Introduction

I, [YOUR NAME], hereby make this affidavit for the purpose of claiming ownership of [DECEDENT'S NAME]'s personal property under the Small Estate laws of Oregon.

Pursuant to Oregon Revised Statutes (ORS) § 114.515, I am entitled to claim the personal property of the deceased, including their bank account held with [BANK NAME], account number [ACCOUNT NUMBER].

Statement of Facts

1. I am the lawful heir of [DECEDENT'S NAME], who passed away on [DECEDENT'S DEATH DATE].

2. [DECEDENT'S NAME] resided at [DECEDENT'S ADDRESS] at the time of their death.

3. To the best of my knowledge, the total value of the assets owned by [DECEDENT'S NAME] at the time of their death, including the bank account referenced below, does not exceed the statutory limit for a small estate in Oregon.

4. Attached to this affidavit is a certified copy of [DECEDENT'S NAME]'s death certificate, which serves as proof of their death.

5. The bank account in question, held at [BANK NAME], is identified as follows:

   • Account Holder: [DECEDENT'S NAME]

   • Account Number: [ACCOUNT NUMBER]

   • Account Type: Savings Account

6. As the lawful heir of [DECEDENT'S NAME], I hereby request that the funds held in the aforementioned bank account be transferred to me.

7. I acknowledge that by signing this affidavit, I am assuming responsibility for any debts or liabilities owed by the deceased to the extent of the value of the transferred assets.

8. I declare that all information provided in this affidavit is true and accurate to the best of my knowledge.

Sworn Oath

I understand that this Small Estate Affidavit is submitted for the purpose of transferring the bank account referenced above and that it may be relied upon by the bank in effecting the transfer of assets.

Signature

[YOUR NAME]

Sworn to before me, a notary public, this [DATE].

[NOTARY PUBLIC NAME]

[NOTARY PUBLIC EXPIRY DATE]

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