District of Columbia Affidavit of Death
Introduction
I, [YOUR NAME], being of lawful age and sound mind, hereby depose and state as follows:
Statement of Facts
I am providing this Affidavit of Death regarding the death of [DECEASED'S NAME], who was a resident of [DECEASED'S ADDRESS].
[DECEASED'S NAME] passed away on [DATE OF DEATH] at [PLACE OF DEATH], as per the attached death certificate.
The cause of death was [CAUSE OF DEATH] as stated in the death certificate.
I have personal knowledge of the death of [DECEASED'S NAME] and am competent to provide this affidavit.
Sworn Oath
I solemnly swear under penalty of perjury that the foregoing statements are true and correct to the best of my knowledge, information, and belief.
Signed this [DATE] day of [MONTH], [YEAR].
[YOUR NAME]
Affiant
Sworn to and subscribed before me on this [DATE] day of [MONTH], [YEAR].
[NOTARY PUBLIC STAMP]
[NOTARY PUBLIC NAME]
My Commission Expires: [EXPIRATION DATE]
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