IN THE OFF OF THE CLERK OF JUDICIAL RECORDS FOR …
IN THE OFFICE OF CLERK OF JUDICIAL RECORDS
OF LEHIGH COUNTY, PENNSYLVANIA
REGISTER OF WILLS DIVISION
|In re: Estate of |File No. | |
| | |
|Deceased |Date of Death | |
AFFIDAVIT OF RELATIONSHIP TO DECEDENT
Commonwealth of Pennsylvania )
) SS:
County of Lehigh )
, being duly sworn according to law, deposes and says:
I am an adult individual who can read, write and understand the English language.
died intestate, and was a resident of Lehigh County, Pennsylvania.
I am the unrelated nominee of the decedent’s intestate heirs.
At the time of death the decedent was:
Married Divorced Widowed Never married
|If the decedent was married, then the spouse of the decedent is: |
| | | |
|Name | |Address |
| |
|If the decedent was divorced, widowed or never married then the issue of the decedent are: |
| | | |
|Name | |Address |
| | | |
|Name | |Address |
| | | |
|Name | |Address |
(If a child of decedent is applying additional documents may be required. In addition, if decedent had more than one child renunciations for children not applying are required.)
|If at the time of death the decedent was not survived by a spouse nor did the decedent have any issue then decedent’s parents are: |
| | | |
|Name | |Address |
| | | |
|Name | |Address |
(If only one parent is applying a renunciation from other parent is required.)
If, at the time of death, decedent was not survived by a spouse, issue or parents then decedent’s siblings are:
| | | |
|Name | |Address |
| | | |
|Name | |Address |
(If decedent is survived by more than one sibling then renunciations are required by all siblings not applying.)
further states that the above facts are true and correct.
______________________________
(Signature of person applying)
SWORN to and subscribed before
me this___________________ day of
_____________________, 20_____.
_____________________________
Notary Public or Register of Wills
Form rev 5/14
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