Affidavit of Domicile Form

Executor / Affiant Name*

Deceased Full Legal Name*

Domicile Address at Time of Death*

Date of Death*

County of Domicile*

Supporting Facts

Affiant Signature*

Signature field

Date Signed*

What is this form?

An affidavit of domicile form to establish the legal residence of a deceased person at the time of death. Required by brokerages, banks, and transfer agents to release assets from an estate.

Who is it for?

Estate executors, attorneys, and financial institutions processing asset transfers after death.