AFFIDAVIT OF HEIRSHIP OF Deceased
STATE OF }SS.COUNTY OF }
, of lawful age, being first duly sworn, on oath deposes and says:That affiant was personally and well acquainted with the above named decedent during the latter’s lifetime, having knowndeceased for years.Decedent died at , County, State of on or about the day of, , being years of age, and aresident of at the time of death.That the following statements and answers to the following questions are based upon the personal knowledge of affiant and aretrue and correct:
Did decedent leave a will? Yes No If so, has the will been admitted to probate? Yes No Give name of County andState in which such proceedings are pending, and name and address of executor.
(If decedent left a will, please attach a certified copy of same, together with a copy of the order of court admitting it to probate, and letters testamentary.)
If decedent left no will, have administration proceedings been started? Yes No If so, give the name of the County andState in which said administration proceedings are pending and name and address of administrator.
Have ancillary probate proceedings been had on decedent’s estate? Yes NoIf so, when? where?
If no administration proceedings have been started, are there any plans to have the estate administered? Yes No
Did decedent leave any unpaid taxes, including federal estate or state inheritance taxes or other debts? Yes NoIf so, give as nearly as possible, the amount of such taxes or other debts, to whom owing, and whether they have since been paid.
Was decedent surety on any bond or guarantor of any other person’s indebtedness at time of death? Yes NoIf so, give details as to principal debtor, amount, etc.
Were there any suits pending or judgments rendered against decedent at time of death? Yes No If so, state briefly thenature, amount involved and parties.
Marital status of decedent at time of death (married, single, divorced, widow, widower)9.If decedent was ever married, give the following information for each marriage: (List names in order of marriage) Name of SpouseDate of MarriageLiving/DeadDivorcedDate of Death or DivorceWas there a propertysettlement:
Yes No10.If decedent had any children by any spouse, or adopted any children, give the following information: Name of ChildDate of BirthAddressLiving/DeadDate of DeathBy Which Spouse
Form 540 Jan2004