WISCONSIN AFFIDAVIT OF DEATH
I, [YOUR NAME], residing at [YOUR ADDRESS], am of legal age and of sound mind, duly swear and state the following:
Statement of Facts
[DECEASED PERSON'S NAME] (hereinafter referred to as the "Decedent") died on [DATE OF DEATH], within the jurisdiction of [COUNTY NAME] County, Wisconsin.
The Decedent resided in and belonged to the community of [CITY/TOWN NAME] in [COUNTY NAME] County, Wisconsin, at the time of their passing.
The Decedent was born on [DATE OF BIRTH] and their Social Security Number was [SOCIAL SECURITY NUMBER].
The Decedent left behind surviving relatives, a list of whom is detailed in the attached roster of heirs.
An authentic copy of the Decedent's death certificate, designated as Exhibit A, is appended herein, with my confirmation of its accuracy and authenticity.
Sworn Oath
I, [YOUR NAME], affirm under penalty of perjury the truth and accuracy of the above statements in this Affidavit of Death.
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 Wisconsin
My Commission Expires: [Expiry Date]
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