ARIZONA AFFIDAVIT OF DEATH

I, [Your Name], being duly sworn, depose and state as follows:

Statement of Facts

1. I am over the age of eighteen and competent to make this affidavit.

2. I am the [Relationship to Deceased], having personal knowledge of the matters stated herein.

3. [Deceased's Name], passed away on [Date of Death], in the city of [City Name], County of [County Name], State of Arizona.

4. The death certificate issued by the Arizona Department of Health Services confirms the death of [Deceased's Name] on the aforementioned date.

5. The Social Security Number of [Deceased's Name] is [Social Security Number].

6. Attached herewith is a copy of the death certificate of [Deceased's Name] issued by the relevant authorities.

Sworn Oath

I solemnly affirm under penalty of perjury that the foregoing is true and correct to the best of my knowledge and belief.

Signature

[Your Name]
Affiant

Subscribed and sworn to before me this [Day] day of [Month], [Year].

[Notary Public's Name]

Notary Public for the State of Arizona

My Commission Expires: [Expiry Date]

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