Affidavit for Transfer & Record of Real Estate Inherited I, _____________________________________________________ being duly sworn say that: ______________________________________________ died intestate on the ______ day of _________________, ______, and a copy of their death certificate is attached hereto. That at the time of h___ death, h___ place of residence was at __________________________________________________________________ That the following are the names, ages and addresses, so far as the ages and addresses are known and can be ascertained of each of such decedent's heirs at law and next of kin, who by h___ death inherited h___ real estate and the relation of each to such ancestor. Names Ages Address Relationship ____________________________________________________ ____________________________________________________ ____________________________________________________ The part or portion of such real estate inherited by each of such heirs at law and next of kin is as follows: Names Part or Portion Inherited ____________________________________________________ ____________________________________________________ ____________________________________________________ That at the time of death of said ____________________________, __he was the owner of and seized of the following described real estate: Attach Legal Description Permanent Parcel No. ___________________________ State of Ohio County of Cuyahoga _________________________________________ Affiant SWORN TO BEFORE ME and subscribed in my presence this _____ day of ______________________________, 20_____. Prepared By: ______________________________________ Notary Public American LegalNet, Inc. www.FormsWorkFlow.com