No      If yes, explain ___________________________________________________________________

___________________________________________________________________________________________________________

5. Did the decedent transfer any asset at any time during his/her lifetime, in which he/she retained the use of the asset for the rest of 

his/her lifetime?       Yes         No      If yes, explain ____________________________________________________________

___________________________________________________________________________________________________________

6. Did the decedent own any annuity contract(s) payable on death to someone other than a Class “A” beneficiary?  Yes  No

                     Description of New Jersey Real Estate                                                  Full Assessed Value Full Market Value 
                                                                                                            for Year of Death    at Date of Death
Street and Number

Municipality                        County

Lot                                 Block

Owner(s)  of Record: (If decedent owned a fractional interest state how held and fractional value thereof).

Amount of Mortgage Balance (if any) $
Street and Number

Municipality                        County

Lot                                 Block

Owner(s)  of Record: (If decedent owned a fractional interest state how held and fractional value thereof).

Amount of Mortgage Balance (if any) $

                                    RIDERS MAY BE ATTACHED WHERE NECESSARY
                     Beneficiaries
    State Full names of all who have an interest in the Estate     Relationship to the Decedent                        Interest of Beneficiary in the Estate
    (vested, contingent, operation of law, transfer, etc.)

Deponent further states the following schedule contains the names of all beneficiaries who predeceased the decedent.
                     Name                                          Date of Death                                                Domicile at Death

                                                                   Complete and Notarize
    Mailing Address  Name _________________________________________________ Phone (         ) ___________________

    To Send          Street _________________________________________________________________________________

All Correspondence   City           ___________________________________________ State __________  Zip ___________________

State of: ____________________________________________             County of: __________________________________________

That ____________________________________________________________________________ being duly sworn, has reviewed the
information contained in this form and declares to the best of his/her knowledge it is true, correct, and complete.  Deponent authorizes the
party listed above to act as the estate's representative and to receive the waiver(s) requested herein.
Subscribed and sworn before me

this _________ day of _____________________,  20______             Affidavit of:                           Executor  Administrator  Joint Tenant

___________________________________________________________        _____________________________________________
                 (Signature of Notary Public or Attesting Officer)                                          Signature of Deponent