Free affidavit of domicile 23
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AFFIDAVIT OF DOMICILE
NOTE: This Affidavit must be completed and executed in the presence of a Notary.

State of

)

County of

:ss.:
)

____________________________________________________ being duly sworn, deposes and says that:
(Name of Surviving Tenant/Executor/Administrator/Trustee)
n

he/she resides at __________________________________________________________________ State of _______
(Street Address and City)

(State)

and is _____________________________________________ of _________________________________________/
(If Corporate Fiduciary, State Title of Affiant and Name of Corporation; Otherwise Leave Blank)

Surviving Tenant/Executor/Administrator/Trustee of the Estate of __________________________________________ ,
(Name of Decedent)

Deceased, who died at _______________________________________________ on the____ day of _______ , ______ ;
(Street Address, City, State, Zip Code)
n

(Date)

(Month)

(Year)

at the time of his/her death the domicile (legal residence) of decede