of Death and Heirship

${input_17_2} (the “Affidavit”), being duly sworn upon oath, deposes and states that the Affiant resides at ${input_17_3_1}   ${input_17_3_3}   ${input_17_3_4}   ${input_17_3_5}   located in the County of ${input_17_3_6}   The Affidavit is the ${input_17_4}   to ${input_17_7}   ${input_17_8}   (the “Decedent”).

The Decedent died on   in the County of ${input_17_60}   in the State of ${input_17_161}   A copy of the official Death Certificate is attached.

In the event that the Decedent passed leaving a Last Will and Testament, a copy of said Last Will and Testament shall be attached. If there is no Last Will and Testament attached hereto, then the Decedent passed intestate.

The estimated approximate total value of the estate of the Decedent, including the taxable interest in the aforesaid property, is $${input_17_82} .


The Affidavit will ensure that the Federal Estate Tax shall be prepared and pay in full any said amount which may be due and payable.

I declare that the information contained herein is true and correct to the best of my knowledge.




State of ${input_17_159}    



County of ${input_17_160}    

This instrument was subscribed and sworn to before me on ______ by ______.

(Notary Public Signature)  
(Notary Public Name)  
My Commission Expires: ______________  

Document Tips:

Please note that in order to file this document, you must also complete the following:


  • Please remember that this affidavit must be notarized.
  • Please confirm that the value of the estate you are claiming does not exceed the maximum total value of estate allowable on this affidavit pursuant to state law.
  • Please ensure that this affidavit is not filed prior to the mandatory waiting period after the Decedent’s death determined by your state.
  • Payment of the Decedent’s liabilities must be made prior to disbursing any proceeds from the Decedent’s Estate.