Minnesota Affidavit of Domicile
Introduction
I, [YOUR NAME], the undersigned, hereby declare under penalty of perjury that I am the duly appointed personal representative of the estate of [DECEASED'S NAME], who passed away on [DECEASED'S DEATH DATE]. I am executing this Minnesota Affidavit of Domicile in accordance with the laws of the State of Minnesota to attest to the residency of the deceased at the time of their death.
Statement of Facts
Personal Representative Information:
Full Name: [YOUR NAME]
Address: [YOUR ADDRESS]
Phone Number: [YOUR PHONE NUMBER]
Email Address: [YOUR EMAIL]
Deceased Information:
Full Name: [DECEASED'S NAME]
Date of Birth: [DECEASED'S BIRTH DATE]
Date of Death: [DECEASED'S DEATH DATE]
Last Known Address: [DECEASED'S LAST ADDRESS]
Statement of Domicile:
I affirm that, to the best of my knowledge and belief, at the time of their death, the deceased, [DECEASED'S NAME], was domiciled in the State of Minnesota.
Purpose:
This Minnesota Affidavit of Domicile is being executed for the purpose of facilitating the transfer of assets and settling the affairs of the deceased's estate.
Signatures
I declare that the foregoing statements are true and correct to the best of my knowledge and belief.
[YOUR NAME]
Personal Representative of the Estate of [DECEASED'S NAME]
I, the undersigned witness, hereby certify that [YOUR NAME], the personal representative, signed this affidavit in my presence.
[WITNESS' NAME]
Witness
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