Recording requested by (name):
____________________________________________
When recorded, mail to
and mail tax statements to:
____________________________________________
____________________________________________
____________________________________________
____________________________________________
Recorder’s Use Only
AFFIDAVIT – DEATH OF JOINT TENANT
Assessor’s Parcel No.: ________________________
__________________________________, of legal age, being first duly sworn, deposes and says:
__________________________________, the decedent mentioned in the attached certified copy of
Certificate of Death, is the same person as ______________________________, named as one of the parties
in that certain deed dated _______________, and executed by
____________________________________________________________________________________ to
______________________________________________________________________________________,
as Joint Tenants, recorded on _______________ as Instrument No _______________ in Book/Reel
_______________, Page/Image _______________, of the Official Records of _______________ County,
California, covering the following described property situated in _______________ County, California:
Dated ____________________
____________________________________________
(Signature of declarant)
____________________________________________
(Type or print name of declarant)
6/3/16