Affidavit Of Heirship Form (Page 3 of 3) in pdf

Affidavit Of Heirship Form Page 3

8. Did the decedent have any legally adopted children or step-children? __________. If so, write their names and addresses in the

blank lines below and indicate as to whether adopted or step children:

Name of Child

Date of Birth of Stepchild or Adopted Child

Address, or if Not Living Date of Death

9. Did the decedent leave any unpaid debts at the time of death? __________. If so, give the amount of such debts and whether they

have since been paid: ______________________________________________________________________________________.

IF DECEDENT LEFT SURVIVING CHILDREN, DO NOT ANSWER THE FOLLOWING QUESTION

10. Give below the names and addresses of the surviving mother, father, brothers and sisters of the decedent:

Name

Relationship

Date of Birth

Address, or if Not Living Date of Death

11. Give below the social security numbers of each heir.

Name

Social Security Number

Affiant

ACKNOWLEDGMENT

State of:

__________________________

County of: __________________________

The foregoing instrument was acknowledged before me on this ___________ day of _____________________, 20____ by

__________________________________.

__________________________________________________

Notary Public

IF ANY OF THE HEIRS OF THE DECEDENT HAVE DIED SINCE HIS OR HER DEATH, A SEPARATE PROOF OF HEIRSHIP WILL BE

REQUIRED FOR EACH HEIR.

Affidavit Of Heirship Form Page 3