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Filer's Affidavit for Death Claim  Form

Filer's Affidavit for Death Claim Form

Use a affidavit for death benefit claim sample with answer template to make your document workflow more streamlined.

At ____________________________ on _____________________________________. That the names and pertinent data of the aforementioned deceased member’s immediate relatives and next to kin are as follows: ADDRESS LEGITIMATE HUSBAND/WIFE DATE & PLACE OF MARRIAGE (if dead, give date and place of death instead) COMMON-LAW HUSBAND/WIFE ADDRESS DATE OF UNION LEGITIMATE/ LEGITIMATED/ LEGALLY ADOPTED CHILDREN DATE/ PLACE OF BIRTH ILLEGITIMATE CHILDREN (if dead, give date and place of death...
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