Fill and Sign the Heirship 481371434 Form

Heirship - Affidavits Questionnaire Client Name: Address: Social Security No.: Birthdate: Home Phone: Work Phone: Cell Phone: Decedent’s Name: Place of Death: Date of Death: Place of Birth:     Date of Birth: Last Residence Address: Decedent’s Mother’s Name: Decedent’s Father’s Name: How long did you know the decedent? Are you well acquainted with the family and near relatives of the said decedent, and with all those who would under the laws of the state, be his/her heirs? Yes No Are you personally familiar with the family and marital history of the decedent? Yes No Gross value of decedent’s estate: QUESTION 1 - Did the decedent leave a will? ANSWER: Yes No QUESTION 2 - If the decedent left a will, has the will been admitted to probate? ANSWER: Yes No N/A If yes, at what place, and when? ANSWER : COUNTY, CAUSE NUMBER DATE QUESTION 4 - If an administrator or personal administrator has been appointed, give the County in which the proceedings are pending, and the name and address of the administrator or personal representative. ANSWER : COUNTY CAUSE NUMBER NAME ADDRESS QUESTION 5 - Give the name and address of the surviving widow or widower of decedent. ANSWER : NAME ADDRESS If not now living, state date of death: QUESTION 6 - If the decedent was married more than once, give the name(s) of the former husband or wife, and state whether said former spouse is dead or divorced. ANSWER : NAME STATUS (Dead or Divorced) QUESTION 7 - Give the names and places of residence of all the surviving children of deceased, together with the other information called for: ANSWER : (Give names of surviving children only) NAME OF CHILD ADDRESS DATE OF BIRTH IF NOT LIVING DATE OF DEATH HUSBAND OR WIFE NAME QUESTION 8 - Give the name and address of any deceased children of the decedent, together with the other information called for: ANSWER : NAME OF CHILD DATE OF BIRTH DATE OF DEATH SURVIVING HUSBAND OR WIFE NAME DATE OF DEATH OF SPOUSE, IF APPLICABLE QUESTION 9 - If decedent was married at the time of death, are all of the above children of that marriage? Yes No QUESTION 10 - Give the names and addresses of the children of any deceased son or daughter of the decedent: ANSWER : NAME OF CHILD ADDRESS OF IF NOT LIVING DATE OF DEATH DATE OF BIRTH NAME OF FATHER OR MOTHER QUESTION 11 - Did the decedent have any adopted children, or step-children taken into his home? ANSWER : Yes No If yes, provide their names, ages and addresses below: NAME ADDRESS AGE QUESTION 12 - Did the decedent have any unpaid debts? ANSWER : Yes No If yes, provide as nearly as possible the amount of the debt and creditor and whether suc h debt has since been paid ANSWER : CREDITOR AMOUNT OF DEBT HAS DEBT NOW BEEN PAID QUESTION 13 - If the decedent left no children, then give below the names and addresses (together with other information called for), or his or her surviving father, mother, brothers, sisters: ANSWER: NAME RELATIONSHIP AGE ADDRESS OR DATE OF DEATH QUESTION 14 - If the decedent left no children, spouse, mother, father, brother or sister, state all other known relatives: ANSWER: NAME RELATIONSHIP AGE ADDRESS QUESTION 15: Did the decedent own any real estate in this state?: ANSWER: Yes No If yes, list Address or short description : County: Address or short description : County: Address or short description : County: Address or short description : County: Address or short description : County: QUESTION 16 : What is your relationship to the deceased? ANSWER : Please attach a copy of decedent’s death certificate to this questionnaire.