Affidavit of Heirship Sample Form

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AFFIDAVITOFHEIRSHIP

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Asto______________________________________

(NameofDeceased)

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Donotcompletethisformifthedecedentleftawillthatwasprobatedincourtoriftherehasbeenacourtadministrationofdecedent’sestate.

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 I,________________________________________________(affiant)beingoflawfulage,beingfirstdulysworn,uponoathdeposesandsays:

 ThatIwaspersonallywellacquainted

withtheabovenameddecedent,du ringhis/herlifetime,havingknownhim(orher)for_________years,

andthataffiantbearsthefollowingrelationshiptosaiddecedent,to‐wit:__________________________________________________________________

1. Decedentdiedon: .



 Decedent’splaceofdeath:



 CITY STATE COUNTY

 Atthetimeofdecedent’sdeath,

decedent’sresidencewas:



 CITY STATE COUNTY



2. Providethefollowinginformationforthedecedent’smaritalhistory:

(Ifnevermarried,pleasestatethatbelow.)

NAMEOFSPOUSE DATEOF

MARRIAGE

DATEOF

DIVORCE

DATEOFSPOUSE’S

DEATH



3. DidDecedentleaveawill?Yes/No

Ifyes,wasDecedent’swillprobated?Yes/No

Ifyes,whatCounty&State_____________________________________

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4. Providethefollowinginformationforthedeceased’snaturalbornandadoptedchildren:

(Iftherearenone,pleasestate“none"below.Ifadditionalspaceis

needed,please provideinformationasanattachment.

NAMEOFCHILD/

CURRENTADDRESS

DATEOF

BIRTH

NAMEOFCHILD’S

OTHERPARENT

DATEOF

CHILD’SDEATH

NameofChild:



Address:

NameofChild:



Address:

NameofChild:



Address:

NameofChild:



Address:

NameofChild:



Address:

NameofChild:

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Address:

NameofChild:

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Address:

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AFFIDAVITOFHEIRSHIP

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5. Providethefollowinginformationforalldeceasedchildrenofdecedent(ifany):



Nameofdeceasedchild:

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 Didhe/sheleaveawill? Yes/NoWaswillprobated?Yes/NoIfyes,whatCounty&State_____________________________________



Nameandaddressof

deceasedchild’s

survivingspouse:

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Name&AddressofChild(ren)ofDeceasedChild Living? DateofBirth DateofDeath NameandAddressof

SurvivingSpouseofDeceasedChild

Name:



Address:



Name:



Address:



Name:



Address:

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Nameofdeceasedchild:

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 Didhe/sheleaveawill? Yes/NoWaswillprobated?Yes/NoIfyes,whatCounty&State_____________________________________



Nameandaddressof

deceasedchild’s

survivingspouse:

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Name&AddressofChild(ren)ofDeceasedChild Living? DateofBirth DateofDeath NameandAddressof

SurvivingSpouseofDeceasedChild

Name:



Address:



Name:



Address:



Name:



Address:



Nameofdeceasedchild:

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 Didhe/sheleaveawill? Yes/NoWaswillprobated?Yes/NoIfyes,whatCounty&State_____________________________________



Nameandaddressof

deceasedchild’s

survivingspouse:



Name&AddressofChild(ren)ofDeceasedChild Living? DateofBirth DateofDeath NameandAddressof

SurvivingSpouseofDeceasedChild

Name:



Address:



Name:



Address:



Name:



Address:

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AFFIDAVITOFHEIRSHIP

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6. Ifthedecedentnevermarriedanddidnothaveanychildren,providethefollowinginformationforthedecedent’sparents:

(

IFDECEDENTLEFTSURVIVINGCHILDREN,QUESTIONS6,7&8NEEDNOTBEANSWERED.)

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DECEASED’S

PARENTS

PARENT’SNAME/

CURRENTADDRESS

PARENT’SDATE

OFDEATH



MOTHER

Name:



Address:



FATHER

Name:



Address:

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7. Providethefollowinginformationforthedecedent’sbrothersand/orsisters:

(Iftherearenone,pleasestate“none” below.)

(

IFDECEDENTLEFTSURVIVINGCHILDREN,QUESTIONS6,7&8NEEDNOTBEANSWERED.)



NameofBrother/Sister



CurrentAddress

Dateo

f



Birth

Brother’sorSister’s

DateofDeath

 

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8. Providethefollowinginformationforthedecedent’sniecesand/ornephewsbornonlytothedeceasedbrothers/sisterslistedinItem6above: 

(Iftherearenone,pleasestate“none”below.Ifadditionalspaceisneeded,pleaseprovidei nformationasanattachment.)

(IFDECEDENTLEFTSURVIVINGCHILDREN,QUESTIONS6,7&8NEEDNOTBEANSWERED .)

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NameofNieceorNephew



CurrentAddress



Dateo

f



Birth

NameofNieceor

Nephew’s

DeceasedParent

 

 

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************************************************************************

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Signedthis______dayof___________________________________,20____.

 

(SIGNATUREOFAFFIANT)

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AFFIDAVITOFHEIRSHIP

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SUBSCRIBEDANDSWORNtobeforemeonthisthe______dayof_________________________________,20____.



(NotarySeal) NotaryPublic



Mycommission

expires:

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STATEOF______________________§



COUNTYOF____________________§

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BEFORE ME, the undersigned authority, on this day  personally appeared

________________________________________, known to me to be the person whose name is subscribed to

the foregoing instrument, and acknowledged to me that he/she executed the same for the purposes and

considerationthereinexpressed.

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GIVENUNDERMYHANDANDSEALOFOFFICEonthisthe_____dayof_____________________,20____.



(NotarySeal)

NotaryPublic



Mycommissionexpires:







AFFIDAVITOFHEIRSHIP

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CORROBORATINGAFFIDAVIT

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STATEOF______________________§



COUNTYOF____________________§

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_____________________________________________________,oflawfulage,beingfirstdulysworn,uponhis

oathstates:Thattheinformationgivenintheaboveandforegoingaffidavitistrue,andaccurate,tothepersonal

knowledgeofthisaffiant.



_____________________________________________



SignatureofCorroboratingAffiant



SUBSCRIBEDANDSWORNtobeforemeonthisthe______dayof______________________________,20____.



(NotarySeal) NotaryPublic



Mycommission

expires:



NOTE:Thisformmaybesignedby amemberofthefamily,aslongastheyarenotanheirtothedeceased,but

theCorroboratingAffidavitMUSTbesignedbyapersonthatisnotamemberofthefamily.



Thisformmustbenotarizedand recorded

incounty/parishrecordswherelandsarelocatedandarecordedcopy

furnishedtothecompanysorequestingit.

Fillable Printable Affidavit of Heirship Sample Form

Fillable Printable Affidavit of Heirship Sample Form