IF ANY MEMBER OF A FAMILY EXPIRES, TO GET DEATH BENEFITS OR TO GET THE PROPERTIES IN THE NAME OF DECEASED, FAMILY MEMBER CERTIFICATE IS NECESSARY. IN THE PROCESS OF GETTING FAMILY MEMBER CERTIFICATE WE NEED TO GET A NOTARIZED AFFIDAVIT.

1. AFFIDAVIT OF FAMILY MEMBERS
I, ____________________ (Name of Applicant), S/o, W/o, D/o, ___________________,
aged about ___ years, resident of ____________________________________________(Address),
do hereby solemnly affirm and state as follows:-
I do hereby declare that my ____________ (Relation of Deceased) by name
_________________________ (Name of Deceased) was died on __________ (Date of Death) due
to _____________ (Reason for Death). He / She left behind the following family members.
S
no
Name of the Family member Age
Gender Relationship with the
deceased
1
2
3
4
Sl No.1 ___________________ (Name of Applicant) being need of Family Members Certificate, I am
giving this affidavit on solemn declaration consciously believing it to be true and in faith thereof.
The above stated facts are true and correct.
Solemnly affirmed before me on ________ (Date of
Signing) at ______________ (Place)
NOTARY