Mississippi Affidavit of Death
Mississippi Affidavit of Death
I, [YOUR NAME], being duly sworn, depose and state as follows:
Statement of Facts
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I am over the age of 18 years and competent to make this affidavit.
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[DECEASED PERSON'S NAME] (hereinafter referred to as the "Decedent") passed away on [DATE OF DEATH], in the County of [COUNTY NAME], State of Mississippi.
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The Decedent was a resident of [CITY/TOWN NAME], County of [COUNTY NAME], State of Mississippi, at the time of their death.
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The Decedent's Social Security Number was [SOCIAL SECURITY NUMBER] and their date of birth was [DATE OF BIRTH].
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The Decedent was survived by their family members and extended kin, as identified in the attached list of heirs.
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The Decedent's death certificate is attached herewith, marked as Exhibit A, and I hereby certify that it is a true and correct copy of the original death certificate issued by the appropriate authority.
Sworn Oath
I declare under penalty of perjury that the foregoing is true and correct.
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 Mississippi
My Commission Expires: [Expiry Date]
