Affidavit of Domicile - DOC
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					                                  Affidavit of Domicile
STATE OF ____________________
COUNTY OF _______________________

       PERSONALLY appeared before me, the undersigned authority in and for said
county and state, (Name of Affiant), who, having been being first duty sworn by the
undersigned Notary Public, deposes and says:

1.     (Name of Affiant) resides at (street address, city, state, zip code), and is executor
(or administrator) of the Estate of (name of decedent), deceased, who departed this life
on the (date).

2.     At the time of the death of the said decedent, his domicile (i.e., legal residence)
was (street address, city, state, zip code), where decedent had resided for (number)

3.      Decedent was not a resident of any other State (oth
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Description: An Affidavit of Domicile is normally required for transferring stock certificates when the registered owner of the stock is deceased. This document will confirm the state of residence at the time of death for tax purposes. The Affidavit of Domicile must be signed by the individual executor, administrator and/or survivor in the presence of a Notary Public. This form provides that the affiant upon oath and personal knowledge verifies the address of the decedent at the time of death. This form is a generic example that may be referred to when preparing such a form for your particular state. It is for illustrative purposes only. Local laws should be consulted to determine any specific requirements for such a form in a particular jurisdiction.
PARTNER William Glover
I received my B.B.A. from the University of Mississippi in 1973 and my J.D. from the University of Mississippi School of Law in 1976. I joined the firm of Wells Marble & Hurst in May 1976 as an Associate and became a Partner in 1979. While at Wells, I supervised all major real estate commercial loan transactions as well as major employment law cases. My practice also involved estate administration and general commercial law. I joined the faculty of Belhaven College, in Jackson, MS, in 1996 as Assistant Professor of Business Administration and College Attorney. While at Belhaven I taught Business Law and Business Ethics in the BBA and MBA programs; Judicial Process and Constitutional Law History for Political Science Department); and Sports Law for the Department of Sports Administration. I am now on the staff of US Legal Forms, Inc., and drafts forms, legal digests, and legal summaries. I am a LTC and was Staff Judge Advocate for the Mississippi State Guard from 2004-2008. I now serve as the Commanding Officer of the 220th MP BN at Camp McCain near Grenada, MS. I served on active duty during Hurricanes Dennis (July, 2005), Katrina (August, 2005) and Gustav in 2008. I played football at the University of Mississippi in 1969-1971 under Coach John Vaught. I am the author of the Sports Law Book (For Coaches and Administrators) and the Sports Law Handbook for Coaches and Administrators (with Legal Forms),