Affidavit of Death
This Affidavit of Death is created in accordance with the laws of the State of ____________.
Know all men by these presents:
I, [Your Name], residing at [Your Address], being duly sworn, hereby declare as follows:
- The decedent’s name: [Decedent's Full Name]
- Date of death: [Date of Death]
- Place of death: [Place of Death]
I affirm that I am personally acquainted with the facts set forth in this affidavit. I have firsthand knowledge of the circumstances surrounding the death of the above-named person.
This affidavit is made for the purpose of [Purpose of Affidavit, e.g., settling a will, claiming insurance] and for all other purposes that may be required by law.
Further, I hereby declare that:
- The decedent’s last known address was [Decedent's Last Address].
- As of this date, there are no other legal proceedings concerning the decedent’s estate pending in any court.
In witness whereof, I have set my hand this ____ day of ___________, 20__.
[Your Signature]
[Your Printed Name]
[Your Contact Information]
Sworn to and subscribed before me this ____ day of ___________, 20__.
[Notary Public Signature]
[Notary Public Printed Name]
[Commission Number]
[My Commission Expires: Date]