<p>Recorded at the Request of:</p><p>When Recorded, mail to:</p><p>Order No: Affidavit Terminating Joint Tenancy</p><p>I, , residing at ,being duly sworn on oath do depose and say:</p><p>That affiant is the surviving joint tenant of who died on or about , at and who was a resident of the state of</p><p>That at the time of death, said decendent was the owner in joint tenancy with this affiant of the following described property:</p><p>The deed vesting title was recorded in Docket at page ;</p><p>That the deceased was one and the same person named in that certain Death Certificate, a certified copy of which is attached hereto and made a part hereof;</p><p>That all property and estate of decedent, wheresoever located, at the time of death, did not exceed the value of $______and</p><p>Further, that there is no Estate Tax due, either Federal or State, on the estate of said deceased.</p><p>Dated:______</p><p>State of County of }ss.</p><p>Subscribed, sworn to and acknowledged before me this _____ day of ______, 19_____, by</p><p>Notary Public My Commission Expires:</p>