North Dakota Affidavit of Death
Introduction
I, [YOUR NAME], being duly sworn, depose and state as follows:
I am over the age of eighteen (18) years and am of sound mind and competent to make this Affidavit.
I am the [RELATIONSHIP TO DECEASED], and I have personal knowledge of the facts stated herein.
Statement of Facts
[DECEASED'S NAME], the decedent, passed away on [DATE OF DEATH], in [COUNTY NAME], North Dakota.
The decedent was a resident of [COUNTY NAME], North Dakota at the time of death.
Attached hereto and incorporated herein as Exhibit A is a true and correct copy of the death certificate of the decedent issued by the relevant authority.
Sworn Oath
I hereby swear under penalty of perjury that the foregoing statements are true and correct to the best of my knowledge, information, and belief.
Signed this [DATE] day of [MONTH], [YEAR].
[YOUR NAME]
Affiant
Notary Acknowledgment
State of North Dakota
County of [COUNTY NAME]
On this [DATE] day of [MONTH], [YEAR], before me, a Notary Public in and for said County and State, personally appeared [YOUR NAME], known to me to be the person whose name is subscribed to the foregoing instrument, and acknowledged that he/she executed the same for the purposes therein contained.
Notary Public
My Commission Expires: [COMMISSION EXPIRY DATE]
[NOTARY SEAL]
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