Affidavit of Heirship Form

• Form Content

  STATE OF ILLINOIS )
    )    SS.
  COUNTY OF ___________________ )

  The undersigned, being duly sworn, affirms and states as follows:

  
  That the relationship of the undersigned to the decedent is as follows: 

  
  That the undersigned resides at 

  
  That the decedent’s name was 

  
  That the decedent died on (date of death) and was, at the time of the decedent’s death, years of age;

  That a certified copy of the medical certificate of death of the decedent is attached to this affidavit.

  That at the time of the decedent’s death, the decedent was an owner of the premises commonly known as   

  
  That the value of the decedent’s estate at the date of the decedent’s death was

  
  That the decedent died as follows: (Testate or intestate; choose one.  If testate, a copy of the decedent’s will and all codicils, if any, should be attached to this affidavit.  Regardless of the testacy, a copy of an obituary notice should be attached to this affidavit); 

  
  That the marital status at the time of the decedent’s death was as follows: (Indicate if the decedent was or was not married at the time of the decedent’s death.  Also, as appropriate, indicate the number of times the decedent was married, the name of each spouse, and how each marriage was terminated—for example, by death or by dissolution of marriage.  In the alternative, state that the decedent was never married); 

  
  That the number of children born of each marriage and the name, age, and marital status of each child is as follows:  If not applicable, state accordingly.

  
  
  
  That the number of children otherwise born to the decedent and the name, age, and marital status of each child is as follows: If not applicable, state accordingly.

  
  
  
  That the number of children adopted by the decedent and the name, age, and marital status of each child is as follows: If not applicable, state accordingly.

  
  That no other children were born to or adopted by the decedent other than those children named in the preceding three paragraphs.

  
  That the undersigned acknowledges that if the decedent left no children or surviving spouse, the undersigned must affirmatively state as such before listing any collateral heirs or other ancestors, such as parents, brothers, sisters, or grandparents. 

  
  That the undersigned is at least eighteen years of age.

  
  Further Affiant sayeth not.

  
  _______________________________________________(Signature of Affiant)

  
  STATE OF ILLINOIS, COUNTY OF ________________________ ss.

  
  I, the undersigned, a notary public in and for said county, in the state aforesaid, certify that

  __________________________________________________________,

  personally known to me to be the person whose name is subscribed to the foregoing instrument, appeared before me this day in person and acknowledged that he or she signed, sealed, and delivered the said instrument as his or her free and voluntary act, for the uses and purposes therein set forth, including the release and waiver of the right of homestead.

  Given under my hand and official seal this date: _______________________.

  
  ________________________________________(Notary Public)

  
  Seal:

  
  Additional Information to the party executing this affidavit of heirship:

  • Note:  If a spouse, child, or other heir died prior to the decedent’s death, the date of said heir’s death and information necessary to determine the identify of the person or persons in whom the deceased descendant’s share is now vested must be provided.  (See 755 ILCS 5/4-11.)

  • Note:  If a spouse, child, or other heir died after the decedent’s death, that heir’s share of the decedent’s estate will pass through said heir’s estate.  In that event, Prairie Land Title Company may need to examine said heir’s estate.

  • Note:  If the affiant indicates that he or she is the sole heir of the decedent, Prairie Land Title Company must be furnished a corroborative affidavit that is executed by a disinterested party.