Fillable Printable Affidavit of Heirship Form - Texas
Fillable Printable Affidavit of Heirship Form - Texas
Affidavit of Heirship Form - Texas
This Af fidavit must be completed by a third disinterested party (Affiant) who will not benefit from the decedent’s est ate. Do not
complete this form if the decedent left a will that was probated in court or there has been some other type of court determina-
tion to the est ate.
Af fidavit of fact s concerning the identity of Heirs for the Estate of: _____________________________________________
Before me, the undersigned authority, on this day personally appeared: ________________________________________
(“Af fiant”) who, being first duly sworn, upon his/her oath st ates:
1. My name is: ___________________________________________________________________________________.
I live at: _______________________________________________________________________________________
I am personally familiar with the family and marital history of: ______________________________________________
(Decedent), and I have personal knowledge of the facts stated in this Affidavit.
2. I knew the decedent from ________________until ________________ Decedent died on ______________________ .
Decedent’ s place of death: ________________________________________________________________________
At the time of decedent’ s death,
CITY STATE COUNTY
decedent’ s residence was: ________________________________________________________________________
CITY STATE COUNTY
NAME OF SPOUSE
DA TE OF DA TE OF DA TE OF
MARRIAGE DIVORCE SPOUSE’S DEATH
3. Provide the following information on the deceased’ s marital history:
(If never married, please state that below.)
NAME OF CHILD/
DATE OF NAME OF CHILD’S DATE OF
CURRENT ADDRESS BIRTH OTHER PARENT CHILD’S DEATH
4. Provide the following information on the deceased’ s natural born and adopted children:
(If there are none, please state that below. If additional space is needed, please provide information as an attachment.)
NAME OF CHILD/
DATE OF NAME OF GRANDCHILD’S
CURRENT ADDRESS BIRTH DECEASED PARENT
5. Provide the following information on the deceased’s grandchildren, born only to the deceased children in Item 4, above:
(If there are none, please state that below.)
DECEASED’S PARENT’S NAME/ PARENT’S DATE
PARENTS CURRENT ADDRESS OF DEATH
6. If the decedent never married and did not have any children, provide the following information on the deceased’ s parent s:
MOTHER
FATHER
53-1 11-A
(Rev.4-07/3)
Claim
number:
AFFIDAVIT OF HEIRSHIP
THIS AFFIDAVIT MUST BE FILED
IN THE COUNTY CLERK’S RECORD.
Reported
owner name:
Form 53-1 11-A (Back)(Rev.4-07/3)
NAME OF NIECE OR NEPHEW/
DATE OF NAME OF NIECE OR NEPHEW’S
CURRENT ADDRESS BIRTH DECEASED PARENT
Signed this ____ day of ____________________, ____________.
_____________________________________________________________________________________
(SIGNATURE OF AFFIANT)
State of _________________________
County of _______________________
Sworn to and subscribed to before me on _________________________________________________
(DATE)
by ________________________________________________________________________________
(NAME OF AFFIANT)
_____________________________________________________________________________________
(NOTARY SIGNATURE)
(Notary Seal) My commission expires: _____ day of __________________, _______.
THIS AFFIDAVIT MUST BE FILED IN THE COUNTY CLERK’S RECORD.
NAME OF CHILD/
DATE OF BROTHER’S OR SISTER’S
CURRENT ADDRESS BIRTH DATE OF DEA TH
7. Provide the following information on the deceased’ s brothers and/or sisters:
(If there are none, please state that below.)
8. Provide the following information on the deceased’ s nieces and/or nephews born only to the deceased brothers/sisters in
Item 7, above:
(If there are none, please state that below . If additional space is needed, please provide information as an attachment.)
Claim
number:
Reported
owner name:
