[{"id":"10d6707a-5392-4653-8b74-9a209ee29074","order":1,"text":"AFFIDAVIT FOR COLLECTION OF PERSONAL PROPERTY","fontSize":"20","textAlign":"center","bold":true,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"42f64e5e-ad10-4a71-a341-99bba9ae9d96","order":2,"text":"(Small Estate Affidavit)","fontSize":"16","textAlign":"center","bold":true,"underline":false,"marginBottom":"20","cflou":false,"active":true},{"id":"32fcab21-4478-471f-955e-5f60d9f48865","order":3,"text":"State of [State]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"4","cflou":false,"active":true},{"id":"61dee2f8-aef6-47ae-958b-a9ded2d88003","order":4,"text":"County of [County]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"20","cflou":false,"active":true},{"id":"937470b6-f047-41b2-8d7d-de477c1c284e","order":5,"text":"In re the Estate of [Full legal name of the decedent], Deceased.","fontSize":"14","textAlign":"left","bold":true,"underline":false,"marginBottom":"20","cflou":false,"active":true},{"id":"a8e04e7f-7d31-43f2-96c0-26972dc00c30","order":6,"text":"BEFORE ME, the undersigned authority, personally appeared [Full legal name of the affiant] (the “Affiant”), who, being first duly sworn upon oath, and under penalty of perjury under the laws of the State of [State], deposes and states as follows:","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"18","cflou":false,"active":true},{"id":"5ae1c524-1ace-4f7b-bcda-daf81787543d","order":7,"text":"1. THE DECEDENT","fontSize":"16","textAlign":"left","bold":true,"underline":true,"marginBottom":"8","cflou":false,"active":true,"marginTop":"6","sectionNum":"S01"},{"id":"87aaf7ef-cf28-4128-9e73-51b1774f5218","order":8,"text":"[Full legal name of the decedent] (the “Decedent”) died on [Date of death], in [City and State of death]. At the time of death the Decedent was domiciled at [Decedent's last legal residence], in the County of [County], State of [State].","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"8","cflou":false,"active":true},{"id":"4c754409-58a6-4af2-8b06-f18491c9c6d6","order":9,"text":"A certified copy of the Decedent’s death certificate is attached to and incorporated in this Affidavit as Exhibit A, and establishes the date of death recited above.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"18","cflou":false,"active":true},{"id":"c94c794e-73af-46aa-b8dd-d7462adfbe36","order":10,"text":"2. THE AFFIANT AND STANDING","fontSize":"16","textAlign":"left","bold":true,"underline":true,"marginBottom":"8","cflou":false,"active":true,"sectionNum":"S02"},{"id":"1d8dc039-2ec1-4ee6-8311-6b202e2961c0","order":11,"text":"The Affiant is [Full legal name of the affiant], residing at [Affiant's residential address], and is of the age of majority and under no legal disability.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"8","cflou":false,"active":true},{"id":"37a14cdc-82c6-4b92-ad02-418d78b9bd90","order":12,"text":"The Affiant is the successor of the Decedent (the “Successor”) with respect to the property described in this Affidavit and has legal standing to make and present this Affidavit, being the [Relationship of the successor to the decedent] of the Decedent.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"8","cflou":false,"active":true,"displayConditions":[{"field":"a63e95c6-2022-43ff-8c53-d61940eb712c","value":"rep","type":"remove","operator":"="}]},{"id":"009db007-7a36-495a-aa1b-ef1f3acfcb00","order":13,"text":"The Affiant makes and presents this Affidavit on behalf of [Full legal name of the successor], the successor of the Decedent with respect to the property described in this Affidavit, being the [Relationship of the successor to the decedent] of the Decedent (the “Successor”).","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"8","cflou":false,"active":true,"displayConditions":[{"field":"a63e95c6-2022-43ff-8c53-d61940eb712c","value":"rep","type":"add","operator":"="}]},{"id":"b2011bd7-a448-408a-940c-2e55e7b3906c","order":14,"text":"The Affiant makes this Affidavit in the Affiant’s own right as a successor of the Decedent.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"8","cflou":false,"active":true,"displayConditions":[{"field":"a63e95c6-2022-43ff-8c53-d61940eb712c","value":"self","type":"add","operator":"="}]},{"id":"7e2da507-3cfd-441d-81e8-ef5ffb4a08d8","order":15,"text":"The Affiant makes this Affidavit not individually but as the duly authorized representative of the Successor, acting in the capacity of [Representative capacity, e.g. attorney-in-fact, guardian, conservator], and is authorized under applicable law to act on behalf of the Successor with respect to the Decedent’s interest in the described property. Evidence of that authority is attached to this Affidavit.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"8","cflou":false,"active":true,"displayConditions":[{"field":"a63e95c6-2022-43ff-8c53-d61940eb712c","value":"rep","type":"add","operator":"="}]},{"id":"f5453252-7173-4008-b6b2-bd8e6a7e1bc3","order":16,"text":"The Successor is the sole person entitled to the described property of the Decedent, and no other person shares an equal or superior right to that property.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"18","cflou":false,"active":true,"displayConditions":[{"field":"e5950e8f-3038-4d9b-a4a9-57776883e0d0","value":"sole","type":"add","operator":"="}]},{"id":"7d7478d0-fd8a-40bc-b325-72b76c7041f5","order":17,"text":"The Successor is one of several persons entitled to succeed to the described property of the Decedent, and this Affidavit is made for the benefit of, and on behalf of, all such successors, as further set out in this Affidavit.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"18","cflou":false,"active":true,"displayConditions":[{"field":"e5950e8f-3038-4d9b-a4a9-57776883e0d0","value":"several","type":"add","operator":"="}]},{"id":"6e8311dd-31af-4764-a2af-ffa75da32df6","order":18,"text":"3. GOVERNING LAW AND ELIGIBILITY","fontSize":"16","textAlign":"left","bold":true,"underline":true,"marginBottom":"8","cflou":false,"active":true,"sectionNum":"S03"},{"id":"06280bea-7834-40e5-b148-6d07fac93708","order":19,"text":"This Affidavit is made pursuant to and in compliance with [Governing small-estate statute, e.g. Cal. Prob. Code §§ 13100–13116] of the State of [State] (the “Small Estate Statute”), which authorizes the collection of a decedent’s personal property by affidavit without the appointment of a personal representative or the commencement of formal probate administration.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"8","cflou":false,"active":true},{"id":"0ccb0612-dc48-4858-86a0-f579a3b4d617","order":20,"text":"At least [Statutory waiting period, e.g. 40] days have elapsed since the date of death of the Decedent, as required by the Small Estate Statute and as shown by the certified copy of the death certificate attached as Exhibit A.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"8","cflou":false,"active":true},{"id":"66c4f5f5-9113-47c5-8213-a15527845df3","order":21,"text":"The fair market value, as of the date of death, of the entire estate of the Decedent subject to administration, wherever located, less liens and encumbrances thereon, does not exceed [Applicable statutory dollar threshold], which is the maximum value permitted under the Small Estate Statute, and does not exceed the total sum of [Actual net value of the estate].","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"8","cflou":false,"active":true},{"id":"9e4bf478-dbad-43dd-aa28-f13bb5557b8a","order":22,"text":"No application or petition for the appointment of a personal representative, executor, administrator, or for summary or formal administration of the Decedent’s estate is pending or has been granted in any jurisdiction, and no such proceeding is contemplated by the Affiant.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"8","cflou":false,"active":true},{"id":"4425ca94-23c2-422f-9433-28beb7598d53","order":23,"text":"The described property is personal property only. This Affidavit is not used, and may not be used, to collect, transfer, or perfect title to any real property or interest in real property of the Decedent. There is no real property in the estate subject to this Affidavit.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"8","cflou":false,"active":true},{"id":"6004ba6c-beb1-4088-a1e0-163b380bf5e5","order":24,"text":"No other affidavit or similar instrument has been made or presented by the Affiant, or to the Affiant’s knowledge by any other person, to collect the same property described in this Affidavit.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"18","cflou":false,"active":true},{"id":"23e31d3a-377d-4ed4-96cc-5067caab2681","order":25,"text":"4. DEBTS, FUNERAL EXPENSES, AND TAXES","fontSize":"16","textAlign":"left","bold":true,"underline":true,"marginBottom":"8","cflou":false,"active":true,"sectionNum":"S04"},{"id":"f84c2a0f-d6de-4642-bb9e-5645209c5ee6","order":26,"text":"To the best of the Affiant’s knowledge, information, and belief, the debts and liabilities of the Decedent, including the expenses of last illness, the funeral and burial or cremation expenses, and the costs of administration, have been paid or provided for, or will be paid or provided for out of the property collected under this Affidavit before any distribution to the persons entitled to it.