Death Of Joint Tenant Affidavit Form
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1RECORDING REQUESTED BY
AND WHEN RECORDED MAIL TO:
NAME
STREET
ADDRESS
CITY, STATE &
ZIP CODE
SPACE ABOVE THIS LINE FOR RECORDER’S USE
AFFIDAVIT – DEATH OF JOINT TENANT
STATE OF ___________________________________
COUNTY OF _________________________________
_______________________________________________________, of legal age, being first duly sworn, deposes and says:
That ________________________________________________________, the decedent mentioned in the attached certified
copy of Certificate of Death, is the same person as __________________________________________________________________
named as one of the parties in that certain ____________________________________ dated ______________________________,
executed by _________________________________________________________________________________________________
to _________________________________________________________________________________________________________
as joint tenants, recorded as Instrument No. _________________, on ________________, ________, ________________________,
of the Official Records in the Office of the County Recorder of ___________________________________________________County,
State of ________________________________, concerning the following
described
real
property
situated in the City of
_______________________________________________, County of _____________________, State of _____________________:
(Insert Legal Description)
That the value of all real and personal property owned by the decedent at the date of death, including the full value of the
above described real property, did not then exceed the sum of $ _____________________________.
Dated _____________, _______.
_______________________________________________
_____________________________________________
Signature of Joint Tenant
Signature of Joint Tenant
_______________________________________________
______________________________________________
(Type or print full name of Joint Tenant)
(Type or print full name of Joint Tenant)
A notary public or other officer completing this certificate
verifies only the
identity of the individual who signed the
attached, and not
document to which this certificate is
the truthfulness, accuracy, or validity of t
hat document.
State of California
}
County of ____________________________ }
SUBSCRIBED AND SWORN TO (or affirmed) before me on this __________ day of ___________________, 20____
by ______________________________________________, proved to me on the basis of satisfactory evidence to be
the person(s) who appeared before me.
SIGNATURE __________________________________________________ (seal)
MAIL TAX STATEMENT TO: _____________________________________________
_____________________________________________________________________
Before you use this form, fill in all blanks, and make whatever changes are appropriate and necessary to
your particular transaction. Consult a lawyer if you doubt the form’s fitness for your purpose and use.
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