COMMONWEALTH OF PENNSYLVANIA

COUNTY OF [County Name]

Introduction:

I, [YOUR NAME], of [YOUR ADDRESS], being duly sworn according to law, depose and say that:

Statement of Facts:

1. The decedent, [Decedent's Name], passed away on [Date], in [City/Town], Pennsylvania.

2. At the time of their passing, the decedent resided at [Decedent's Address]. As the [relationship to the decedent] of the decedent, I possess comprehensive knowledge of their family history and the circumstances surrounding their estate.

3. The decedent departed intestate, without leaving behind a last will and testament. According to the laws of the Commonwealth of Pennsylvania, the individuals entitled to inherit the estate are as follows: [Heir #1 Name], who is the [relationship] of the decedent, residing at [address]; [Heir #2 Name], who is the [relationship] of the decedent, with their address at [address]; along with additional heirs as identified.

4. This affidavit is prepared to formally establish the rightful heirs to the decedent’s estate for the purpose of asset distribution in alignment with Pennsylvania's intestacy laws.

5. The decedent owned the following assets requiring the execution of this affidavit for the purpose of transfer of ownership:

   • [Description of Asset #1, including any identifying numbers, location, etc.]

   • [Description of Asset #2]

Declarations:

There are no known disputes regarding the decedent’s will or the distribution of the estate. The value of the decedent’s entire estate subject to administration does not exceed the statutory limit for small estates under Pennsylvania law.

I hereby affirm that this affidavit is executed in good faith for the sole purpose of transferring the described assets to the entitled heirs according to Pennsylvania intestacy laws.

Signature:

[YOUR NAME]

[Notary Public Name]

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