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"8","cflou":false,"active":true},{"id":"fc39fadf-5f75-4fe7-ad67-6b4cceb400f6","order":27,"text":"The Affiant further states that all federal and state taxes owed by the Decedent or the Decedent’s estate that are due and payable have been paid, or will be paid out of the property collected under this Affidavit, and that the Affiant will not distribute the property in a manner that defeats the lawful claim of any taxing authority.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"18","cflou":false,"active":true},{"id":"7ce99fc4-30e3-4a2c-81ff-9e4d869e4c3f","order":28,"text":"5. PUBLIC BENEFITS AND ESTATE RECOVERY","fontSize":"16","textAlign":"left","bold":true,"underline":true,"marginBottom":"8","cflou":false,"active":true,"displayConditions":[{"field":"3bd8eb20-bb96-4065-9f7a-8414381744f8","value":"Yes","type":"add","operator":"="}],"sectionNum":"S05"},{"id":"994d7674-993b-4811-a578-e524d9a0ea05","order":29,"text":"The Decedent received medical assistance or other public benefits that may be subject to estate recovery. The Affiant acknowledges that the applicable State agency may have a claim against the Decedent’s estate for reimbursement of such benefits, agrees to give any notice to that agency required by law, and agrees that any valid claim for reimbursement shall be satisfied out of the property collected under this Affidavit, to the extent of its value, before distribution to the persons entitled to it.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"18","cflou":false,"active":true,"displayConditions":[{"field":"3bd8eb20-bb96-4065-9f7a-8414381744f8","value":"Yes","type":"add","operator":"="}]},{"id":"9583b6f5-776c-42e0-a62d-e9f14711c8ee","order":30,"text":"6. BASIS OF ENTITLEMENT","fontSize":"16","textAlign":"left","bold":true,"underline":true,"marginBottom":"8","cflou":false,"active":true,"sectionNum":"S06"},{"id":"75fcdf97-3f98-462e-962a-fe157cbdda84","order":31,"text":"The Decedent died testate, leaving a valid Last Will and Testament dated [Date of the will], which remains unrevoked. Under the terms of that Will, the Successor is entitled to payment, delivery, or transfer of the described property. A true and correct copy of the Will, or of the relevant portion identifying the Successor’s entitlement, is attached to and incorporated in this Affidavit.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"8","cflou":false,"active":true,"displayConditions":[{"field":"5a8d2fe7-ae05-4799-b8a0-dc2aeda6f86f","value":"testate","type":"add","operator":"="}]},{"id":"79d3dbea-fd66-4160-a2ae-e7e85de7c124","order":32,"text":"The Decedent died intestate, without leaving a valid Last Will and Testament. The Successor is entitled to payment, delivery, or transfer of the described property as a successor of the Decedent under the laws of intestate succession of the State of [State].","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"8","cflou":false,"active":true,"displayConditions":[{"field":"5a8d2fe7-ae05-4799-b8a0-dc2aeda6f86f","value":"intestate","type":"add","operator":"="}]},{"id":"d05bcf4a-7235-4c6f-97ed-f02e1fd28c17","order":33,"text":"The Successor is entitled to payment, delivery, or transfer of the described property, and no other person has a right to the interest of the Decedent in that property that is superior to that of the Successor.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"18","cflou":false,"active":true,"displayConditions":[{"field":"e5950e8f-3038-4d9b-a4a9-57776883e0d0","value":"several","type":"remove","operator":"="}]},{"id":"6cc6fbf8-e1e0-4538-8cf2-bf938cd31927","order":34,"text":"The Successor, and the co-successors named in this Affidavit, are entitled to payment, delivery, or transfer of the described property, and no other person has a right to the interest of the Decedent in that property that is superior to theirs.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"18","cflou":false,"active":true,"displayConditions":[{"field":"e5950e8f-3038-4d9b-a4a9-57776883e0d0","value":"several","type":"add","operator":"="}]},{"id":"da23af07-4657-40b1-b63e-e7e12628c2b0","order":35,"text":"7. COMMUNITY AND MARITAL PROPERTY","fontSize":"16","textAlign":"left","bold":true,"underline":true,"marginBottom":"8","cflou":false,"active":true,"displayConditions":[{"field":"08992b1f-728f-4a3b-80d1-77d98915d4dc","value":"Yes","type":"add","operator":"="}],"sectionNum":"S07"},{"id":"15a2c534-8b15-4692-b1ad-ae5b78dac280","order":36,"text":"The Successor is the surviving spouse of the Decedent. The described property, or the Decedent’s interest in it, constitutes or includes community or marital property, and the Successor is entitled to have that property confirmed, delivered, or transferred to the Successor as surviving spouse in accordance with the community and marital property laws of the State of [State], without administration. This Affidavit is made in aid of, and consistently with, those laws.