Affidavit of Heirship Questionnaire Details of the person filling this formYour Name(Required)Your Email(Required) Your Phone Number(Required)Your Address(Required)Relationship to the deceased(Required)Relationship with deceased began in what year?(Required)Information about the DeceasedFull name of the Deceased(Required)Deceased date of birth(Required) MM slash DD slash YYYY Deceased place of birth(Required)Deceased date of death(Required) MM slash DD slash YYYY Deceased place of death (city & state)(Required)Deceased age at time of death(Required)Deceased address at time of death(Required)At date of death, deceased was(Required) Married Widowed Divorced Never Married Did deceased leave a Will?(Required) Yes No Please upload a copy of the WillMax. file size: 32 MB. Date the Will was signed MM slash DD slash YYYY Was administration taken out on estate of deceased?(Required) Yes No Deceased’s marriages InformationWas deceased married?(Required) Yes No Number of times deceased was married(Required) 1 2 Deceased’s First marriage InformationName of First spouseDate of deceased first marriage MM slash DD slash YYYY Place of deceased first marriageFirst Marriage terminated by Death Divorce Date of Termination of deceased first marriage(Required) MM slash DD slash YYYY Place of Termination of deceased first marriage(Required)Number of children born to first marriage(Required)Living Children From First MarriageDid the deceased have living children from their first marriage?(Required)Living children born to or adopted by deceased during first marriage Yes No Number of living children form their first marriage(Required) 1 2 3 Name of living child 1 from first marriageDate of Birth of living child 1 from first marriage MM slash DD slash YYYY Birthplace of living child 1 from first marriageCurrent spouse of living child 1 from first marriageCurrent address of living child 1 from first marriageName of living child 2 from first marriageDate of Birth of living child 2 from first marriage MM slash DD slash YYYY Birthplace of living child 2 from first marriageCurrent spouse of living child 2 from first marriageCurrent address of living child 2 from first marriageName of living child 3 from first marriageDate of Birth of living child 3 from first marriage MM slash DD slash YYYY Birthplace of living child 3 from first marriageCurrent spouse of living child 3 from first marriageCurrent address of living child 3 from first marriageDeceased Children From First MarriageDid the deceased have any deceased children from their first marriage?(Required) Yes No Number of deceased children form their first marriage(Required) 1 2 Name of deceased child 1 from first marriageDate of Birth of deceased child 1 from first marriage MM slash DD slash YYYY Birthplace of deceased child 1 from first marriageDate of Death of deceased child 1 from first marriage MM slash DD slash YYYY Place of Death of deceased child 1 from first marriageAddress at time of Death of deceased child 1 from first marriageDid deceased child 1 have any children, either born to them or adopted? - First Marriage Yes No Number of children, either born or adopted by deceased child 1 form first marriage 1 2 3 Name of child 1 either born or adopted by deceased child 1 form first marriageDate of Birth of child 1 either born or adopted by deceased child 1 form first marriage MM slash DD slash YYYY Address of child 1 either born or adopted by deceased child 1 form first marriageName of child 2 either born or adopted by deceased child 1 form first marriageDate of Birth of child 2 either born or adopted by deceased child 1 form first marriage MM slash DD slash YYYY Address of child 2 either born or adopted by deceased child 1 form first marriageName of child 3 either born or adopted by deceased child 1 form first marriageDate of Birth of child 3 either born or adopted by deceased child 1 form first marriage MM slash DD slash YYYY Address of child 3 either born or adopted by deceased child 1 form first marriageName of deceased child 2 from first marriageDate of Birth of deceased child 2 from first marriage MM slash DD slash YYYY Birthplace of deceased child 2 from first marriageDate of Death of deceased child 2 from first marriage MM slash DD slash YYYY Place of Death of deceased child 2 from first marriageAddress of deceased child 2 from first marriageDid deceased child 2 have any children, either born to them or adopted? - First Marriage Yes No Number of children, either born or adopted by deceased child 2 form first marriage 1 2 3 Name of child 1 either born or adopted by deceased child 2 form first marriageDate of Birth of child 1 either born or adopted by deceased child 2 form first marriage MM slash DD slash YYYY Address of child 1 either born or adopted by deceased child 2 form first marriageName of child 2 either born or adopted by deceased child 2 form first marriageDate of Birth of child 2 either born or adopted by deceased child 2 form first marriage MM slash DD slash YYYY Address of child 2 either born or adopted by deceased child 2 form first marriageName of child 3 either born or adopted by deceased