Heirship Affidavit

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——above this line for official use only——–

HEIRSHIP AFFIDAVIT

(Heirship of ______________________Deceased)

STATE OF ____________

COUNTY OF ___________

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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.
  1. The Decedent died on _____________________ (insert date of death) at the following place of death:  _____________________ (City) ,____________________ (County), ________________ (State), ________________________________________(insert place of death). At the time of decedent’s death, decedent’s residence address was _____________________________________________________(Street), ____________________ (City), ___________________ (State) , _________ (Zip).(insert address of decedent’s residence).
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

http://www.uslegalforms.com/affidavits/


Inside Heirship Affidavit