AFFIDAVIT OF SURVIVORSHIP STATE OF ________; _________ COUNTY: ss: The undersigned, ___________________ (hereinafter referred to as “Affiant”), whose address is __________________________________________________________upon being first duly sworn in accordance with _________ law, states as follows: 1. On ___________, ________, by Survivorship Deed recorded in Volume _____,
Page _____ of the ______ County, _______ Records (the “Deed”), Affiant acquired, along with [his/her spouse], _____________________.the following described premises: Insert Legal Description Here Property Address: _______________________________________ Parcel ID Number: ________________ 2. On ____________, 20___, ___________________, died thereby terminating his/her interest in the above-described real property. A certified copy of the death certificate of __________________ is attached hereto as Exhibit A. Further, Affiant saith naught. The undersigned has executed this Affidavit Relating to Title to Real Property on this ______ day of _____________ 20___.
_____________________
Sworn to and subscribed before me by ___________________, who appeared before me on the date shown below, and acknowledged before me that_____ did sign the foregoing Affidavit and that the same is _______ free act and deed. IN WITNESS WHEREOF, I have hereunto set my hand and official seal at _______ County, _________, on this _____ day of __________ 20___.
Notary Public