child 2 form first marriageDate of Birth of child 3 either born or adopted by deceased child 2 form first marriage MM slash DD slash YYYY Address of child 3 either born or adopted by deceased child 2 form first marriageDeceased’s Second marriage InformationName of Second spouseDate of deceased second marriage MM slash DD slash YYYY Place of deceased second marriageSecond Marriage terminated by Death Divorce Date of Termination of deceased second marriage MM slash DD slash YYYY Place of Termination of deceased second marriageNumber of children born to second marriageLiving Children From Second MarriageDid the deceased have living children from their Second MarriageLiving children born to or adopted by deceased during second marriage Yes No Number of living children form their second marriage 1 2 3 Name of living child 1 from second marriageDate of Birth of living child 1 from second marriage MM slash DD slash YYYY Birthplace of living child 1 from second marriageCurrent spouse of living child 1 from second marriageCurrent address of living child 1 from second marriageName of living child 2 from second marriageDate of Birth of living child 2 from second marriage MM slash DD slash YYYY Birthplace of living child 2 from second marriageCurrent spouse of living child 2 from second marriageCurrent address of living child 2 from second marriageName of living child 3 from second marriageDate of Birth of living child 3 from second marriage MM slash DD slash YYYY Birthplace of living child 3 from second marriageCurrent spouse of living child 3 from second marriageCurrent address of living child 3 from second marriageDeceased Children From Second MarriageDid the deceased have any deceased children from their second marriage? Yes No Number of deceased children form their second marriage 1 2 Name of deceased child 1 from second marriageDate of Birth of deceased child 1 from second marriage MM slash DD slash YYYY Birthplace of deceased child 1 from second marriageDate of Death of deceased child 1 from second marriage MM slash DD slash YYYY Place of Death of deceased child 1 from second marriageAddress at time of Death of deceased child 1 from second marriageDid deceased child 1 have any children, either born to them or adopted? - Second Marriage Yes No Number of children, either born or adopted by deceased child 1 form second marriage 1 2 3 Name of child 1 either born or adopted by deceased child 1 form second marriageDate of Birth of child 1 either born or adopted by deceased child 1 form second marriage MM slash DD slash YYYY Address of child 1 either born or adopted by deceased child 1 form second marriageName of child 2 either born or adopted by deceased child 1 form second marriageDate of Birth of child 2 either born or adopted by deceased child 1 form second marriage MM slash DD slash YYYY Address of child 2 either born or adopted by deceased child 1 form second marriageName of child 3 either born or adopted by deceased child 1 form second marriageDate of Birth of child 3 either born or adopted by deceased child 1 form second marriage MM slash DD slash YYYY Address of child 3 either born or adopted by deceased child 1 form second marriageName of deceased child 2 from second marriageDate of Birth of deceased child 2 from second marriage MM slash DD slash YYYY Birthplace of deceased child 2 from second marriageDate of Death of deceased child 2 from second marriage MM slash DD slash YYYY Place of Death of deceased child 2 from second marriageAddress of deceased child 2 from second marriageDid deceased child 2 have any children, either born to them or adopted? - Second Marriage Yes No Number of children, either born or adopted by deceased child 2 form second marriage 1 2 3 Name of child 1 either born or adopted by deceased child 2 form second marriageDate of Birth of child 1 either born or adopted by deceased child 2 form second marriage MM slash DD slash YYYY Address of child 1 either born or adopted by deceased child 2 form second marriageName of child 2 either born or adopted by deceased child 2 form second marriageDate of Birth of child 2 either born or adopted by deceased child 2 form second marriage MM slash DD slash YYYY Address of child 2 either born or adopted by deceased child 2 form second marriageName of child 3 either born or adopted by deceased child 2 form second marriageDate of Birth of child 3 either born or adopted by deceased child 2 form second marriage MM slash DD slash YYYY Address of child 3 either born or adopted by deceased child 2 form second marriageAdditional Living Children (Not from marriage(s) listed above)Did the deceased have any other living children besides those from the marriage(s) listed above?(Required) Yes No Number of living children the deceased have besides those from the marriage(s) listed above? 