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Affidavit of Death Template
Confirm a death formally with a sworn Affidavit of Death for administrative and record purposes using this template.
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Affidavit of Death Template
This Affidavit of Death (the “Affidavit”) is made on [Date] by:
Affiant: [Full Name], address: [Address], phone/email: [Contact].
Relationship/Authority: ☐ Spouse ☐ Child ☐ Executor/Personal Representative ☐ Heir ☐ Attorney-in-fact ☐ Other: [Explain]
Decedent: [Full Legal Name]
Date of Birth (Optional): [DOB]
Date of Death: [Date]
Place of Death (City/State/Country): [City/State/Country]
Last Known Address: [Address]
1. Purpose
1.1 I am making this Affidavit to formally confirm the Decedent’s death for the following purpose(s):
☐ Bank/financial account update
☐ Insurance claim/benefit processing
☐ Lease/tenancy or landlord records
☐ Employer/benefits records
☐ Real estate title/record update
☐ Other: [Purpose]
2. Statement of Death
2.1 The Decedent named above died on [Date of Death] in [Place of Death].
2.2 A certified copy of the death certificate is: ☐ attached ☐ will be provided.
3. Property/Record Information (Optional)
3.1 Institution/Agency Receiving This Affidavit: [Name].
3.2 Account/Policy/Reference Number (Optional): [].
3.3 Real Estate (If Applicable): Property address: []. Parcel/Legal description (optional): [__].
3.4 Recording Information (If Known): [County recorder, instrument #, book/page].
4. Supporting Documents (Attach as Available)
4.1 ☐ Certified death certificate
4.2 ☐ Proof of identity of affiant
4.3 ☐ Letters testamentary/administration (if applicable)
4.4 ☐ Will (if applicable)
4.5 ☐ Marriage certificate (if spouse)
4.6 ☐ Property deed/title document (if applicable)
4.7 ☐ Other: [List]
5. Statement Under Oath
5.1 I declare under penalty of perjury that the statements in this Affidavit are true and correct to the best of my knowledge.
Signatures
Affiant: [Full Name]
Date: [Date]
Signature: ___________________________
Witnesses (If Required)
Witness Name: [Name]
Date: [Date]
Signature: ___________________________
Notary / Notarization (If Required)
State of [State]
County of [County]
On [Date], before me, [Notary Name], personally appeared [Affiant Full Name], known to me (or satisfactorily proven) to be the person whose name is subscribed to this Affidavit, and acknowledged that they executed it for the purposes stated.
Notary Public Signature: _______________________
My Commission Expires: _______________________
Notary Seal (if applicable): ___________________
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Affidavit of Death Template
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For quick answers, scroll below to see the FAQ.
Click below for detailed info on the template.
For quick answers, scroll below to see the FAQ.
AFFIDAVIT OF DEATH TEMPLATE FAQ
What is an affidavit of death?
An Affidavit of Death is a sworn statement confirming that a person has died. It is often used with a certified death certificate to help update records, transfer assets, change title/ownership, or notify institutions such as banks, insurers, or landlords.
Who can sign it?
Typically a spouse, family member, executor/personal representative, or another person with personal knowledge can sign. Some institutions have specific requirements, so it’s best to confirm what they need before submitting.
What information is included?
Common fields include: the decedent’s full name, date of death, place of death, last address, the affiant’s relationship/authority, and the reason the affidavit is being provided. This template also includes optional filing/recording information for property records.
Do you need to attach a death certificate?
Usually yes. Many organizations will not accept an affidavit alone. This template includes an attachments section with a death certificate checkbox and other common supporting documents.
Do you need notarization?
Often yes, especially if the affidavit will be recorded or used for asset transfers. This template includes a notarization section and an optional witness section.
Can this be used to transfer real estate?
Sometimes it is used as part of a title update when a joint owner dies, but requirements vary by jurisdiction. If real estate is involved, confirm local recorder rules and consider using a form required by the county recorder.
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