Affidavit of Death
This Affidavit of Death is executed in accordance with the laws of the State of [Your State]. It serves as a formal declaration of the death of the individual named herein. Please provide the necessary information in the spaces indicated.
The undersigned, being duly sworn, deposes and states the following:
- Affiant's Name: _________________________________
- Affiant's Address: _________________________________
- Affiant's Phone Number: _________________________________
- Deceased's Full Name: _________________________________
- Date of Death: _________________________________
- Place of Death: _________________________________
- Relationship to Deceased: _________________________________
This affidavit is made for the purpose of establishing the date of death and supporting any claims or requests for information related to the deceased. The information provided is true to the best of my knowledge.
By my signature below, I declare under penalty of perjury that the statements made herein are true and correct.
Affiant's Signature: _________________________________
Date: _________________________________
Subscribed and sworn before me this ___ day of __________, 20__.
Notary Public Signature: _________________________________
Notary My Commission Expires: _________________________________