1 2 3 Name of living Child 1 of the deceased besides those from the marriage(s) listed aboveDate of Birth of living Child 1 of the deceased besides those from the marriage(s) listed above MM slash DD slash YYYY Birthplace of living Child 1 of the deceased besides those from the marriage(s) listed aboveName of Other Parent of living Child 1 of the deceased besides those from the marriage(s) listed aboveCurrent spouse of living Child 1 of the deceased besides those from the marriage(s) listed aboveCurrent address of living Child 1 of the deceased besides those from the marriage(s) listed aboveName of living Child 2 of the deceased besides those from the marriage(s) listed aboveDate of Birth of living Child 2 of the deceased besides those from the marriage(s) listed above MM slash DD slash YYYY Birthplace of living Child 2 of the deceased besides those from the marriage(s) listed aboveName of Other Parent of living Child 2 of the deceased besides those from the marriage(s) listed aboveCurrent spouse of living Child 2 of the deceased besides those from the marriage(s) listed aboveCurrent address of living Child 2 of the deceased besides those from the marriage(s) listed aboveName of living Child 3 of the deceased besides those from the marriage(s) listed aboveDate of Birth of living Child 3 of the deceased besides those from the marriage(s) listed above MM slash DD slash YYYY Birthplace of living Child 3 of the deceased besides those from the marriage(s) listed aboveName of Other Parent of living Child 3 of the deceased besides those from the marriage(s) listed aboveCurrent spouse of living Child 3 of the deceased besides those from the marriage(s) listed aboveCurrent address of living Child 3 of the deceased besides those from the marriage(s) listed aboveAdditional Deceased Children (Not from marriage(s) listed above)Did the deceased have any other deceased children besides those from the marriage(s) listed above?(Required) Yes No Number of deceased children the deceased have besides those from the marriage(s) listed above? 1 2 Name of Child 1 of the deceased besides those from the marriage(s) listed aboveDate of Birth of Child 1 of the deceased besides those from the marriage(s) listed above MM slash DD slash YYYY Birthplace of Child 1 of the deceased besides those from the marriage(s) listed aboveDate of Death of Child 1 of the deceased besides those from the marriage(s) listed above MM slash DD slash YYYY Place of Death of Child 1 of the deceased besides those from the marriage(s) listed aboveAddress at time of Death of Child 1 of the deceased besides those from the marriage(s) listed aboveName of other parent of Child 1 of the deceased besides those from the marriage(s) listed aboveDid Child 1 of the deceased have any children, either born to or adopted? Yes No Number of children of Child 1 of the deceased, either born to or adopted? 1 2 3 Name of first child of Child 1 of the deceased, either born to or adopted?Date of Birth of first child of Child 1 of the deceased, either born to or adopted? MM slash DD slash YYYY Address of first child of Child 1 of the deceased, either born to or adopted?Name of second child of Child 1 of the deceased, either born to or adopted?Date of Birth of second child of Child 1 of the deceased, either born to or adopted? MM slash DD slash YYYY Address of second child of Child 1 of the deceased, either born to or adopted?Name of third child of Child 1 of the deceased, either born to or adopted?Date of Birth of third child of Child 1 of the deceased, either born to or adopted? MM slash DD slash YYYY Address of third child of Child 1 of the deceased, either born to or adopted?Name of Child 2 of the deceased besides those from the marriage(s) listed aboveDate of Birth of Child 2 of the deceased besides those from the marriage(s) listed above MM slash DD slash YYYY Birthplace of Child 2 of the deceased besides those from the marriage(s) listed aboveDate of Death of Child 2 of the deceased besides those from the marriage(s) listed above MM slash DD slash YYYY Place of Death of Child 2 of the deceased besides those from the marriage(s) listed aboveAddress at time of Death of Child 2 of the deceased besides those from the marriage(s) listed aboveName of other parent of Child 2 of the deceased besides those from the marriage(s) listed aboveDid Child 2 of the deceased have any children, either born to or adopted? Yes No Number of children of Child 2 of the deceased, either born to or adopted? 1 2 3 Name of first child of Child 2 of the deceased, either born to or adopted?Date of Birth of first child of Child 2 of the deceased, either born to or adopted? MM slash DD slash YYYY Address of first child of Child 2 of the deceased, either born to or adopted?Name of second child of Child 2 of the deceased, either born to or adopted?Date of Birth of second child of Child 2 of the deceased, either born to or adopted? MM slash DD slash YYYY Address of second child of Child 2 of the deceased, either born to or adopted?Name of third child of Child 2 of the deceased, either born to or adopted?Date of Birth of third child of Child 2 of the deceased, either born to or adopted? MM slash DD slash YYYY Address of third child of Child 2 of the deceased, either born to or adopted?Deceased Parent's InformationDeceased Mother Full nameDate of Birth of Deceased Mother MM slash DD slash YYYY Is deceased mother alive? Yes No Date of Death of Deceased