District of Columbia Affidavit of Death

District of Columbia Affidavit of Death

Introduction

I, [YOUR NAME], being of lawful age and sound mind, hereby depose and state as follows:

Statement of Facts

  1. I am providing this Affidavit of Death regarding the death of [DECEASED'S NAME], who was a resident of [DECEASED'S ADDRESS].

  2. [DECEASED'S NAME] passed away on [DATE OF DEATH] at [PLACE OF DEATH], as per the attached death certificate.

  3. The cause of death was [CAUSE OF DEATH] as stated in the death certificate.

  4. I have personal knowledge of the death of [DECEASED'S NAME] and am competent to provide this affidavit.

Sworn Oath

I solemnly swear under penalty of perjury that the foregoing statements are true and correct to the best of my knowledge, information, and belief.

Signed this [DATE] day of [MONTH], [YEAR].

[YOUR NAME]

Affiant


Sworn to and subscribed before me on this [DATE] day of [MONTH], [YEAR].

[NOTARY PUBLIC STAMP]

[NOTARY PUBLIC NAME]

My Commission Expires: [EXPIRATION DATE]

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