Affidavit Request

Affidavit as to Death of Owner Request Form
Affidavit as to Death of Owner Request F[...]
Adobe Acrobat document [148.1 KB]

Affidavit as to Death of Grantor Request Form
Affidavit as to Death of Grantor Request[...]
Adobe Acrobat document [147.0 KB]

Please Print, Complete and Mail in the appropriate Request Form

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_______________________________________________________________________

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 draft and 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. You understand and agree no other drafting services are being provided to you and no legal advice has been offered or given to you.

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 is being provided to you and you should consult with an Attorney of your choice for any desired legal advice.

4. In your behalf and on behalf of your estate you hereby release and hold harmless Michael J. Denk, Attorney at Law and Missouri Beneficiary Deed, LLC, 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 draft and 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. You understand and agree no other drafting services are being provided to you and no legal advice has been offered or given to you.

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 is being provided to you and you should consult with an Attorney of your choice for any desired legal advice.

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