STATE OF NEW HAMPSHIRE

COUNTY OF [County Name]

Introduction:

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

Statement Of Facts:

1. The decedent, [Decedent's Name], passed away on [Date], leaving behind an estate subject to the laws of the State of New Hampshire.

2. At the time of death, the decedent resided at [Decedent's Address], located in the city of [City], county of [County], State of New Hampshire.

3. This affidavit is prepared in connection with the decedent's estate to address assets not covered by the existing Will and to ensure the rightful distribution of such assets according to state law.

4. A Last Will and Testament of the decedent exists and was duly probated in the [Name of the Court] in [County Name], New Hampshire. However, the Will did not encompass all of the decedent's assets.

5. I am the [relationship to the decedent], and my address is [YOUR ADDRESS].

6. To the best of my knowledge and belief, the following individuals are the decedent’s heirs at law, entitled to the decedent's assets not covered by the Will:

   • [Heir #1 Full Name], Relationship: [relationship], Address: [address]

   • [Heir #2 Full Name], Relationship: [relationship], Address: [address]

7. The assets not covered by the Will consist of the following:

Bank Account:

• Location: [Bank Name]

• Account Number: [Account Number]

• Approximate Balance: $[Amount]

Investment Portfolio:

• Location: [Investment Firm]

• Account Number: [Account Number]

• Approximate Value: $[Amount]

Real Estate Property:

• Location: [Property Address]

• Legal Description: [Legal Description]

• Description: [Property Description]

Oaths:

I affirm that the decedent left no debts unpaid at the time of death to the best of my knowledge. I understand that this affidavit is being made for the purpose of collecting the decedent's assets not covered by the Will and to distribute them according to New Hampshire laws.

I hereby declare under penalty of perjury that the foregoing is true and correct to the best of my knowledge, information, and belief.

Executed on this day [Date] of [Month], [Year].

Signature:

[YOUR NAME]

[NOTARY PUBLIC NAME]

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