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Form No.5 - Affirmation Or Affidavit Of Death - Hong Kong Special Administrative Region Court Of First Instance

FORM NO.5

Affirmation or Affidavit of Death

IN THE HIGH COURT OF THE

HONG KONG SPECIAL ADMINISTRATIVE REGION

COURT OF FIRST INSTANCE

IN THE ESTATE of ............... (name) ..................

late of ................................. (address) ...................

(occupation/description) ....................... deceased.

I, ............... A.B. .............., ............................... (occupation/description) ..........................

of .................................. (address) ............................................., do hereby *[solemnly, sincerely and

truly affirm] [make oath and say] as follows:–

I knew and was well acquainted with the abovenamed deceased when alive. The said deceased

died on the ................ day of ................., 19.........., at ................. (place of death) ..........................

I was present when ................... died *[and/or I also attended ........................ *his/her ........................

funeral.]

**[ 2.

I am aged .................... years and came to live in Hong Kong from ..................... (name

of country) .................) on ..................... (date) .............. and I was ............... (relation to the

deceased) .....................]

AFFIRMED/SWORN

)

this ............... day of .....................

)

20..........

)

Before me,

*Solicitor/A Commissioner, etc.

(Firm name)

Note:

(i)

* Delete or adapt as appropriate.

(ii)

**In this paragraph the deponent is required to give his own particulars as well as his

relationship with the deceased.

(iii)

The present paragraph is only an example which has been commonly used.

Form No.5 - Affirmation Or Affidavit Of Death - Hong Kong Special Administrative Region Court Of First Instance