Affidavit Of Domicile - Scottrade
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AFFIDAVIT OF DOMICILE
DOMICILE INFORMATION
State of:
County of:
City of:
, being duly sworn, deposes that he/she
resides at
,
Executor/
Administrator/ or
Surviving Tenant of the Estate of
and is
State of
, Deceased; who died at
,
on the
of
, 20
; at the time of his/her death the
domicile (legal residence) of said decedent was at
City/County of
, State of
; that decedent
resided at such address for
, 20
on
years, such residence having commenced
;
that decedent last voted in the year
at
,
City/County of
, State of
;
that decedent’s most recent Federal income tax return showed his/her legal residence as
City/County of
, State of
;
a resident of another state (if decedent resided
that within three years prior to death, decedent
was/or
was not
in another State within three years prior to death, set forth the name of the State and facts as to change of residence
and establishment of final domicile); that any and all debts, taxes and claims against the estate have been paid or
provided for that this affidavit is made for the purpose of securing the transfer or delivery of property owned by the
decedent at the time of his/her death to a purchaser or the persons legally entitled thereto under the laws of the
decedent’s domicile and that any apparent inequality in distribution has been satisfied or provided for out of other
assets of the estate.
X
Signature
Executor,
Administrator, or
Survivor
Date
Notary:
Sworn to (or affirmed) before this
______day of ______________, 20____
*SF1030*
X
My commission expires: _____________
SF1030/8-15
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