Fillable Printable Affidavit of Heirship - Southwestern Energy
Fillable Printable Affidavit of Heirship - Southwestern Energy
Affidavit of Heirship - Southwestern Energy
INSTRUCTIONS FOR COMPLETING HEIRSHIP AFFIDAVIT.
READ INSTRUCTIONS BELOW BEFORE COMPLETING THIS FORM.
IMPORTANT – REMOVE THIS PAGE BEFORE RECORDING DOCUMENT. FAILURE TO REMOVE THIS
PAGE WILL RESULT IN ADDITIONAL RECORDING FEES BY THE COUNTY CLERK.
ATTACH FOLLOWING PAPERS:
1. IF ANY HEIRS OF DECEDENT HAVE DIED since his (or her) death, secure separate proof of
heirship as to each.
2. If decedent left a Will, attach a certified copy thereof.
3. If executor or administrator has been appointed for estate of decedent, attach a certificate of appointment
from the Court which made the appointment (example: Letters Testamentary)
4. If administration on decedent’s estate has been completed and final order or decree of distribution has
been rendered, attached certified copy of such order or decree.
Instructions for completing Affidavit:
1) The first signature to this form may be signed by a member of the family, as
long as they are NOT an heir/beneficiary to the deceased.
2) The Corroborating Affidavit (2
nd
signature) MUST be signed by a person
not a member of the family.
This form must be signed in the presence of a Notary Public.
After signed and notarized, we require that you have it recorded in the
county/parish where the well(s)/land(s) are located.
Once the affidavit has been recorded and returned to you, a recorded copy
must be furnished to our office via fax (832-796-4757) or mailed to:
ATTN: DIVISION ORDERS
PO BOX 12359
Spring, TX 77391
You should retain the original Affidavit and submit to our office a recorded
copy.
When sending the recorded Affidavit to our office, we must be provided with
addresses and social security numbers for all heirs/beneficiaries. Failure to
provide this information will delay processing.
AFFIDAVIT OF HEIRSHIP
INFORMATION CONCERNING DECEDENT.
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, during his/her lifetime, having known him (or her) for _______
years, and that affiant bears the following relationship to said decedent, to-wit:_______________________________________
1. Said decedent departed this life at _______________________ in ______________________ County/Parish, State of
__________________, on or about ________________________ day, being _______ years old at the date of his (or her) death.
2. Said Decedent owned, at the time of his (or her) death, the land si tuated in
County/Parish, State of .
3. The land described above was / was not
occupied as the hometead of the deceased.
(circle one)
4. The land described above is / is not
now occupied as homstead of deceased’s surviving husband / wife.
(circle one) (circle one )
5. The land described above is / is not
community property
(circle one)
Affiant further states that affiant was well acquainted with the family and near relatives of the said decedent, and 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 decedent leave a Will? (If so, attach a certified cop y thereof.)
2. Where was Will first admitted to probate? Give name of court, and also of the city, county, and state in which court is located:
3. Has Will been probated or admitted to record in the state where the above described land is situated?
If so, give date,
name of court and county
4. Is administration pending on the estate of decedent?
If so, in what court, county/ parish and state?
5. Has an executor or administrator been appointed for the estate of the decedent?
If so, give his/her name and address
6. What is the present condition of the administration? (Answer this question regardless of whether or not decedent left a Will.)
Has administration been complete d?
If so, has final order or decree of distribution been rendered by the Court?
7. Were you acquainted with decedent’s business affairs?
Did decedent leave any debts or obligations unpaid?
Have all such debts or obligations been paid?
If not, how much remains unpaid?
What is reason these debts have not been paid?
Note: If decedent left a Will, but said Will was NOT probated, the laws of Intestate Descent and Distribution will apply, and NOT the terms of the Will.
INFORMATION CONCERNIN G HEIRS OF DECEDENT
8. Did decedent leave a surviving wife or husband ?
If so, give name & address
Date of marriage: . If not
living, give date of death. _____________________
9. If the decedent was married more than once, give name or names of former spouse or spouses, and state whether any such former spouse is
dead or divorced, together with the date of death or divorce:_______________________________________________________________
_______________________________________________________________________________________________________________
10. Give following information concerning all children born to decedent, or legally adopted children of decedent, who were living
at the time
of decedent’s death.
Name Address Date of Birth
11. Give below the names of any deceased
children of decedent:
Name Date of Birth & Date of
Death
Surviving Spouse Surviving Spouse Address
12. Give below the names of the living children
of any deceased son or daughter (those listed above in Item #11) of the decedent:
Name Date of Birth Name of Mother or Father from
Item #11 above
Address
IF DECEDENT LEFT SURVIVING SPOUSE OR CHILDREN, THEN ITEM #13
BELOW MAY BE DISREGARDED –
PROCEED TO ITEM #14
13. If decedent left no surviving spouse or children, give the following information in the following order:
1) List parents, if living. If parents not living,
2) List all brothers and sisters;
3) If any brother or sister died before decedent, also list his or her children.
4) If no parent, brother or sister survived decedent, list following if any surviving: grandparents, nephews and nieces; uncles and aunts;
cousins; if none of foregoing survived, list nearest of kin surviving.
Name Address Date of Birth Date of Death / Relationship to
Decedent
ATTACH ADDITIONAL PAPER IF NEEDED TO COMPLETE SECTION ABOVE
14. (If land is in Oklahoma) Did decedent file in County Clerk’s office election to come under the Community Property Act?
____________________________________________________
Signature of Affiant
SUBSCRIBED AND SWORN to before me this _______ day of _________________________________________, 20_______.
My commission expires:
Notary Public
CORROBORATING AFFIDAVIT
State of _________________________ (TO BE SIGNED BY SOME PERSON OTHER THAN
THE ONE MAKING THE FOREGOING AFFIDAVIT)
County/Parish of _______________________ AFFIANT MAY NOT BE AN HEIR NAMED ABOVE
______________________________________________, 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.
____________________________________________________
S ignatu re of Corrob o ratin g Affian t
SUBSCRIBED AND SWORN to before me this _______ day of _________________________________________, 20_______.
My commission expires:
Notary Public
IMPORTANT
ATTACH FOLLOWING PAPERS:
1. IF ANY HEIRS OF DECEDENT HAVE DIED since his (or her) death, secure separate proof of heirship as to each.
2. If decedent left a Will, attach a certified copy thereof.
3. If executor or administrator has been appointed for estate of decedent, attach a certificate of appointment from the Court which made the
appointment (example: Letters Testamentary)
4. If administration on decedent’s estate has been completed and final order or decree of distribution has been rendered, attached certified
copy of such order or decree.
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 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.
Heirship Affidavit