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"18","cflou":false,"active":true,"displayConditions":[{"field":"08992b1f-728f-4a3b-80d1-77d98915d4dc","value":"Yes","type":"add","operator":"="}]},{"id":"ac4f7129-9ad7-412e-895d-f9e7a3a37b89","order":37,"text":"8. PROPERTY TO BE COLLECTED","fontSize":"16","textAlign":"left","bold":true,"underline":true,"marginBottom":"8","cflou":false,"active":true,"sectionNum":"S08"},{"id":"19b8430b-5acf-4a1b-b60d-955f3ff1a1e3","order":38,"text":"The Affiant, for and on behalf of the Successor, is entitled to, and hereby claims, payment, delivery, or transfer of the following described personal property of the Decedent, now in the possession or control of, or owed by, the person or institution to whom this Affidavit is presented (the “Holder”):","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"8","cflou":false,"active":true},{"id":"9a617604-e0ba-469f-ba6f-e0eea346efbb","order":39,"text":"[Detailed description of the property to be collected]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"8","cflou":false,"active":true},{"id":"fbefaa42-bcad-45fb-a711-c838ae93ab54","order":40,"text":"The property described above is held by, or owed by, [Name of the person or institution holding the property], located at [Address of the holder] (the “Holder”).","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"18","cflou":false,"active":true},{"id":"b5fad807-5832-4672-95a3-8bc513406a54","order":41,"text":"9. MOTOR VEHICLE","fontSize":"16","textAlign":"left","bold":true,"underline":true,"marginBottom":"8","cflou":false,"active":true,"displayConditions":[{"field":"1bb387e8-ec5b-4314-a070-909553f88630","value":"Yes","type":"add","operator":"="}],"sectionNum":"S09"},{"id":"de316914-079b-4f40-9057-c43bfad1da2e","order":42,"text":"The described property includes one or more motor vehicles registered in the name of the Decedent, more particularly the vehicle bearing Year/Make/Model [Year, make, and model of the vehicle], Vehicle Identification Number [Vehicle Identification Number (VIN)]. The Affiant requests that the certificate of title and registration of such vehicle be transferred to the Successor, and consents to the transfer of ownership on the records of the applicable Department of Motor Vehicles or equivalent authority, in accordance with applicable law.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"18","cflou":false,"active":true,"displayConditions":[{"field":"1bb387e8-ec5b-4314-a070-909553f88630","value":"Yes","type":"add","operator":"="}]},{"id":"6a6a1833-2d8d-4ac2-93e9-3cbec38b0cba","order":43,"text":"10. NO DISPUTE AND DILIGENT INQUIRY","fontSize":"16","textAlign":"left","bold":true,"underline":true,"marginBottom":"8","cflou":false,"active":true,"sectionNum":"S10"},{"id":"c69dfe69-2004-4715-97a8-a1c51da3e64d","order":44,"text":"The Affiant has made diligent inquiry to determine whether the Decedent left a will and to identify all persons entitled to succeed to the Decedent’s property, and the statements in this Affidavit reflect the results of that inquiry.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"8","cflou":false,"active":true},{"id":"e62f5550-f0c9-4e8e-960b-5b5a92c36072","order":45,"text":"The Affiant is not aware of any dispute concerning the Decedent’s estate or the described property, of any pending action or proceeding contesting the Successor’s right to the property, or of any person, other than those disclosed in this Affidavit, claiming a right to the property superior or equal to that of the Successor.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"18","cflou":false,"active":true},{"id":"a887f67d-3196-47b7-b026-7f88057b9ad9","order":46,"text":"11. SUCCESSOR LIABILITY AND DISTRIBUTION","fontSize":"16","textAlign":"left","bold":true,"underline":true,"marginBottom":"8","cflou":false,"active":true,"sectionNum":"S11"},{"id":"5b5b3767-5efd-436d-a60b-b75b363b9872","order":47,"text":"The Successor acknowledges and agrees, and the Affiant acknowledges and agrees on the Successor’s behalf, that by receiving the described property under the Small Estate Statute the Successor is answerable and accountable for the property so received, and is personally liable, to the extent of the fair market value of the property received (valued as of the date of delivery, less any liens and encumbrances), to any personal representative later appointed for the Decedent’s estate, to the persons having a superior right to that property, and to the unsecured creditors of the Decedent.