Virginia Affidavit of Death
Introduction
I, [YOUR NAME], being of sound mind and legal age, hereby declare under penalty of perjury under the laws of the Commonwealth of Virginia. This Affidavit of Death is executed to facilitate beneficiary claims to the estate of the deceased individual.
Statement of Facts
The deceased individual is [DECEASED'S NAME], who resided at [DECEASED'S NAME],
The deceased passed away on [DATE OF DEATH], at [PLACE OF DEATH], Virginia.
The deceased's death was due to [CAUSE OF DEATH], as certified by [CERTIFYING AUTHORITY].
I, the affiant, am [RELATIONSHIP TO DECEASED], and I have personal knowledge of the facts stated herein.
To the best of my knowledge, there are no pending legal proceedings related to the estate of the deceased individual.
Sworn Oath
I hereby swear or affirm that the foregoing statements are true and correct to the best of my knowledge, information, and belief. I understand that making a false statement in this affidavit may subject me to penalties for perjury.
Executed on this [DATE] day of [MONTH], [YEAR].
[YOUR NAME]
Affiant
Sworn and subscribed before me this [DATE] day of [MONTH], [YEAR].
Notary Public: [NOTARY PUBLIC NAME]
My Commission Expires: [COMMISSION EXPIRATION DATE]
[NOTARY SEAL]
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