Name of Decedent
*
Decedent's Address
Date of Death
Decedent's Age
Death Certificate
Upload PDF or Image File
Primary Affiant's Information
First Name
*
Last Name
*
Email
*
Address
*
City
State
Postal code
How long did you know the decedent?
Secondary Affiant
Secondary Affiant Email
Secondary Affiant Address
How long did you know the decedent?
If at time of death, Decedent was:
Single
Married
Divorced
Widow or widower
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Time of death relationship status
*(1) EXAMPLE - Spouse name: _______ Marriage Date:_________ Divorce or death Date:________
Previous Marriages
*(1.2) EXAMPLE - Spouse name: _______ Marriage Date:_________ Divorce Date:________
Did the decedent have children?
Yes
No
Spouse & Children Of Decedent, Living or Deceased
(1.3) EXAMPLE - Name________Birth date_____ Address________ Relationship____________
Decedent Property
(1.4) EXAMPLE - Address_____ City_____County____State____Zip____
Decedent Property Documents
Upload any deeds or documents related to property
