Affidavit Of Heirship (Page 2 of 2) in pdf

Affidavit Of Heirship Page 2

Affidavit of Heirship

I agree to indemnify and hold harmless SUMMUM and its affiliates, officers, counselors,

directors employees, representatives, agents and assigns from any and all liabilities, claims or causes of

action arising out of, or in any way connected with, my representation, authorization and instructions

concerning who would have rights to the disposition of my body. I further agree that it is my

responsibility to keep this affidavit up to date, by adding or deleting any persons involved with my

disposition.

________________________________________

______________________________

Signature of Affiant

Date

________________________________________

Print Name

SUBSCRIBED AND SWORN to before me this _______ day of ____________________,

20_______.

________________________________________

Notary Public

[ Notary Seal ]

My commission expires:

________________________________________

Page 2 of 2

Affidavit Of Heirship Page 2