
Introduction
I, [YOUR NAME], residing at [YOUR ADDRESS], hereby solemnly affirm and declare the following:
Statement of Facts
I am a family member of the deceased, [DECEASED PERSON'S NAME], who passed away on [DATE OF DEATH], in [PLACE OF DEATH].
I have personal knowledge of the death of the aforementioned individual and can verify the accuracy of this information.
[DECEASED PERSON'S NAME] was [RELATIONSHIP], and I have been intimately involved in handling their affairs following their passing.
I am initiating probate proceedings in the state of Kentucky on behalf of the deceased person's estate.
This Affidavit of Death is submitted to formally notify your agency of the death of [DECEASED PERSON'S NAME] for the purpose of probate proceedings and to facilitate any necessary administrative actions related to their estate.
I understand the importance of providing accurate and timely information to your agency for the proper handling of the deceased person's affairs.
I declare under penalty of perjury under the laws of the state of Kentucky that the foregoing is true and correct to the best of my knowledge, information, and belief.
Signature

[YOUR NAME]
Notarization
Sworn to and subscribed before me this [DATE].

[NOTARY PUBLIC'S NAME]
My Commission Number:
My Commission Expiration Date:
Free Kentucky Affidavit of Death
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