Vermont Affidavit of Death

STATE OF VERMONT

COUNTY OF [County Name]

Introduction:

I, [YOUR NAME], being duly sworn, depose and say:

Statement of Facts:

1. The deceased, [Deceased's Name], passed away on [Date of Death].

2. The death occurred in [City/Town Name], Vermont.

3. At the time of death, the deceased's last known address was [Deceased’s Last Known Address].

4. I am the [relationship to the deceased], and I have personal knowledge of the facts stated herein.

5. Attached hereto is a certified copy of the death certificate of the deceased.

6. The deceased was the lessee or co-lessee of a safety deposit box located at [Bank Name], situated at [Bank Address], Vermont.

7. The safety deposit box is identified as Box Number [Box Number].

8. This affidavit is made for the purpose of accessing the safety deposit box of the deceased to retrieve the will, burial instructions, or other important documents or items of the deceased.

9. I assert my right as the [Executor of the Will/Administrator of the Estate/close relative] of the deceased to access the safety deposit box as per the laws of the State of Vermont.

10. To the best of my knowledge and belief, the deceased did not revoke the document that gives me the authority to access the safety deposit box, nor has my authority been revoked or terminated.

Signature:

[YOUR NAME]

Sworn to (or affirmed) and subscribed before me this [Day] of [Month], [Year], by [YOUR NAME].

[NOTARY PUBLIC NAME]

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