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Form preview Oregon heirship form Heirship Affidavit Prepared by -------------------above this line for official use only----------------- If recorded return to HEIRSHIP AFFIDAVIT Heirship of Deceased STATE OF OREGON COUNTY 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 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. I knew decedent from insert date until insert date. I was personally well acquainted with the named decedent during his/her lifetime. 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 would I was well acquainted with the family and near relatives of the said decedent and with all those who under the laws of the State of Oregon 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 correct. 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/NA. If YES at what place and when ANSWER COUNTY Oregon CAUSE NUMBER estate of said deceased ANSWER YES/NO 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 NAME ADDRESS CAUSE NUMBER QUESTION 5 - Give the name and address of the surviving widow or widower of decedent. If not now living state date of death state whether said former spouse is dead or divorced* STATUS Dead or Divorced other information called for ANSWER Give names of surviving children only NAME OF CHILD DATE OF BIRTH IF NOT LIVING DEATH HUSBAND OR WIFE information called for SURVIVING SPOUSE IF APPLICABLE ADDRESS OF IF NOT LIVING DATE OF NAME OF FATHER OR MOTHER ANSWER YES/NO. If yes provide their names ages and addresses below AGE If yes provide as nearly as possible the amount of the debt and creditor and whether such debt has since been paid CREDITOR AMOUNT OF DEBT HAS DEBT NOW BEEN PAID RELATIONSHIP ADDRESS OR DATE OF relatives If yes list Address or short description QUESTION 15 What is your relationship to the deceased DATED THIS THE DAY OF 20. Signature of Affiant SWORN TO AND SUBSCRIBED before me this the day of 2000. NOTARY PUBLIC My Commission Expires. 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. I knew decedent from insert date until insert date. I was personally well acquainted with the named decedent during his/her lifetime.

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