Fill and Sign the Quotaffiantquot Who is Personally Known to Me or If Not Being Personally Known to Me Did Confirm Hisher Identity Form

Heirship Affidavit Prepared by: If recorded, return to: ))))))))))-------------------above this line for official use only----------------- HEIRSHIP AFFIDAVIT (Heirship of _______________________________ Deceased) STATE OF NEW YORKCOUNTY OF _____________ )) BEFORE ME, the undersigned authority, on this day personally appeared _____________________________, ("AFFIANT") who is personally known to me (or, if not being personally known to me, did confirm his/her identity presenting ______________________ as identification (i.e. drivers license #), and appearing to be fully competent and of sufficient age, upon being duly sworn, stated upon Affiant's oath the following: 1. My name is ________________________________________ (insert name of affiant), and I live at ________________________________________________________ (insert address of affiant's residence). I am personally familiar with the family and marital history of ____________________________________ ("Decedent") (insert name of decedent), and I have personal knowledge of the facts stated in this affidavit. 2. I knew decedent from _______________________ (insert date) until _________________________ (insert date). I was personally well acquainted with the named decedent during his/her lifetime. 3. The Decedent died on _________________________________________ (insert date of death) at the following place of death: _____________________________________(City), ______________________, (County), _________________________ (State) (insert place of death). At the time of decedent's death, decedent's residence address was ____________________________________________________________________ (Street), _________________________________(City), New York , _________________ (Zip).(insert address of decedent's residence). 4. I was well acquainted with the family and near relatives of the said decedent, and with all those who would under the laws of the State of New York , be his/her heirs. The following statements and the information contained herein, including my answers to named questions below, are based upon my personal knowledge and are true and co
Ordinated within the limits contained herein, except that I understand all statements to be made to the best of my knowledge, believe the facts stated therein to be true, and am not the subject of the statements herein to which such statement, by its very nature, is untrue. 5. On the day of decedent's death, the decedent's deceased brother and his wife and children were present and present to witness and to be witnesses to (my death.) the decedent was buried in (street), (city) , (county), (state) (insert place of burial.). 6. The decedent was an active member and was involved in activities in the religion of his deceased religious denomination of his own volition when he (he/him/his/her/the) took his life, (“i made this written statement in the presence of those whom I know and have personal knowledge of.")(signature of affianced) signed this affidavit with my own hand (notarized) before me and the undersigned authority. 7. I (name and full date of birth) fully disclose and attest that I am not a legally recognized person in the United States (state/county/city) and under the laws of the state of New York, and under section 7-106 of the general business law, as may be amended by the New York state legislature (hereinafter referred to as “the laws of the state of new york"), my written declaration and affidavits filed herewith are not sufficient proof that I am the person named as heir herein and that I am not the beneficiary of the decedent in the property held in trust by executors in will of the decedent. By this declaration and affidavit (information in affidavit may be made available to law enforcement agencies at request of the department of health and mental hygiene, if any other person was a beneficiary of the decedent.) I acknowledge that my statements regarding the facts I state below are true and correct to the best of my knowledge, belief, and belief, and as to statements contained herein I shall be subject only to the penalties for perjury as prescribed by the revised penal law. I further acknowledge and agree that by providing this affidavit I am releasing and disclaiming any legal or equitable claims, including personal rights, claims, causes, actions, or causes of action against or arising from any of the following (name of person to whom or authority to whom assets of decedent were held, the name of his/