___________________________________________________
(Signature of the Affiant, the person preparing this affidavit)
Signed and sworn to me on the ___ day of __________________, in the year
20___.
State of _____________
County of _____________
I, the undersigned authority in and for said County in said State, hereby certify
that __________________, whose name is signed as the Affiant in this small
estate affidavit, and who is known to me, acknowledged before me on this day
that, being informed of the contents of the said document, (s)he executed the
same voluntarily on the day the same bears date.
Given under my hand this ___ day of _____________, 20___.
Notary Public Signature ____________________ State of _________________.
Printed Name: _____________________________.
My commission expires: _____________________
(Notary Seal)
Note: in addition, your State may require the affidavit and signatures of two (2)
disinterested witnesses.
WITNESS 1
I have no interest in the estate of ________________________, deceased, nor
am I related to the decedent. The statements made in this affidavit are true to
the best of my knowledge.
____________________________
________________________________
(Disinterested Witness's signature)
(Disinterested Witness’s printed name)
WITNESS 2
I have no interest in the estate of ________________________, deceased, nor
am I related to the decedent. The statements made in this affidavit are true to
the best of my knowledge.
____________________________
________________________________
(Disinterested Witness's signature)
(Disinterested Witness’s printed name)