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"8","cflou":false,"active":true},{"id":"2a4df68a-3083-42d0-90c1-93a9724c599a","order":48,"text":"The Affiant agrees to apply and distribute the property collected under this Affidavit, or the proceeds thereof, first to any person or creditor having a superior claim as provided by law, and thereafter to the person or persons lawfully entitled to it, and to account for the property to any person entitled to an accounting.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"18","cflou":false,"active":true},{"id":"203af803-e9d5-4780-8d99-4f01b3dc457f","order":49,"text":"12. CO-SUCCESSORS","fontSize":"16","textAlign":"left","bold":true,"underline":true,"marginBottom":"8","cflou":false,"active":true,"displayConditions":[{"field":"e5950e8f-3038-4d9b-a4a9-57776883e0d0","value":"several","type":"add","operator":"="}],"sectionNum":"S12"},{"id":"23c3133f-8e8c-446f-b530-6355c881e149","order":50,"text":"The Affiant makes this Affidavit on behalf of all persons entitled to succeed to the described property. The names of the other persons so entitled, and their respective relationships to the Decedent, are as follows: [Names and relationships of the other successors]. The Affiant agrees to distribute to each such person that person’s lawful share of the property collected under this Affidavit.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"18","cflou":false,"active":true,"displayConditions":[{"field":"e5950e8f-3038-4d9b-a4a9-57776883e0d0","value":"several","type":"add","operator":"="}]},{"id":"130780a5-ad93-477e-9c75-a691570aa1f5","order":51,"text":"13. INDEMNIFICATION OF THE HOLDER","fontSize":"16","textAlign":"left","bold":true,"underline":true,"marginBottom":"8","cflou":false,"active":true,"sectionNum":"S13"},{"id":"76d79712-bb01-4fa0-ae98-f80cc3956e48","order":52,"text":"In consideration of the payment, delivery, or transfer of the described property, the Affiant agrees to indemnify, defend, and hold harmless the Holder, and its officers, agents, and employees, from and against any and all claims, demands, losses, liabilities, costs, and expenses (including reasonable attorneys’ fees) arising out of or relating to the payment, delivery, or transfer of the property to the Successor, or as the Affiant lawfully directs, in reliance upon this Affidavit. The Holder is released and discharged, to the fullest extent permitted by the Small Estate Statute and other applicable law, from all liability upon making such payment, delivery, or transfer, to the same extent as if the property had been delivered to a personal representative of the Decedent’s estate.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"18","cflou":false,"active":true},{"id":"453d5a02-1210-4d77-b5f2-d2b14ef33a65","order":53,"text":"14. REQUEST FOR TRANSFER AND ENFORCEMENT","fontSize":"16","textAlign":"left","bold":true,"underline":true,"marginBottom":"8","cflou":false,"active":true,"sectionNum":"S14"},{"id":"0281166c-196e-4d14-a889-3cfa5630beee","order":54,"text":"The Affiant requests and demands that the Holder pay, deliver, or transfer the described property to the Successor, or as the Affiant may lawfully direct, in accordance with the Small Estate Statute. The Holder is entitled to rely upon this Affidavit and is under a duty to pay, deliver, or transfer the property upon presentation of this Affidavit and a certified copy of the Decedent’s death certificate.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"8","cflou":false,"active":true},{"id":"b156d922-bb9f-4582-b9de-1e83822f2d76","order":55,"text":"If the Holder refuses without reasonable cause to pay, deliver, or transfer the described property upon presentation of this Affidavit, the Affiant may recover the property, or compel its payment, delivery, or transfer, in an action brought for that purpose, together with any costs and reasonable attorneys’ fees recoverable under the Small Estate Statute or other applicable law.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"18","cflou":false,"active":true},{"id":"feb26aff-6e9f-4a14-8dc9-b2e404da215b","order":56,"text":"15. GENERAL PROVISIONS","fontSize":"16","textAlign":"left","bold":true,"underline":true,"marginBottom":"8","cflou":false,"active":true,"sectionNum":"S15"},{"id":"c1a0d23f-94ee-412e-a857-23d993ebf422","order":57,"text":"This Affidavit shall be governed by and construed in accordance with the laws of the State of [State], including the Small Estate Statute. If any provision of this Affidavit is held to be invalid or unenforceable, the remaining provisions shall continue in full force and effect, and the invalid provision shall be reformed only to the extent necessary to make it enforceable. This Affidavit shall be binding upon the Affiant and the Affiant’s heirs, successors, and personal representatives, and shall inure to the benefit of the Holder and each person lawfully relying upon it.