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AFFIDAVIT OF DEATH AND HEIRSHIP
“Decedent”
Before me, the undersigned authority, on this day, personally appeared:
_______(“Affiant”),
who resides at
, who, being of lawful age, being first duly sworn, upon
his/her oath deposes and says:
My name is ___________________________________________________________. I am personally familiar with the family and martial history
of_________________________________, Decedent. I bear the following relationship to Decedent, to-wit:
.
1. I knew the Decedent from
a. Decedent died on
being

until

.
at or near ____________________________________________________

years of age at the time of death.

b. At the time of death, Decedent resided at ____________________________________________________________________________________
2. The Decedent did/did not leave a Will which was/was not admitted to probate. Probate proceedings have commenced in
the following Court/County/State:
3. An heirship determination proceeding has/has not been conducted in a court