Free Affidavit of Domicile Form

An Affidavit of Domicile certifies the legal state of residence (domicile) of a deceased person at the time of their death. It is most commonly required by brokerage firms and financial institutions before they will re-register or transfer securities to an estate or beneficiary.

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Affidavit of Domicile

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Affiant Information
Sworn Statement

I swear or affirm that the above information is true and correct to the best of my knowledge.

Signature

Notary Acknowledgment

State of _________________________ County of _________________________

Subscribed and sworn to before me on this _____ day of _______________, 20_____.

Notary Public: __________________________    My Commission Expires: __________________

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How to Complete This Form

  1. 1Enter the full legal name of the deceased and the date of death.
  2. 2Identify yourself as the executor, administrator, or authorized family member.
  3. 3State the city and state where the deceased was legally domiciled at the time of death.
  4. 4Sign the completed form before a licensed notary public.
  5. 5Submit the notarized affidavit to the brokerage firm, transfer agent, or financial institution that requires it.

What Is an Affidavit of Domicile?

An Affidavit of Domicile is a sworn statement made by the executor or administrator of an estate, or by a surviving family member, certifying the state in which the deceased person was legally domiciled (i.e., their permanent legal home) at the time of death. This information determines which state's laws govern the estate administration and the applicable inheritance and estate taxes. Brokerage houses, mutual fund companies, and transfer agents typically require this form before they will release or re-register securities.

An affidavit of domicile form is a standard requirement across most major brokerage firms and transfer agents when transferring investment accounts after a death. The legal concept of domicile differs from simple residency — a person can have multiple residences but only one domicile, which is the place they consider their permanent home and intend to return to. Correctly identifying the state of domicile determines which state's estate and inheritance taxes apply.

When filling out an affidavit of domicile, the executor or estate representative must swear to facts within their personal knowledge. If the decedent lived in multiple states during their final years, documenting evidence of intent — such as voter registration, driver's license state, and tax filing location — can help establish domicile clearly. The completed affidavit of domicile template must be notarized before submission.

When Do You Need an Affidavit of Domicile?

  • A brokerage or financial institution requires it to re-register or transfer securities
  • The executor needs to establish the decedent's state of domicile for estate tax purposes
  • A transfer agent requests documentation before releasing stock certificates
  • The estate includes out-of-state assets and the domicile must be established
  • A mutual fund company requires it to distribute fund shares to beneficiaries
  • You are administering an estate that owned investment accounts
Notarization Required

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Frequently Asked Questions