RECORDING REQUESTED BY AND WHEN RECORDED MAIL DOCUMENT AND TAX STATEMENT TO: NAME STREET ADDRESS CITY, STATE & ZIP CODE TITLE ORDER NO. ESCROW NO. SPACE ABOVE THIS LINE FOR RECORDER'S USE ONLY APN: AFFIDAVIT ­ DEATH OF JOINT TENANT STATE OF COUNTY OF , of legal age, being first duly sworn, deposes and says: That Certificate of Death, is the same person as parties in that certain dated , the decedent mentioned in the attached certified copy of named as one of the executed by to as joint tenants, recorded as Instrument No. of the County Recorder of the following described real property situated in the City of , State of : (Insert legal description) , on County, State of of the Official Records in the Office , concerning , County of That the value of all real and personal property owned by the decedent at the date of death, including the full value of the above described real property, did not then exceed the sum of $ Dated this day of , . (Signature of affiant) (Type or print full name of affiant) A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Subscribed and sworn to (or affirmed) before me on this by, person(s) who appeared before me. day of , , proved to me on the basis of satisfactory evidence to be the (Signature) (Seal) * There are various types of deed forms depending on each person's legal status. Before you use this form you may want to consult an attorney if you have questions concerning which document form is appropriate for your transaction. Rev. 1/01/16 American LegalNet, Inc. www.FormsWorkFlow.com