Affidavit Of Heirship - Surviving Spouse Or Descendant

Affidavit of Heirship - Surviving Spouse or Descendant AFHSSD (6/13) UNITED STATES OF AMERICA STATE OF ILLINOIS COUNTY OF LASALLE IN THE CIRCUIT COURT OF THE THIRTEENTH JUDICIAL CIRCUIT Estate of ________________________________________ Deceased No. ______________ AFFIDAVIT OF HEIRSHIP - SURVIVING SPOUSE OR DESCENDANT __________________________________________________________________________on oath states: 1. The Decedent, ______________________________________________________________________, died at ___________________________________________ on _____________________________________________ (place of death) (date of death) at the age of _______________________ years. 2. I am of legal age. I reside at __________________________________________________________________ (street address) ______________________________________________, I am a _______________________________________ (city and state) (state relationship) of the decedent. I am not related to the Decedent, but I have knowledge of the Decedent's heirship as a result of the following: 3. A. The Decedent was never married. B. The Decedent was married ______________________________________________________________ and (did) (did not) leave a surviving spouse whose name is __________________________________________ The following is the information with respect to each marriage of the Decedent: Marriage terminated by death or dissolution (give app. dates) Name of Spouse 1. 2. 3. 4. A. No child was born to or adopted by Decedent. LASALLE COUNTY CIRCUIT CLERK OTTAWA, ILLINOIS 61350 American LegalNet, Inc. www.FormsWorkFlow.com B. The following children and no others were born to or adopted by Decedent: By Spouse number Name of child 1. 2. 3. 4. 5. Minor - M Disabled - D Adopted - A Predeceased Decedent - P 5. The following is the information with respect to each of the above children who predeceased the Decedent: Name of deceased child Name of each child of deceased child (grandchild) Minor - M Disabled - D Adopted - A Predeceased Decedent - P 1. ________________ a. _______________________________ b. _______________________________ 2. ________________ a. _______________________________ b. _______________________________ If additional space is required, attach an addendum. If an additional generation is required, or other data is required, attach an addendum and refer it here. All of the above in the absence of an indication to the contrary, are of legal age, are mentally conpetent, and, if children, are natural children. ______________________________________ Affiant SUBSCRIBED AND SWORN to before me this _______ day of ____________________, A.D. 20 ______ ____________________________________ Notary Public ______________________________________________________ Attorneys for Estate ________________________________________________________________________________________ Street Address ________________________________________________________________________________________ City and State ________________________________________________________________________________________ Phone NOTE: This form is provided as a convenience and guide. It is not intended to cover all possible heirship situtations. American LegalNet, Inc. www.FormsWorkFlow.com