AFFIDAVIT (LACK OF PROBATE)
The undersigned affiant/grantee ______________________________, being first duly sworn
Name of Affiant
deposes and states as follows: That they are a rightful heir as listed on heirs at law, to the real
property described below, and is _____________________________________________________
Relationship to decedent
of _________________________________________________ , who died on ________________
Decedent/Grantor Date
at _______________________________________________________________________
City County State
REAL PROPERTY SUBJECT TO THE AFFIDAVIT:
Abbreviated Legal Description:
Assessor’s Property Tax Parcel/Account Number: ________________________________
(Attach full legal description of the property)
Decedent left no Last Will and Testament.
Decedent left a Last Will and Testament which HAS NOT been Probated or Revoked.
“Heirs at law” includes surviving spouse, children, adopted children, issue of
predeceased child or adopted child, parents, brothers and sisters of the decedent.
Affiant hereby identifies all heirs at law of the decedent: (use additional pages if
necessary)
(Page 1 of _____)
REV 84 0017 (1/3/17)
Return Address:
_______________________________________________
_______________________________________________
________________________________________________
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Full name, age, relationship, address
Full name, age, relationship, address
Full name, age, relationship, address
Full name, age, relationship, address
Full name, age, relationship, address
Full name, age, relationship, address
Full name, age, relationship, address
Full name, age, relationship, address
Dated : __________________________________________________
Affiant’s full name
Telephone number
_______________________________________________________________________________
Street
_______________________________________________________________________________
City State Zip Code
________________________________________ _________________________________
Signature Date
------------------------------------------------------------------------------------------------------------------------
State of County of
I know or have satisfactory evidence that
(name of person)
is the person who appeared before me, and said person acknowledged that (he/she) signed this
affidavit and acknowledged it to be (his/her) free and voluntary act for the uses and purposes
mentioned in this affidavit.
Dated: / / _____________________________________________
Signature of Notary Public
(SEAL OR
STAMP)
Residing at: ____________________________________
Notary Public in and for the State of ______________
My appointment expires: _______/________
REV 84 0017 (1/3/17)
