IN THE CIRCUIT COURT OF THE SIXTH JUDICIAL CIRCUIT, IN AND FOR PINELLAS COUNTY, FLORIDA; PROBATE DIVISION IN RE: ESTATE OF Deceased. (The clerk will provide these numbers) File No. Division AFFIDAVIT OF HEIRS For purposes of this document, you must list ALL RELATIVES of the decedent. If the relative was deceased at the time of the decedent222s death, please provide the deceased relative222s name, indicate deceased, and date of death. Answering with an N/A, not applicable, or any other such designation is inappropriate for this document. If there are no other relatives for a particular category, write 223None.224 When appropriate you must indicate if the relationship is that of a half-relative (i.e. half-brother or half-sister). Spouse of Decedent. (Provide name, age, and address; or if deceased, provide name, indicate deceased, and date of death). Children of the Decedent, or descendants of deceased children. (Provide name, age, and address; or if deceased, provide name, indicate deceased, and date of death). If any of the children are not biologically related to both the decedent and the spouse at the time of death, provide the name of that particular child222s biological parent. AFHS Affidavit of Heirs Pg. 1 of 4 American LegalNet, Inc. www.FormsWorkFlow.com Parents of the Decedent. (Provide name, age, and address; or if deceased, provide name, indicate deceased, and date of death). Siblings, and descendants of the deceased siblings. You must indicate whether the relationship is that of a half-relative (i.e. half-brother or half-sister). (Provide name, age, and address; or if deceased, provide name, indicate deceased, and date of death). Grandparents. (Provide name, age, and address; or if deceased, provide name, indicate deceased, and date of death). AFHS Affidavit of Heirs Pg. 2 of 4 American LegalNet, Inc. www.FormsWorkFlow.com Aunts and Uncles of the Decedent. (Provide name, age, and address; or if deceased, provide name, indicate deceased, and date of death). Kindred of last deceased spouse (ONLY IF filing intestate and is not previously listed above). (Provide name, age, and address; or if deceased, provide name, indicate deceased, and date of death). I, the affiant, am am not related to the decedent as follows . I have known the decedent for years. Decedent died on . AFHS Affidavit of Heirs Pg. 3 of 4 American LegalNet, Inc. www.FormsWorkFlow.com Under penalties of perjury, I declare that I have read the foregoing Affidavit of Heirs and the facts stated therein are true. (DO NOT sign until you are in front of a clerk or notary.) (Signature of Affiant) (Address of Affiant) (City, State, Zip) (Telephone) (Date Signed) Subscribed and sworn to (or affirmed) before me on by . He/she is personally known to me or has presented as identification. By Notary: -- OR -- Ken Burke, Signature of Notary Clerk of Circuit Court & Comptroller Pinellas County, Florida Name of Notary typed, printed or stamped By: Deputy Clerk (seal) Commission Number & Expiration Date AFHS Affidavit of Heirship Pg. 4 of 4 American LegalNet, Inc. www.FormsWorkFlow.com