Missouri Beneficiary Deed
Missouri Beneficiary Deed

                     Affidavit Request

Affidavit as to Death of Owner Request Form
Affidavit as to Death of Owner Request F[...]
Adobe Acrobat document [148.3 KB]
Affidavit as to Death of Grantor Request Form
Affidavit as to Death of Grantor Request[...]
Adobe Acrobat document [147.2 KB]

Print, Complete and Mail in the appropriate Request Form

 

 

1. You may download the PDF version by clicking on the appropriate PDF

    form above

 

or

 

2.  You may print this page by using the printer icon button at the bottom of

     this page or by using the printer option on your computer.

 

 

 

_______________________________________________________________________

 

 

 

 

Affidavit as to Death of Owner

 

Request Form

 

Deceased Owner's Name as set forth in original

General Warranty Deed or Quit Claim Deed

(send copy of such deed)

 

________________________________________________________________________________

 

 

Date of Death of Owner (send copy of death certificate)

 

________________________________________________________________________________

 

 

Relationship of Deceased Owner to Surviving Owner

 

 

________________________________________________________________________________

 

 

Missouri County where the Real Property is located

 

 

_______________________________________________________________________________

 

 

Address of Real Property

 

______________________________________________________________________________

 

 

______________________________________________________________________________

 

 

Your Full Name

 

_____________________________________________________________________________

 

 

Your Relationship to Surviving Owner_____________________

 

 

Your Mailing Address

 

___________________________________________________________________________

 

 

___________________________________________________________________________

 

 

 

Your Telephone Number

 

___________________________________________________________________________

 

 

Your Signature*

 

___________________________________________________________________________

 

 

Surviving Owner's Mailing Address

 

___________________________________________________________________________

 

 

___________________________________________________________________________

 

 

Surviving Owner's Telephone Number

 

___________________________________________________________________________

 

 

Signature of Surviving Owner*

 

___________________________________________________________________________

 

(*Signatures Required - by signing this form you acknowledge and agree to the Important Notes below)

 

.

IMPORTANT NOTES*

 

1. By signing this form you agree this form will serve as the complete written agreement between yourself and Missouri Beneficiary Deed, LLC, to provide you with one (1) Affidavit as to Death of Owner (at the cost of $145) per your request and based upon the information you provide on this form.

 

2. The proper signing of your Affidavit in the presence of a notary public and the recording of your Affidavit and the fee charged by the your County Recorder of Deeds office to record such Affidavit will be and is your responsibility.

 

3. You understand and agree no legal advice has been provided to you and no legal services have been provided to you. Consult with an Attorney of your choice for legal advice and a review of your particular legal concerns and affairs.

 

4. In your behalf and on behalf of your estate you hereby release and hold harmless Missouri Beneficiary Deed, LLC, and Michael J. Denk, Attorney at Law, from any and all claims relating to your request, use and implementation of such Affidavit.

 

 

 

_______________________________________________________________________

 

 

 

 

Affidavit as to Death of Grantor

 

Request Form

 

 

Grantor's Name as set forth in Beneficary Deed

(send copy of such Beneficiary Deed)

 

__________________________________________________________________________________

 

 

Date of Death of Grantor (send copy of death certificate)

 

__________________________________________________________________________________

 

 

Name(s) of Grantee(s)/Beneficiay(ies) as set forth in Beneficiary Deed

 

_____________________________________________________________________________

 

 

_____________________________________________________________________________

 

 

_____________________________________________________________________________

 

 

_____________________________________________________________________________

 

 

Name and Mailing Address of one Grantee (no P.O. Box)

 

____________________________________________________________________________

 

 

____________________________________________________________________________

 

 

____________________________________________________________________________

 

 

Missouri County where Real Property is located

 

____________________________________________________________________________

 

 

 

Missouri City where Real Property is located

 

___________________________________________________________________________

 

 

 

Address of Real Property

 

__________________________________________________________________________

 

 

__________________________________________________________________________

 

 

Your Full Name

 

__________________________________________________________________________

 

 

Your Relationship to the Grantor___________________________

 

 

Your Mailing Address

 

___________________________________________________________________________

 

 

___________________________________________________________________________

 

 

 

Your Telephone Number

 

___________________________________________________________________________

 

 

 

Your Signature*

 

___________________________________________________________________________

 

(*Signature Required - by signing this form you acknowledge and agree to the Important Notes below)

 

IMPORTANT NOTES*

 

1. By signing this form you agree this form will serve as the complete written agreement between yourself and Missouri Beneficiary Deed, LLC, to provide you with one (1) Affidavit as to Death of Grantor (at the cost of $145) per your request and based upon the information you provide on this form.

 

2. The proper signing of your Affidavit in the presence of a notary public and the recording of your Affidavit and the fee charged by your local County Recorder of Deeds office to record such Affidavit will be and is your responsibility.

 

3. You understand and agree no legal advice has been provided to you and no legal services have been provided to you. Consult with an Attorney of your choice for legal advice and a review of your particular legal concerns and affairs.

 

4. In your behalf and on behalf of your estate you hereby release and hold harmless Missouri Beneficiary Deed, LLC, and Michael J. Denk, Attorney at Law, from any and all claims relating to your request, use and implementation of such Affidavit.

 

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