Louisiana Affidavit of Death
This Louisiana Affidavit of Death is executed in accordance with the relevant provisions of Louisiana law. It serves as an official statement to certify the death of an individual. This document is often required to complete transactions or to settle matters related to the estate of the deceased person.
STATE OF LOUISIANA
PARISH OF ____________
BEFORE ME, the undersigned authority, personally appeared ______________________ (Affiant), who, after being duly sworn, deposes and states:
- My full legal name is ________________________________.
- I am of sound mind, over the age of eighteen (18) years, and have personal knowledge of the facts stated herein.
- The Deceased, known to me as __________________________, passed away on ________, as evidenced by the attached certified copy of the death certificate.
- The Deceased's date of birth was ________.
- At the time of death, the Deceased was a resident of ___________________________________, Louisiana.
- The Deceased died intestate (without a will) / testate (with a will), with the will dated ________.
The Affiant further states that this Affidavit is made for the purpose of requesting the transfer or delivery of property or the making of a payment or the granting of any benefit belonging to, payable to, or in the possession of the Deceased, to which the Affiant is entitled under the provisions of Louisiana law.
FURTHER AFFIANT SAYETH NAUGHT.
SUBSCRIBED AND SWORN TO before me, this __ day of ___________, 20__.
Affiant Signature: ___________________________
Printed Name: _______________________________
Title: _____________________________________
Notary Public Signature: _____________________
My Commission Expires: ______________________