Affidavit Of Survivorship
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1AFFIDAVIT OF SURVIVORSHIP
STATE OF
COUNTY OF
I,
, residing at
,
in the county of
in the state of
and being duly sworn, do hereby depose and attest that:
1. The Decedent,
, is named in the
attached death certificate.
2. The Decedent died on
and {was/was not}
legally married at the time.
3. The names of the Decedent’s survivors are
4. My relationship to the Decedent was
5. At the time of death, the Decedent was the joint owner of
along with
6. The property is legally described as follows:
Affiant
Date
Subscribed and sworn to before me
this
day of
20
(Notary Public),
County.
My commission expires
20
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