Affidavit Of Domicile

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AFFIDAVIT OF DOMICILE
STATE OF
COUNTY OF
I,
, having been duly sworn,
do depose and attest that I reside at
,
in the county of
in the state of
and that I have resided there for
days.
I am the
Executor
Representative
Heir for the deceased,
named
, who died on
/
/
.
At the time of death, the deceased was residing at the following address:
,
in the county of
in the state of
.
The deceased resided at the aforementioned address for
years
prior to death, and was not a resident of any other state during that time.
This affidavit is made for the purpose of securing the transfer or delivery of property or
securities registered to or owned by the deceased at the time of death to a purchaser or
persons legally entitled thereto under the laws of the deceased’s domicile.
AFFIANT
day of
20
Subscribed and sworn to before me this
(Notary Public),
County.
My commission expires
20
 
 

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