State of Louisiana s6

STATE OF LOUISIANA PARISH OF ______

SMALL SUCCESSION AFFIDAVIT OF DEATH AND HEIRSHIP PURSUANT TO CODE OF CIVIL PROCEDURE ARTICLE 3432

BEFORE ME, the undersigned authority, personally came and appeared:

______, a major resident of and domiciled in Union Parish, Louisiana address ______

______a major resident of and domiciled in Union Parish, Louisiana address ______. who after being by me first sworn on their oath, did depose and say: That they were well and personally acquainted with ______, who departed this life intestate on ______. That at the time of his death, ______was domiciled in Union Parish, Louisiana on which date he had maintained his permanent place of residence and domicile in Union Parish, Louisiana at ______That they know of their own personal knowledge that he was married but once, and then to ______, who predeceased him. Of that marriage, ______children were born, namely, ______The above surviving children of ______are above the age of twenty-four and one are incapable of taking care of their person or administering their estates because of mental incapacity or physical infirmity. ______was not a father to any other children and he never adopted any other person. That the only heirs of the decedent are listed above. Affiants further declare that the following is a brief description of the movable property left by the deceased, at the time of his death and the value thereof: MOVABLE PROPERTY DEBTS AND OBLIGATIONS

Affiants further declares ______be recognized and decreed to be the sole and only heirs of the Decedent and as such, entitled to the ownership and to be placed in possession of all Decedent's property of which he was possessed at the time of his death. By signing below, Affiants, ______and ______have accepted the succession of the deceased. Affiants further declares that under penalty of perjury that the information contained in the Affidavit is true, correct and complete to the best of their knowledge, information and belief.

WITNESSES:

______

SWORN TO AND SUBSCRIBED BEFORE ME, Notary Public for the Parish of ______, State of Louisiana on this the ______day of ______, 20____.

______NOTARY PUBLIC ID#______