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"18","cflou":false,"active":true},{"id":"8b5afc74-d9b1-472a-a293-e76deaf67231","order":58,"text":"16. VERIFICATION AND EXECUTION","fontSize":"16","textAlign":"left","bold":true,"underline":true,"marginBottom":"8","cflou":false,"active":true,"sectionNum":"S16"},{"id":"595b4b45-8177-4e3e-9f29-a57a8d7c22fb","order":59,"text":"The Affiant declares under penalty of perjury under the laws of the State of [State] that the foregoing statements are true and correct, that the Affiant has read and understands this Affidavit, and that the Affiant makes this Affidavit for the purpose of inducing the Holder to pay, deliver, or transfer the described property.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"24","cflou":false,"active":true},{"id":"efee4ec9-da21-4273-b2a3-c7c982e4c87b","order":60,"text":"Executed at [City and State of signing], on [Date of signing].","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"30","cflou":false,"active":true},{"id":"16a34121-c888-41d6-8ae6-af2d596c1f2f","order":61,"text":" ","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"4","cflou":false,"active":true},{"id":"ddd154df-8ed0-400d-b3fc-e6d62c5b2b4f","order":62,"text":"_______________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"4","cflou":false,"active":true},{"id":"006dd787-ed04-4b7d-9b09-12656d03e6f0","order":63,"text":"[Full legal name of the affiant], Affiant","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"30","cflou":false,"active":true},{"id":"c3eba39e-36b9-403e-a826-156301808f12","order":64,"text":"ACKNOWLEDGMENT AND JURAT","fontSize":"16","textAlign":"center","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"427d943a-e5fe-4a47-a610-6e1435716c76","order":65,"text":"State of [State]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"4","cflou":false,"active":true},{"id":"4572a0d5-0091-4548-b423-5076f801f94c","order":66,"text":"County of [County]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"14","cflou":false,"active":true},{"id":"d9315c44-3cb1-41a0-89a5-7dc154770d09","order":67,"text":"Subscribed and sworn to (or affirmed) before me on this [Date] by [Full legal name of the affiant], proved to me on the basis of satisfactory evidence to be the person who appeared before me.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"30","cflou":false,"active":true},{"id":"0480b368-90c1-4664-996d-ff3ebd0c28ce","order":68,"text":"_______________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"4","cflou":false,"active":true},{"id":"cf7dc6a8-3983-47d9-abd3-e3966a3e271e","order":69,"text":"Notary Public","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"4","cflou":false,"active":true},{"id":"5fc9e155-68a4-4c90-aa19-e3cf2ee3b081","order":70,"text":"My commission expires: _______________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"30","cflou":false,"active":true},{"id":"6ec10b72-8b78-409d-95a1-5002aa348155","order":71,"text":"SCHEDULE OF EXHIBITS","fontSize":"16","textAlign":"left","bold":true,"underline":true,"marginBottom":"8","cflou":false,"active":true},{"id":"aad7775f-169e-455e-80f6-3f48e210cfd8","order":72,"text":"Exhibit A — Certified copy of the Decedent’s death certificate.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"4","cflou":false,"active":true},{"id":"11f86133-46b8-453b-9982-964c36174ab8","order":73,"text":"Exhibit B — Inventory and description of the property to be collected.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"4","cflou":false,"active":true},{"id":"802bafea-3d50-405c-9008-4166c90a5d41","order":74,"text":"The following additional documents are attached to and incorporated in this Affidavit:","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"4","cflou":false,"active":true,"marginTop":"6","displayConditions":[{"field":"5a8d2fe7-ae05-4799-b8a0-dc2aeda6f86f","value":"testate","type":"add","operator":"="},{"field":"a63e95c6-2022-43ff-8c53-d61940eb712c","value":"rep","type":"add","operator":"="}]},{"id":"25af96ab-f835-42eb-9822-1a7adf1eaba9","order":75,"text":"— A true and correct copy of the Decedent’s Last Will and Testament, or the relevant portion thereof.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"4","cflou":false,"active":true,"displayConditions":[{"field":"5a8d2fe7-ae05-4799-b8a0-dc2aeda6f86f","value":"testate","type":"add","operator":"="}]},{"id":"2e390c00-1423-42f9-8fdb-9f5a27420247","order":76,"text":"— Evidence of the Affiant’s authority to act as representative of the successor.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"4","cflou":false,"active":true,"displayConditions":[{"field":"a63e95c6-2022-43ff-8c53-d61940eb712c","value":"rep","type":"add","operator":"="}]}]