Prepared by:
If recorded, return to:
| ))) ) ) ) ) ) ) ) ——above this line for official use only——– | |||||||||||||||
HEIRSHIP AFFIDAVIT | ||||||||||||||||
(Heirship of ______________________Deceased) | ||||||||||||||||
STATE OF ____________ COUNTY OF ___________ | )) | |||||||||||||||
BEFORE ME, the undersigned authority, on this day personally appeared ____________________________, (“AFFIANT”) who is personally known to me (or, if not being personally known to me, did confirm his/her identity presenting _______________________ as identification (i.e. drivers license #), and appearing to be fully competent and of sufficient age, upon being duly sworn, stated upon Affiant’s oath the following: | ||||||||||||||||
1. My name is ____________________________ (insert name of affiant), and I live at________________________________________________________________(insert address of affiant’s residence). I am personally familiar with the family and marital history of _______________________ (“Decedent”) (insert name of decedent), and I have personal knowledge of the facts stated in this affidavit. | ||||||||||||||||
2. I knew decedent from _____________________________ (insert date) until ____________________ (insertdate). I was personally well acquainted with the named decedent during his/her lifetime. | ||||||||||||||||
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4. I was well acquainted with the family and near relatives of the said decedent, and with all those who would under the laws of the State of ________________ , be his/her heirs. The following statements and the information contained herein, including my answers to named questions below, are based upon my personal knowledge and are true and correct. | ||||||||||||||||
QUESTION 1 – Did the decedent leave a will? ANSWER: YES (__) / NO (__) | ||||||||||||||||
QUESTION 2 – If the decedent left a will, has the will been admitted to probate?ANSWER: YES (__) / NO (__) / NA (__) . If YES, at what place, and when? ANSWER: ___________ COUNTY, ____________ (STATE) , __________ CAUSE NUMBER ___________________ DATE | ||||||||||||||||
QUESTION 3 – If the decedent left no will, has an administrator or personal representative been appointed for the estate of said deceased? ANSWER: YES (__) / NO (__) | ||||||||||||||||
QUESTION 4 – If an administrator or personal administrator has been appointed, give the County in which the proceedings are pending, and the name and address of the administrator or personal representative. ANSWER:_______________________________________________________ | ||||||||||||||||
COUNTY ________________ CAUSE NUMBER __________________ | NAME ____________________ | ADDRESS ___________________ ___________________ ____________________ | ||||||||||||||
QUESTION 5 – Give the name and address of the surviving widow or widower of decedent. ANSWER: | ||||||||||||||||
NAME ___________________ | ADDRESS ____________________ ____________________ ____________________ | If not now living, state date of death: ____________________ | ||||||||||||||
QUESTION 6 – If the decedent was married more than once, give the name(s) of the former husband or wife, and state whether said former spouse is dead or divorced.ANSWER: | ||||||||||||||||
NAME | STATUS (Dead or Divorced) | |||||||||||||||
QUESTION 7 – Give the names and places of residence of all the surviving children of deceased, together with the other information called for:ANSWER: (Give names of surviving children only) | ||||||||||||||||
NAME OF CHILD | ADDRESS | DATE OF BIRTH | IF NOT LIVING DATE OF DEATH | HUSBAND OR WIFE NAME | ||||||||||||
QUESTION 8 – Give the name and address of any deceased children of the decedent, together with the other information called for:ANSWER: | ||||||||||||||||
NAME OF CHILD | DATE OF BIRTH | DATE OF DEATH | SURVIVING HUSBAND OR WIFE NAME | DATE OF DEATH OF SPOUSE, IF APPLICABLE | ||||||||||||
QUESTION 9 – Give the names and addresses of the children of any deceased son or daughter of the decedent:ANSWER: | ||||||||||||||||
NAME OF CHILD | ADDRESS OF IF NOT LIVING DATE OF DEATH | DATE OF BIRTH | NAME OF FATHER OR MOTHER | |||||||||||||
QUESTION 10 – Did the decedent have any adopted children, or step-children taken into his home?ANSWER: YES / NO . If yes, provide their names, ages and addresses below: | ||||||||||||||||
NAME | ADDRESS | AGE | ||||||||||||||
QUESTION 11 – Did the decedent have any unpaid debts? ANSWER: YES/NO.If yes, provide as nearly as possible the amount of the debt and creditor and whether such debt has since been paid ANSWER: | ||||||||||||||||
CREDITOR | AMOUNT OF DEBT | HAS DEBT NOW BEEN PAID | ||||||||||||||
QUESTION 12 – If the decedent left no children, then give below the names and addresses (together with other information called for), or his or her surviving father, mother, brothers, sisters:ANSWER: | ||||||||||||||||
NAME | RELATIONSHIP | AGE | ADDRESS OR DATE OF DEATH | |||||||||||||
QUESTION 13 – If the decedent left no children, spouse, mother, father, brother or sister, state all other known relatives:ANSWER: | ||||||||||||||||
NAME | RELATIONSHIP | AGE | ADDRESS | |||||||||||||
QUESTION 14: Did the decedent own any real estate in this State:ANSWER: YES (__) / NO (__) If yes, list Address or short description : _____________________________________ County: _________________________ Address or short description : _____________________________________ County: _________________________ Address or short description : _____________________________________ County: _________________________ Address or short description : _____________________________________ County: _________________________ Address or short description : _____________________________________ County: _________________________ | ||||||||||||||||
QUESTION 15: What is your relationship to the deceased?ANSWER: | ||||||||||||||||
DATED THIS THE _____ DAY OF _____________________, 20____ .___________________________________ Signature of Affiant SWORN TO AND SUBSCRIBED before me this the _____ day of ______________, 20____ . __________________________ NOTARY PUBLIC My Commission Expires: ___________________ | ||||||||||||||||
State Specific Affidavit Forms
—-For State Specific Affidavit Forms you can download in Word Format go to