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This document is an affidavit of debts and domicile for an estate. It provides information about the executor filing the affidavit, the deceased person whose estate it concerns, the deceased's last domicile and residences, and asserts that all debts and claims against the estate have been paid. The purpose of the affidavit is to induce the transfer of property owned by the deceased to those legally entitled to it under the laws of the deceased's domicile.

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75 views1 page

Preview Preview: Affidavit of Debts And/Or Domicile

This document is an affidavit of debts and domicile for an estate. It provides information about the executor filing the affidavit, the deceased person whose estate it concerns, the deceased's last domicile and residences, and asserts that all debts and claims against the estate have been paid. The purpose of the affidavit is to induce the transfer of property owned by the deceased to those legally entitled to it under the laws of the deceased's domicile.

Uploaded by

DEShif
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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3039Affidavit of Domicile (Residence) and Debts, 5-12.

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2012 BlumbergExcelsior, Inc., Publisher, NYC 10013

www.blumberg.com

affidavit of debts and/or domicile


STATE OF

ss.:

County of

W
E


being duly sworn deposes and says that:
1. He/she resides at State of
and is the Executor(trix) Administrator(trix) Surviving Tenant Survivor Beneficiary
Other:
of the Estate of
Deceased;
who died at
on 20

I
V

2. At the time of his/her death the domicile (legal residence) of said decedent was at
County of State of
that decedent resided in said state for
years, such residence having commenced
on

E
R
P

3. Decedent last voted in the year


at
County of State of
4. Decedents principal place of business at the time of his/her death was at
County of State of

W
E

5. Decedents most recent Federal income tax return showed his/her legal residence as
County of State of

6. Within three years prior to death decedent was was not a resident of another State (if
decedent resided in another State within three years prior to death, set forth the name of the State and
the facts as to change of residence and establishment of final domicile)

I
V

7. Any and all debts, taxes and claims against the estate have been paid or provided for.

E
R
P

8. This affidavit is made for the purpose of securing the transfer or delivery of property owned by
decedent at the time of his/her death to a purchaser or the person or persons legally entitled thereto
under the laws of decedents domicile and that any apparent inequality in distribution has been
satisfied or provided for out of other assets in the estate.
9. This affidavit is made in order to induce
to transfer
belonging to said decedent as a distribution to the persons legally entitled thereto under the laws of the
decedents domicile. Any inequality in the distribution of said property has been equalized by delivery
to the beneficiaries of other money, property or securities.

Sworn to before me on

20

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