Fillable Printable Affidavit of Heirship Sample Template
Fillable Printable Affidavit of Heirship Sample Template
Affidavit of Heirship Sample Template
AFFIDAVIT OF HEIRSHIP
As to_______________________________
(Name of Deceased)
STATE OF________________________§
COUNTY OF______________________§
I,
, of lawful age, residing at
_______________________________________________ , being first duly sworn, upon
oath deposes and says: That affiant was personally well acquainted with the above
named decedent, during his (or her) lifetime, having known him (or her) for
years, and
that affiant bears the following relationship to said decedent, to-wit:
____________________.
Said decedent departed this life in
County, State of on or about
_______________________, 20 , being years old at the
date of his (or her) death.
Affiant further states that affiant was well acquainted with the family and close relatives of
the said decedent, and that the following statements and the answers to the following
questions are based upon the personal knowledge of affiant and are true and correct:
1. Did the decedent leave a will?
If so, has the will been admitted to
probate?
In what county? When?____________________
2. Has an administrator/executor been appointed for the estate of said decedent?_________.
If so, give name and address of administrator or executor_________________________
_______________________________________________________________________.
3. Give name and address of surviving widow or widower of decedent:
_________________________________________________________. If not living,
give date of death____________________.
4. If the decedent was married more than once, give name of former husband or wife and
state whether said former spouse is dead or divorced:__________________________
____________________________________________________________________.
5. On the blank lines below, provide information requested for all children of decedent:
1
Name of Child(ren) Age Address Living?
Date of
Death By Which Spouse
6. If a deceased child left descendents, give the following information:
NAME OF DECEASED CHILD: ____________________________________________
DID HE/SHE LEAVE A WILL? Yes / No
Name of Child(ren) Living?
Date of
Death
Name and Addr ess of Surviving Spouse
NAME OF DECEASED CHILD: ____________________________________________
DID HE/SHE LEAVE A WILL? Yes / No
Name of Child(ren) Living?
Date of
Death
Name and Addr ess of Surviving Spouse
2
NAME OF DECEASED CHILD: _______________________________________________
DID HE/SHE LEAVE A WILL? Yes / No
Name of Child(ren) Living?
Date of
Death Name and Address of Surviving Spouse
NAME OF DECEASED CHILD: _______________________________________________
DID HE/SHE LEAVE A WILL? Yes / No
Name of Child(ren) Living?
Date of
Death
Name and Addr ess of Surviving Spouse
7. Did the decedent have any legally adopted children or step-children taken into his (or her)
home? Yes / No
If so, write their names, ages and addresses in blank lines below and indicate as to each whether
adopted or step-child:
Name
Adopted or Step-Child
Age Address
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8. State (so far as known to affiant) whether any inheritance tax is due on the estate of
decedent or whether any inheritance tax thereon has been paid: _________________
9. Give below the names and addresses (together with other information called for) of the
surviving father, mother, brothers and sisters of decedent:
(IF DECEDENT LEFT SURVIVING CHILDREN, THEN QUESTIONS 9 AND 10 NEED NOT BE ANSWERED.)
NAME RELATIONSHIP AGE
ADDRESS OR, IF DECEASED, DATE OF
DEATH
10. Give below the names and addresses (together with other information called for) of the
surviving children of any deceased b rother or sister of the decedent:
NAME OF CHILD
DATE OF
BIRTH
ADDRESS O R , IF
DECEASE D, DAT E OF
DEATH
NAME OF FATHER
AND MOTHER
________________________________
Affiant
Subscribed and sworn to before me this
day of , 20______.
My commission expires: ______________________________________________________
4
_______________________________
Notary Public
NOTE: If any of the heirs of decedent have died since his (or her) death, secure separate
proof of heirship as to each.
AFFIDAVITOFHEIRSHIP.PDF
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