Affidavit of Domicile

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An affidavit of domicile confirms the residence of a deceased person at the time of death. Establishing residence is important for transferring financial securities to the entitled parties. The person completing the form (executor, heir, spouse, etc.) will include the decedent’s name, address, and date of death as well as their own name and address.

Affidavit of Domicile

An affidavit of domicile confirms the residence of a deceased person at the time of death. Establishing residence is important for transferring financial securities to the entitled parties. The person completing the form (executor, heir, spouse, etc.) will include the decedent’s name, address, and date of death as well as their own name and address.

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Last updated November 20th, 2024

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An affidavit of domicile confirms the residence of a deceased person at the time of death. Establishing residence is important for transferring financial securities to the entitled parties. The person completing the form (executor, heir, spouse, etc.) will include the decedent’s name, address, and date of death as well as their own name and address.

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What is an Affidavit of Domicile

An affidavit of domicile is required by financial institutions to properly transfer the stocks of a deceased individual to the new owner. Knowing which state the decedent died in is important for determining which tax and probate laws apply to the situation.

The affidavit is completed under oath, meaning the signing party is swearing under penalty of perjury that the statements within the document are accurate. A notary public must acknowledge the person’s identity and signature and certify the form with their own signature and notary seal.

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AFFIDAVIT OF DOMICILE

Date: [MM/DD/YYYY]

1. THE DECEDENT.

Account Number: [ACCOUNT NUMBER]
Decedent Name: [DECEDENT NAME]
Date of Death: [MM/DD/YYYY]
Legal Residence Address: [DECEDENT ADDRESS OF RESIDENCE]

2. THE DECEDENT.

Identification: ☐ Executor ☐ Administrator ☐ Personal Representative ☐ Spouse ☐ Trustee ☐ Beneficiary ☐ Heir at Law ☐ Survivor of Joint Tenancy
Affiant Name: [AFFIANT NAME]
Affiant Address: [AFFIANT ADDRESS]

3. PURPOSE. This affidavit of domicile is made for the purpose of securing the transfer or delivery of property owned at the time of the decedent’s death to a purchaser or the person(s) legally entitled thereto under the laws of the state of the decedent’s domicile.

Under penalty of perjury I, [AFFIANT NAME], hereby declare and acknowledge that the information in this affidavit of domicile is true and correct.

Affiant Signature: ______________________________ Date: _______________

NOTARY ACKNOWLEDGMENT

A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.

State of [STATE]
County of [COUNTY]

The foregoing instrument was acknowledged before me, [NOTARY PUBLIC NAME], on [MM/DD/YYYY], by the undersigned, [AFFIANT NAME], who is personally known to me or satisfactorily proven to me to be the person whose name is subscribed to the within instrument.

WITNESS my hand and official seal.

Signature: ________________________

(Seal)