Free Affidavit Separation for Tax Purposes Template

Affidavit Separation for Tax Purposes

I. Personal Information

  1. Affiant 1:
    Name: John Doe
    Address: 123 Main Street, Springfield, State 12345
    Date of Birth: January 1, 2025

  2. Affiant 2:
    Name: Jane Doe
    Address: 456 Elm Street, Springfield, State 12345
    Date of Birth: February 14, 2025


II. Separation Details

  • Date of Separation: June 15, 2050

  • Living Arrangements:
    As of the separation date, the affiants have been residing at separate addresses provided above. Neither party shares a household, utilities, or other cohabitation-related expenses.

  • Financial Arrangements:
    The affiants maintain separate financial accounts and do not jointly manage assets or liabilities, including mortgage payments, rent, or other obligations.


III. Purpose of Affidavit

This affidavit is submitted for the following purposes:

  1. To support the claim for a "Head of Household" tax filing status by John Doe for the year ending December 31, 2050.

  2. To provide evidence of separation for legal and financial institutions as required.

  3. To affirm that Jane Doe will not claim joint tax liability with John Doe for the period starting June 15, 2050.


IV. Affiant Acknowledgment

We, the undersigned, affirm that the statements in this affidavit are true to the best of our knowledge. We understand that providing false information may result in penalties under applicable laws.

Affiant

Signature

Date Signed

John Doe

June 20, 2050

Jane Doe

June 20, 2050

Affidavit Templates @ Template.net