Mother MM slash DD slash YYYY Place of Death of Deceased MotherCurrent address of Deceased MotherDeceased Father Full nameDate of Birth of Deceased Father MM slash DD slash YYYY Is deceased father alive? Yes No Date of Death of Deceased Father MM slash DD slash YYYY Place of Death of Deceased FatherCurrent address of Deceased FatherDeceased Living Sibling InformationDid the deceased have any living siblings(Required) Yes No Number of living siblings the deceased had(Required) 1 2 3 Living Sibling InformationName of living sibling 1Date of Birth of living sibling 1 MM slash DD slash YYYY Birthplace of living sibling 1Mother Name of living sibling 1Father Name of living sibling 1Current address of living sibling 1Current spouse of living sibling 1Name of living sibling 2Date of Birth of living sibling 2 MM slash DD slash YYYY Birthplace of living sibling 2Mother Name of living sibling 2Father Name of living sibling 2Current address of living sibling 2Current spouse of living sibling 2Name of living sibling 3Date of Birth of living sibling 3 MM slash DD slash YYYY Birthplace of living sibling 3Mother Name of living sibling 3Father Name of living sibling 3Current address of living sibling 3Current spouse of living sibling 3Deceased Passed Away Sibling InformationDid the deceased have any siblings who have passed away?(Required) Yes No Number of siblings of the deceased who have passed away(Required) 1 2 3 Name of deceased sibling 1Date of Birth of deceased sibling 1 MM slash DD slash YYYY Birthplace of deceased sibling 1Mother Name of deceased sibling 1Father Name of deceased sibling 1Date of Death of deceased sibling 1 MM slash DD slash YYYY Place of Death of deceased sibling 1Address at time of Death of deceased sibling 1Did sibling 1 of the deceased have any children either born or adopted? Yes No Number of children either born or adopted by sibling 1 of the deceased 1 2 3 Name of Child 1 of sibling 1Date of Birth of Child 1 of sibling 1 MM slash DD slash YYYY Name of Child 2 of sibling 1Date of Birth of Child 2 of sibling 1 MM slash DD slash YYYY Name of Child 3 of sibling 1Date of Birth of Child 3 of sibling 1 MM slash DD slash YYYY Name of deceased sibling 2Date of Birth of deceased sibling 2 MM slash DD slash YYYY Birthplace of deceased sibling 2Mother Name of deceased sibling 2Father Name of deceased sibling 2Date of Death of deceased sibling 2 MM slash DD slash YYYY Place of Death of deceased sibling 2Address at time of Death of deceased sibling 2Did sibling 2 of the deceased have any children either born or adopted? Yes No Number of children either born or adopted by sibling 2 of the deceased 1 2 3 Name of Child 1 of sibling 2Date of Birth of Child 1 of sibling 2 MM slash DD slash YYYY Name of Child 2 of sibling 2Date of Birth of Child 2 of sibling 2 MM slash DD slash YYYY Name of Child 3 of sibling 2Date of Birth of Child 3 of sibling 2 MM slash DD slash YYYY Name of deceased sibling 3Date of Birth of deceased sibling 3 MM slash DD slash YYYY Birthplace of deceased sibling 3Mother Name of deceased sibling 3Father Name of deceased sibling 3Date of Death of deceased sibling 3 MM slash DD slash YYYY Place of Death of deceased sibling 3Address at time of Death of deceased sibling 3Did sibling 3 of the deceased have any children either born or adopted? Yes No Number of children either born or adopted by sibling 3 of the deceased 1 2 3 Name of Child 1 of sibling 3Date of Birth of Child 1 of sibling 3 MM slash DD slash YYYY Name of Child 2 of sibling 3Date of Birth of Child 2 of sibling 3 MM slash DD slash YYYY Name of Child 3 of sibling 3Date of Birth of Child 3 of sibling 3 MM slash DD slash YYYY Estate InformationAre or were there any debts to be paid?(Required)This includes any real property. Yes No At the time of death, estimate the value of the deceased’s estate(Required)At the time of death, was the property the homestead of the deceased?(Required) Yes No Please provide the Legal Description of deceased property Do you have a copy of the deed?(Required) Yes No Please upload a copy of the deedMax. file size: 32 MB. Witness InformationQualification for a WitnessDo you have any interest in the estate? Yes No Do you know the deceased long enough to be able to verify the facts stated in the Affidavit of Heirship as true and correct? Yes No Did you know the deceased during their childbearing years? Yes No Are you willing to read the Affidavit and swear to its correctness before a Notary Public? Yes No Witness 1 InformationWitness 1 NameAddress of Witness 1What year did the relationship with deceased begin? - Witness 1Relationship to the deceased with Witness 1Witness 2 InformationWitness 2 NameAddress of Witness 2What year did the relationship with deceased begin? - Witness 2Relationship to the deceased with Witness 2 I hereby represent to Carr & Cole, PLLC, that the information contained in this intake form is accurate and complete, and I understand the law firm will rely on this information. I understand if the information contained herein is inaccurate or incomplete, the recommendations made by the law firm may not be appropriate.
