Pennsylvania Affidavit of Death
Introduction
I, [YOUR NAME], being duly sworn according to law, depose and state as follows:
I am over the age of eighteen (18) years and competent to make this Affidavit.
I make this Affidavit in connection with the death of [DECEASED'S NAME], who passed away on [DATE OF DEATH], as evidenced by the attached copy of the Death Certificate.
The purpose of this Affidavit is to transfer ownership of the vehicle described below from the deceased to the rightful heir or beneficiary.
Statement of Facts
The deceased, [DECEASED'S NAME], was the registered owner of the following vehicle:
I am familiar with the circumstances surrounding the death of the deceased and can confirm that he/she is deceased.
The vehicle was owned solely by the deceased at the time of his/her death, and no other person or entity has a legal claim to ownership of the vehicle.
Sworn Oath
I swear under penalty of perjury that the statements made in this Affidavit are true and correct to the best of my knowledge, information, and belief. I understand that any false statements made in this Affidavit may subject me to criminal penalties.
[YOUR NAME]
Affiant
Sworn to and subscribed before me this [DATE] day of [MONTH], [YEAR].
Notary Public, State of Pennsylvania
My commission expires: [EXPIRATION DATE]
[NOTARY SEAL]
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