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Affidavit of Death

, being first duly sworn, upon oath, depose and say the following:
(Name of Beneficiary)


signed and recorded a beneficiary deed with the intent to convey the
(Name of Grantor)

following property located in

, Montana described as follows:
(Name of County)

2. The beneficiary deed was recorded in
, Page

, Instrument Number

3. The grantor died on


County on






At the time of death, the grantor had not revoked the above described beneficiary deed.
4. The following person(s) is/are the person(s) named as the grantee beneficiary(ies) under the beneficiary deed described above, and are entitled to succeed to the grantor’s
interest in the real property described above as a result of the grantor’s death:
(Grantee Beneficiary Name):
Mailing address:
Dated this

day of