State of Colorado

County of [County Name]

Introduction:

I, [YOUR NAME], being duly sworn, declare and affirm under penalty of perjury under the laws of the State of Colorado that:

Statement of Facts:

1. The individual in question, [Deceased's Name], was born on [Deceased's Date of Birth] and sadly passed away on [Deceased's Date of Death].

2. At the time of their passing, [Deceased's Name] resided at [Deceased's Last Known Address], which was considered their last known place of domicile.

3. This affidavit is prepared in connection to their estate and the management of their assets following their death.

4. I am the [state relationship] of the above-named deceased individual.

5. The deceased was the sole owner of the following described property located in the State of Colorado:

   • Property Description: [Provide a detailed description of the property, including address and legal description as found on the deed or property records]

6. This Affidavit is made for the purpose of transferring the above-described property from the deceased to the undersigned, pursuant to Colorado law.

7. Attached hereto is a certified copy of the death certificate of [Deceased's Name].

Declaration:

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

I understand that this affidavit is being submitted to facilitate the transfer of the described property and may be relied upon by county officials, financial institutions, and others involved in the transfer process.

Signature:

[YOUR NAME]

Subscribed and sworn to (or affirmed) before me on this [Day] of [Month], [Year], by [YOUR NAME], proved to me on the basis of satisfactory evidence to be the person who appeared before me.

[NOTARY PUBLIC NAME]

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