Introduction

I, [YOUR NAME], hereby declare under penalty of perjury, as the duly appointed personal representative of the estate of [DECEASED'S NAME], deceased, that the following statements are true and accurate to the best of my knowledge:

Statement of Facts

1. I am the personal representative of the estate of [DECEASED'S NAME], who passed away on [DECEASED'S DEATH DATE], and I have been granted authority to act on behalf of the estate in accordance with the laws of the State of Washington.

2. [DECEASED'S NAME] was domiciled in the State of Washington at the time of their death. Their primary residence was located at [DECEASED'S ADDRESS], [CITY NAME], WA [ZIP CODE].

3. This affidavit is being provided for the purpose of estate administration and to inform relevant entities involved in the administration of the estate, including financial institutions, government agencies, and other parties, of the domicile of the deceased person.

4. I understand that this affidavit may be relied upon by third parties for the administration of the estate, including the transfer of assets, resolution of legal matters, and fulfillment of tax obligations.

5. I hereby affirm that all information provided in this affidavit is true and correct to the best of my knowledge, information, and belief.

Sworn Oath

I declare under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct.

Signature

[YOUR NAME]

[DATE]

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