"Affidavit of Death Form"

What Is an Affidavit of Death?

An Affidavit of Death is a legal document completed by the deceased person's heir, successor, or another individual who has personal knowledge about this person's death to certify under oath that the individual indicated in the affidavit has passed away. It is usually used in circumstances involving the transfer of the deceased's property when it is necessary to take care of their estate and other legal affairs.

If you need to file an Affidavit of Death Form, download a ready-made template through the link below.

A Death Affidavit is accepted by businesses, courts, and various entities as notification of an individual's death with or without a death certificate. For instance, it is needed for the deceased's creditors and insurance companies so that the family member, beneficiary, or successor may receive the deceased's benefits, obtain ownership of inherited assets, collect life insurance payments, or pay off the deceased's debts.

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How to Write an Affidavit of Death?

To create a proper Death Affidavit, include this information in your document:

  1. Indicate the location where the Affidavit of Death was completed and signed.
  2. State your name and address and certify you are of legal age.
  3. Write down the name of the deceased individual, residential address at the time of death, their dates of birth and death, and social security number. Add the place of death - state, county, and city. Attach a copy of the death certificate to confirm the date and place of death.
  4. Provide details regarding the deceased's estate. Include a full description of the assets and their value.
  5. Name the deceased's heirs if the purpose of your affidavit is to pass the property from the estate to them.
  6. Confirm the statements in the affidavit are true and correct to the best of your knowledge.
  7. Sign and date the form in the presence of a notary public. Once this is done, you may use the document freely when communicating with various institutions to manage the deceased's estate.

How to Fill Out an Affidavit of Death of Joint Tenant?

One of the most common situations for using a Death Affidavit is a joint tenancy. When a married couple holds their real property in joint tenancy and one of them dies, the other spouse becomes the sole owner of that estate. An Affidavit of Death of Joint Tenant is completed to notify the county property assessor and title company in order to modify the existing title and make the surviving spouse the only legal owner of the house or apartment.

In case a married couple holds property using a living trust as co-trustors and one spouse dies, the property and assets go to the surviving spouse. An Affidavit of Death of Trustee is a similar document that allows the surviving trustor to confirm their spouse has died and they now own all the property and assets previously jointly held by the couple.


Check out these related forms and templates:

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Download "Affidavit of Death Form"

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Affidavit of Death
State of _____________________
County of ___________________
I, _________________, being duly sworn, hereby affirm under penalty of perjury, on this
____ day of _________________, that I am the:
☐ Executor
☐ Administrator
☐ Heir
☐ Survivor
(check one)
of the Estate of _________________ (hereinafter referred to as the “Decedent”). The
purpose of this affidavit is to secure the transfer or delivery of Decedent’s:
☐ real property at the time of their death.
☐ securities at the time of their death.
☐ bank accounts at your financial institution.
(check one)
The Decedent died on _________________. At the time of death, the Decedent’s legal
residence was ___________________________________________________________.
Decedent lived at this residence for ____ years prior to death and was not a resident of
any other State within the United States of America at that time. Decedent’s social
security number is _________________.
The value of the decedent’s estate is subject to probate. All debts of the decedent,
including funeral expenses, have been paid or provided for.
Accordingly, I am requesting the transfer or delivery of the items described above and in
the accompanying exhibits.
© ​
T EMPLATEROLLER.COM
Affidavit of Death
State of _____________________
County of ___________________
I, _________________, being duly sworn, hereby affirm under penalty of perjury, on this
____ day of _________________, that I am the:
☐ Executor
☐ Administrator
☐ Heir
☐ Survivor
(check one)
of the Estate of _________________ (hereinafter referred to as the “Decedent”). The
purpose of this affidavit is to secure the transfer or delivery of Decedent’s:
☐ real property at the time of their death.
☐ securities at the time of their death.
☐ bank accounts at your financial institution.
(check one)
The Decedent died on _________________. At the time of death, the Decedent’s legal
residence was ___________________________________________________________.
Decedent lived at this residence for ____ years prior to death and was not a resident of
any other State within the United States of America at that time. Decedent’s social
security number is _________________.
The value of the decedent’s estate is subject to probate. All debts of the decedent,
including funeral expenses, have been paid or provided for.
Accordingly, I am requesting the transfer or delivery of the items described above and in
the accompanying exhibits.
© ​
T EMPLATEROLLER.COM
I have served notice on all other successors as per my state’s laws. As exhibits to this
affidavit please find a list of the:
☐ real property.
☐ securities.
☐ bank accounts owned by the decedent, as well as a Certificate of Death.
(check one)
_________________________________
Affiant’s Printed Name
_________________________________
Affiant’s Signature
_________________________________
Date
© ​
T EMPLATEROLLER.COM
Notary Acknowledgment
State of _____________________
County of ___________________
The foregoing was acknowledged before me this ____ day of _________________, by
the undersigned, _________________, who is personally known to me or satisfactorily
proven to me to be the person whose name is subscribed to the within instrument.
_________________________________
Printed Name of Notary Public
_________________________________
Signature of Notary Public
My commission expires: ___________________
(seal)
© ​
T EMPLATEROLLER.COM
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