AFFIDAVIT OF DEATH
I ___________________ , being first duly sworn, upon oath, depose and say the following:
1. ____________________signed and recorded a beneficiary deed with the intent to convey the
following property located in ______________ county, Montana described as follows:
2. The beneficiary deed was recorded in ______________ County on _________ day of
_____________200__. Book _______, Page ______, Instrument Number___________.
3. The grantor died on the ________ day of ___________ 200___. 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:_______________________________________