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2 AFFIDAVITS
FORM III
AFFIDAVIT OF DEATH
In the Supreme Court of Tasmania
Ecclesiastical Jurisdiction
In the estate of
I,

deceased,
, make oath and say:

of
(1) That
at

the above-named deceased, died
in Tasmania on the
day of
20

(2) That
[Signature of Deponent]
Sworn at

this
Before me,
A Commissioner, &c

day of

20