NYAffidavit of Heirship

AFFIDAVIT OF HEIRSHIP

TITLE CO.:       
TITLE NO.:      
DATE:       

STATE OF      
              )SS.:
COUNTY OF       )

     , being duly sworn, depose(s) and say(s):

That (s)he is the       of deceased, who acquired title to premises in follows:

described as      (the "Premises").

That said       died a resident of the County of       State of New York, on the       day of      , 20     , seized of said premises, (testate)

(intestate, and no proceedings were had in the estate) leaving him/her surviving as his/her only lawful distributees, the following named persons:

          That said decedent left him/her surviving no husband or wife, no child or children, (legitimate or illegitimate), no adopted child or children, no descendants of any deceased child or children, no descendants of any deceased adopted child or children, no father or mother, no brothers or sisters, no issue of any deceased brothers or sisters, no grandparents, no uncle, no aunt, and no issue of a deceased uncle or aunt other than those above named.

          That all of the persons above named are of full age, except:      

          That all of the persons above named are of sound mind, except:      

          That said deceased in his/her lifetime was a citizen of the United States or a subject of      

          This affidavit is made to induce       to issue its policy of title insurance covering the above premises knowing that it relies upon the truth hereof.

                                                                                                            ______________________________
                                                                                         

Sworn to before me on      ,      

                                                .

___________________________                                                     

Notary Public State of New York