Affidavit of Death

Affidavit of Death

[DATE]

Introduction

I, [YOUR NAME], of Seattle, WA 98101, solemnly declare and affirm the following under oath, based on my personal knowledge, regarding the death of Sigmund Corwin, who was the policyholder of a life insurance policy.

Policy Details

  • Insurance Company: [INSURANCE COMPANY NAME]

  • Policyholder: Sigmund Corwin

  • Policy Number: [POLICY NUMBER]

Statement of Facts

  1. I am an individual who has personal knowledge of the death of Sigmund Corwin, who passed away on [DEATH DATE].

  2. The deceased, Sigmund Corwin, was the policyholder of the life insurance policy with the aforementioned policy number.

  3. I am aware that a claim needs to be initiated for the life insurance policy of the deceased, and I am providing this Affidavit of Death to prompt the processing of the claim.

  4. I declare that, to the best of my knowledge, the information provided in this affidavit is true, accurate, and complete.

  5. I understand the consequences of making false statements in this affidavit, and I affirm that the information presented herein is intended to facilitate the legitimate processing of the life insurance claim.

I request the prompt attention and processing of the life insurance claim to ensure timely resolution and disbursement of any benefits due to the designated beneficiaries.

Should you require any additional documentation or information, please do not hesitate to contact me at 222 555 7777 or [YOUR EMAIL].

I appreciate your prompt attention to this matter.

Sincerely,

[YOUR NAME]

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