RECORDING REQUESTED BY AND WHEN RECORDED MAIL TO: NAME S R U PAGE SIZE DA MISC LONG RFD COPY M A L 465 426 PCOR NCOR SMF NCHG EXAM CTY UNI STREET ADDRESS CITY, STATE & ZIP CODE T: SPACE ABOVE THIS LINE FOR RECORDER’S USE AFFIDAVIT – DEATH OF JOINT TENANT STATE OF ___________________________________ COUNTY OF _________________________________ _______________________________________________________, of legal age, being first duly sworn, deposes and says: That ________________________________________________________, 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 ____________________________________ dated _________________, _____________, executed by _________________________________________________________________________________________________ to _________________________________________________________________________________________________________ as joint tenants, recorded as Instrument No. _________________, on ________________, ________, ________________________, of the Official Records in the Office of the County Recorder of ___________________________________________________County, State of ________________________________, concerning the following described real property situated in the City of _______________________________________________, County of _____________________, State of _____________________: (Insert Legal Description) 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 _____________, _______. _______________________________________________ _____________________________________________ Signature of Joint Tenant Signature of Joint Tenant _______________________________________________ ______________________________________________ (Type or print full name of Joint Tenant) (Type or print full name of Joint Tenant) State of California } County of } SUBSCRIBED AND SWORN TO (OR AFFIRMED) BEFORE ME ON this __________ day of ____________, 20____ by ____________________________, personally known to me or proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me. (seal) SIGNATURE MAIL TAX STATEMENT TO: ______________________________________________________________________________________________________ Before you use this form, fill in all blanks, and make whatever changes are appropriate and necessary to your particular transaction. Consult a lawyer if you doubt the form’s fitness for your purpose and use. American LegalNet, Inc. www.FormsWorkflow.com