Who should sign an Affidavit of Domicile?

The affidavit should be signed by the executor or administrator of the estate, or, if there is no formal estate administration, by the surviving spouse or next of kin. The signer must have personal knowledge of where the deceased lived and must be willing to swear to that under oath. Because brokerage firms and transfer agents rely on this document to release securities, accuracy is essential.

Why do brokerages require an Affidavit of Domicile?

Brokerage firms need to know the decedent's domicile state to determine which state's transfer-on-death and inheritance laws apply, and to comply with applicable estate tax reporting requirements. Different states have different rules regarding unclaimed property and estate taxes. Without the affidavit, a financial institution cannot legally release or re-register securities to heirs or beneficiaries.

Is an Affidavit of Domicile the same as a death certificate?

No. A death certificate confirms the fact of death, while an Affidavit of Domicile confirms the deceased's legal home state at the time of death. Both documents are often required together when transferring financial accounts after a death. The death certificate establishes that the transfer is appropriate; the Affidavit of Domicile tells the financial institution which state's rules govern the transaction.

Do I need to provide supporting evidence of domicile with the affidavit?

Most brokerage firms and transfer agents accept the notarized Affidavit of Domicile without additional evidence, provided it is signed by the executor or estate administrator. In cases where domicile is disputed or unclear — for example, if the deceased split time between multiple states — supplementary documentation such as a driver's license, voter registration record, or prior year tax return may strengthen the claim.

What happens if the wrong state of domicile is listed on the affidavit?

Providing incorrect information on a notarized affidavit is a serious matter and could constitute perjury. From a practical standpoint, listing the wrong domicile state can result in incorrect estate tax treatment, complications with state unclaimed property laws, and potential legal liability. If you are uncertain about the decedent's true domicile, consult an estate attorney before signing.

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.

Complete the Form

Fill in the fields below, then download your completed affidavit.

Affidavit of Domicile

Fill in the fields below to generate your form.

Section 1 — Decedent Information

Full Legal Name of Decedent *

Date of Death *

Date of Birth

Social Security Number — last 4 digits only

Optional — some transfer agents require this

State of Domicile at Time of Death *

County of Domicile at Time of Death *

Street Address of Domicile *

City *

State *

ZIP Code *

Length of Time at This Address

Section 2 — Affiant Information (Person Signing)

Full Legal Name *

Relationship to Decedent *

Street Address *

City *

State *

ZIP Code *

Phone

Section 3 — Account / Security Information

Optional — fill in if a specific institution requires it

Name of Financial Institution or Transfer Agent

Account Number or Certificate Number

Section 4 — Sworn Statement

Pre-populated statement — updates as you fill the form

I, [Affiant Name], being duly sworn, depose and say that [Decedent Name] was, at the time of death on [Date of Death], a legal resident and domiciliary of the State of [State of Domicile], residing at [Address of Domicile]. This affidavit is made for the purpose of establishing the decedent’s state of domicile for the transfer of securities, accounts, or other assets.

Section 5 — Signature & Notary

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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Submitting does not file any legal document. This tool generates a printable template only.

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How to Complete This Form

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

A grieving family at a funeral, representing matters of estate and domicile

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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