Kentucky Affidavit of Death

Introduction

I, [YOUR NAME], residing at [YOUR ADDRESS], hereby solemnly affirm and declare the following:

Statement of Facts

1. I am a family member of the deceased, [DECEASED PERSON'S NAME], who passed away on [DATE OF DEATH], in [PLACE OF DEATH].

2. I have personal knowledge of the death of the aforementioned individual and can verify the accuracy of this information.

3. [DECEASED PERSON'S NAME] was [RELATIONSHIP], and I have been intimately involved in handling their affairs following their passing.

4. I am initiating probate proceedings in the state of Kentucky on behalf of the deceased person's estate.

5. This Affidavit of Death is submitted to formally notify your agency of the death of [DECEASED PERSON'S NAME] for the purpose of probate proceedings and to facilitate any necessary administrative actions related to their estate.

6. I understand the importance of providing accurate and timely information to your agency for the proper handling of the deceased person's affairs.

7. I declare under penalty of perjury under the laws of the state of Kentucky that the foregoing is true and correct to the best of my knowledge, information, and belief.

Signature

[YOUR NAME]

Notarization

Sworn to and subscribed before me this [DATE].

[NOTARY PUBLIC'S NAME]

My Commission Number:                               

My Commission Expiration Date:                               

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