STATE OF LOUISIANA



STATE OF LOUISIANA

PARISH OF ______________________

SMALL SUCCESSION

AFFIDAVIT OF DEATH AND HEIRSHIP

PURSUANT TO CODE OF CIVIL PROCEDURE ARTICLE 3432

BEFORE ME, the undersigned authority, personally came and appeared:

_________________________________________________, a major resident of and domiciled in Union Parish, Louisiana address ____________________________________________________________________________________________________________________________________

and

__________________________________________________ a major resident of and domiciled in Union Parish, Louisiana address ___________________________________________________________________________________________________________________________________.

who after being by me first sworn on their oath, did depose and say:

That they were well and personally acquainted with ___________________________, who departed this life intestate on ___________________________________.

That at the time of his death, _______________________________ was domiciled in Union Parish, Louisiana on which date he had maintained his permanent place of residence and domicile in Union Parish, Louisiana at ________________________________________________________________________

That they know of their own personal knowledge that he was married but once, and then to _________________________________________________, who predeceased him.

Of that marriage, _____________ children were born, namely, ________________________________________________________________________________________________________________________________________________ The above surviving children of _____________________________________ are above the age of twenty-four and one are incapable of taking care of their person or administering their estates because of mental incapacity or physical infirmity. _________________________ was not a father to any other children and he never adopted any other person.

That the only heirs of the decedent are listed above.

Affiants further declare that the following is a brief description of the movable property left by the deceased, at the time of his death and the value thereof:

MOVABLE PROPERTY

DEBTS AND OBLIGATIONS

Affiants further declares _____________________________________________ ______________________________________________________________________________________________________________________be recognized and decreed to be the sole and only heirs of the Decedent and as such, entitled to the ownership and to be placed in possession of all Decedent's property of which he was possessed at the time of his death.

By signing below, Affiants, _______________________________ and ________________________________ have accepted the succession of the deceased.

Affiants further declares that under penalty of perjury that the information contained in the Affidavit is true, correct and complete to the best of their knowledge, information and belief.

WITNESSES:

_______________________________ ____________________________________

_______________________________ ____________________________________

SWORN TO AND SUBSCRIBED BEFORE ME, Notary Public for the Parish of ________________, State of Louisiana on this the __________ day of _____________, 20____.

________________________________________

NOTARY PUBLIC

ID#_________________

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