Affidavit of Heirship

State of
County of

Before me, the undersigned authority, on this day personally appeared ("Affiant"), who, being duly sworn, deposes and states as follows:

1. Name of Decedent:
Date of Death:
Place of Death:
Residence at Time of Death:
2. Relationship of Affiant to Decedent:
3. Decedent died (check one):
Testate (with a will)
Intestate (without a will)
4. List of Heirs:
Name Relationship to Decedent Address Date of Birth
5. Marital History of Decedent (names, dates, status):
6. Children of Decedent (if any):
Name Date of Birth Parent's Name
7. Other Relevant Information:

Affiant further states that the foregoing statements are true and correct to the best of their knowledge, information, and belief.

Affiant Signature
Date

Sworn to and subscribed before me this day of , 20.

Notary Public Signature
My Commission Expires