Oregon Affidavit of Death

STATE OF OREGON
COUNTY OF [County Name]

Introduction:

I, [YOUR NAME], being duly sworn, depose and state as follows:

Statement of Facts:

1. The decedent, [Decedent's Name], born on [Date of Birth], died on [Date of Death], as evidenced by a certified copy of the Death Certificate attached hereto as Exhibit A.

2. I am the [relationship to the deceased] of the decedent and have direct knowledge of the decedent's death.

3. At the time of death, the decedent was a resident of [Decedent's Address].

4. To the best of my knowledge, the decedent's estate consists of personal property not exceeding the value required for a formal probate process in the State of Oregon and does not include real property.

5. The known heirs of the decedent are as follows: [List Names and Relationships].

6. This affidavit is made for the purpose of inducing [Name of Bank, Financial Institution, or Agency] to transfer ownership or release assets of the decedent to the undersigned, as permitted under Oregon law for small estates.

Declaration:

I declare under penalty of perjury under the laws of the State of Oregon that the foregoing is true and correct.

DATED this [Day] of [Month], [Year].

Signature:

[YOUR NAME]

Subscribed and sworn to before me this [Day] of [Month], [Year], by [YOUR NAME].

[NOTARY PUBLIC NAME]

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