Fillable Printable Sample Affidavit of Heirship
Fillable Printable Sample Affidavit of Heirship
Sample Affidavit of Heirship
1
AFFIDAVIT OF HEIRSHIP
DECEDENT: ____________________________________________
RE: ____________________________________________
DATE: ____________________________________________
STATE OF _________________________ ( )
COUNTY/PARISH OF _________________________( )
_____________________________________, whose address is ________________________________________, hereinafter
referred to as "Affiant," being of lawful age and being duly sworn, upon oath deposes and says that he (she) was well acquainted with
________________________________________ hereinafter referred to as " the Decedent," and that the answers and statements given
in the following questionnaire are based upon Affiant's personal knowledge and are true and correct:
1. How long did you know the Decedent? • 1-3 years • Whole life • Other ___________________________
2. How well did you know the Decedent? • Very well • Well • Other _______________________________
3. What was your relationship to the Decedent? _________________________________________________________
4. Complete the following sentences: The Decedent's home was at ___________________________________________.
Decedent died at the age of _____, on _______________________, 19___, at ________________________________,
State of ______________________________.
5. Did the Decedent leave a will? • Yes • No • I do not know
6. Was there any time during the Decedent's life when the Decedent was not of sound mind?
• Yes • No If Yes, Date(s)_________________________________________________________________
7. Have any proceedings been commenced with respect to the Decedent's estate? ________________________________.
If so, complete the following sentence to the best of your knowledge: Proceedings were commenced in
_______________________________ County/Parish, State of ____________________, and the name and address of the
executor or administrator is ________________________________________________________________________
8. Are there any debts still owing by the Decedent's estate? • Yes • No If Yes, will the size of the estate be sufficient in your
opinion to pay such debts? • Yes • No
9. At the time of death was the Decedent • Single • Married • Divorced • Widow • Widower. If married,
what was the Decedent's surviving husband's or wife's name? ___________________________________________
10. If the Decedent was married at the time of death, what is the surviving husband's or wife's present address or, if deceased, when
did such surviving husband or wife die?__________________________________________________
11. How many times was the Decedent married? • None • Once • Twice • Other ________________________
12. What was the total number of Decedent's children, both natural and adopted? ________________________________.
2
AFFIDAVIT OF HEIRSHIP
*Complete the following table with respect to all children of the Decedent, whether living or dead, natural or adopted:
Name of Child
Child's Other
Present Address
(Natural)
Date of Birth
Parent
or Date of Death
13. Were any of Decedent's children adopted? • Yes • No If Yes, which ones and when.
Name of Child
When
Living or
(Adopted)
Adopted
Deceased
Address
14. Complete the following table with respect to all children of every deceased child (if any) of the Decedent:
Name of the
Children of
Date of
Present
Decedent's
the Deceased
Birth
Address or
Deceased Child
Child
Date of Death
15. If the Decedent was not survived by any children or grandchildren, then give below the names and addresses of the Decedent's
father, mother, and all brothers and sisters:
Name of Relative
Relationship
Age
Present Address or Date of Death
3
AFFIDAVIT OF HEIRSHIP
16. If the Decedent was not survived by any children, grandchildren, father, mother, brothers or sisters, then give below the names and
addresses of the nearest surviving relatives:
Name
Relationship
Age
Present Address
Additional Remarks:
Affiant's Signature: _______________________________________
Subscribed and sworn to before me this _______ day of _________________________, 20______.
Notary Public Signature: ___________________________________
My commission expires ___________________________, 20______.
