Mississippi Affidavit of Death
I, [YOUR NAME], being duly sworn, depose and state as follows:
Statement of Facts
I am over the age of 18 years and competent to make this affidavit.
[DECEASED PERSON'S NAME] (hereinafter referred to as the "Decedent") passed away on [DATE OF DEATH], in the County of [COUNTY NAME], State of Mississippi.
The Decedent was a resident of [CITY/TOWN NAME], County of [COUNTY NAME], State of Mississippi, at the time of their death.
The Decedent's Social Security Number was [SOCIAL SECURITY NUMBER] and their date of birth was [DATE OF BIRTH].
The Decedent was survived by their family members and extended kin, as identified in the attached list of heirs.
The Decedent's death certificate is attached herewith, marked as Exhibit A, and I hereby certify that it is a true and correct copy of the original death certificate issued by the appropriate authority.
Sworn Oath
I declare under penalty of perjury that the foregoing is true and correct.
Signature
[Your Name]
Affiant
Subscribed and sworn to before me this [Day] day of [Month], [Year].
[Notary Public's Name]
Notary Public for the State of Mississippi
My Commission Expires: [Expiry Date]
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