Small Estate Affidavit
for Safe Deposit Box Access

Decedent Information

Full Name:

Date of Death:

Last Known Address:

Affiant Information

Your Full Name:

Relationship to Decedent:

Address:

Phone Number:

Safe Deposit Box Information

Bank Name:

Branch Address:

Safe Deposit Box Number:

Affidavit

I, , being duly sworn, affirm that I am entitled to access the safe deposit box listed above as per state small estate laws. I declare that all statements in this affidavit are true and correct to the best of my knowledge and belief.

Affiant Signature: Date:

Notary Public Signature: Date:

Notary Seal:

Small Estate Affidavitfor Safe Deposit Box Access

Decedent Information

Affiant Information

Safe Deposit Box Information

Affidavit

Small Estate Affidavit
for Safe Deposit Box Access