AFFIDAVIT OF HEIRSHIP QUESTIONNAIRE

PURPOSE OF THIS QUESTIONNAIRE

When a family member dies without a will, additional legal steps are required to clear title to any real estate they owned. Completing this questionnaire is the first step in preparing an Affidavit of Heirship, which identifies the Decedent’s heirs under Texas law so the property can be sold with clear, marketable title.

Please answer every question fully and accurately. Each item is necessary for the attorney to prepare the final affidavit. Do not leave any question blank.

You will also need to list two non-family members who knew the Decedent for at least ten years and can verify the family history. These individuals will serve as affiants and will swear to the facts provided. Some title companies may accept affiants with a shorter relationship if the information is well-documented.

If you are unsure how to answer any question, contact your Barnett & Hill agent, who will connect you with the attorney preparing the affidavit.

1. PERSON COMPLETING THIS QUESTIONNAIRE:

name of person completing questionnaire

First Middle Last Suffix

address

Street Address City State ZIP Code

Phone

Email(Required)

2. GENERAL INFORMATION REGARDING DECEDENT

Name of Decedent

First Middle Last Suffix

date of birth

city & state of birth

City State

date of death

city & state of death

City State

social security number

age at death

did Decedent have a will?

upload a copy of Decedent's will if available

Accepted file types: jpg, gif, png, pdf, hei, Max. file size: 300 MB.

did Decedent revoke will?

what is the date of the will?

was will ever probated?

city & state where decedent's will was probated

City State

link to Decedent's obituary that, ideally, includes names of children and siblings

upload copy of Decedent's death certificate

Accepted file types: jpg, gif, png, pdf, hei, Max. file size: 300 MB.

3. DECEDENT'S MARITAL HISTORY

how many times was Decedent married?

1ST SPOUSE

name of first spouse

First Middle Last Suffix

date of marriage

city & state of marriage

City State

how did marriage end?

date of spouse's death

city & state of spouse's death

City State

link to primary spouse's obituary that includes names of Decedent, children, and siblings

Upload copy of spouse's death certificate

Accepted file types: jpg, gif, png, pdf, hei, Max. file size: 300 MB.

date of spouse's divorce

city & state of divorce

City State

2ND SPOUSE

name of 2nd spouse

First Middle Last Suffix

date of 2nd marriage

city & state of 2nd marriage

City State

how did 2nd marriage end?

date of 2nd spouse's death

city & state of 2nd spouse's death

City State

link to 2nd spouse's obituary that includes names of Decedent, children, and siblings

Upload copy of 2nd spouse's death certificate

Accepted file types: jpg, gif, png, pdf, hei, Max. file size: 300 MB.

date of 2nd spouse's divorce

city & state of divorce in 2nd marriage

City State

3RD SPOUSE

name of 3rd spouse

First Middle Last Suffix

date of 3rd marriage

city & state of 3rd marriage

City State

how did 3rd marriage end?

date of 3rd spouse's death

city & state of 3rd spouse's death

City State

link to 3rd spouse's obituary that includes names of Decedent, children, and siblings

Upload copy of 3rd spouse's death certificate

Accepted file types: jpg, gif, png, pdf, hei, Max. file size: 300 MB.

date of 3rd spouse's divorce

city & state of divorce in 3rd marriage

City State

4TH SPOUSE

name of 4th spouse

First Middle Last Suffix

date of 4th marriage

city & state of 4th marriage

City State

how did 4th marriage end?

date of 4th spouse's death

city & state of 4th spouse's death

City State

link to 4th spouse's obituary that includes names of Decedent, children, and siblings

Upload copy of 4th spouse's death certificate

Accepted file types: jpg, gif, png, pdf, hei, Max. file size: 300 MB.

date of 4th spouse's divorce

city & state of divorce in 4th marriage

City State

5TH SPOUSE

name of 5th spouse

First Middle Last Suffix

date of 5th marriage

city & state of 5th marriage

City State

how did 5th marriage end?

date of 5th spouse's death

city & state of 5th spouse's death

City State

link to 5th spouse's obituary that includes names of Decedent, children, and siblings

Upload copy of 5th spouse's death certificate

Accepted file types: jpg, gif, png, pdf, hei, Max. file size: 300 MB.

date of 5th spouse's divorce

city & state of divorce in 5th marriage

City State

6TH SPOUSE

name of 6th spouse

First Middle Last Suffix

date of 6th marriage

city & state of 6th marriage

City State

how did 6th marriage end?

date of 6th spouse's death

city & state of 6th spouse's death

City State

link to 6th spouse's obituary that includes names of Decedent, children, and siblings

Upload copy of 6th spouse's death certificate

Accepted file types: jpg, gif, png, pdf, hei, Max. file size: 300 MB.

date of 6th spouse's divorce

city & state of divorce in 6th marriage

City State

7TH SPOUSE

name of 7th spouse

First Middle Last Suffix

date of 7th marriage

city & state of 7th marriage

City State

how did 7th marriage end?

date of 7th spouse's death

city & state of 7th spouse's death

City State

link to 7th spouse's obituary that includes names of Decedent, children, and siblings

Upload copy of 7th spouse's death certificate

Accepted file types: jpg, gif, png, pdf, hei, Max. file size: 300 MB.

date of 7th spouse's divorce

city & state of divorce in 7th marriage

City State

4. DECEDENT'S LIVING CHILDREN

How many living children - biological & adopted - claim Decedent as parent?

1ST CHILD

1st child's name

First Last

Is 1st child biological to or adopted by Decedent?

Biological

Adopted

1st child's address

Street Address City State ZIP Code

1st child's phone number

1st child's email

Name of 1st child's other parent

First Last

1st child's date of birth

1st child's city/state of birth

City State

1st child's date of adoption

1st child's city/state of adoption

City State

2ND CHILD

2nd child's name

First Last

Is 2nd child biological to or adopted by Decedent?

Biological

Adopted

2nd child's address

Street Address City State ZIP Code

2nd child's phone number

2nd child's email

Name of 2nd child's other parent

First Last

2nd child's date of birth

2nd child's city/state of birth

City State

2nd child's date of adoption

2nd child's city/state of adoption

City State

3RD CHILD

3rd child's name

First Last

Is 3rd child biological to or adopted by Decedent?

Biological

Adopted

3rd child's address

Street Address City State ZIP Code

3rd child's phone number

3rd child's email

Name of 3rd child's other parent

First Last

3rd child's date of birth

3rd child's city/state of birth

City State

3rd child's date of adoption

3rd child's city/state of adoption

City State

4TH CHILD

4th child's name

First Last

Is 4th child biological to or adopted by Decedent?

Biological

Adopted

4th child's address

Street Address City State ZIP Code

4th child's phone number

4th child's email

Name of 4th child's other parent

First Last

4th child's date of birth

4th child's city/state of birth

City State

4th child's date of adoption

4th child's city/state of adoption

City State

5TH CHILD

5th child's name

First Last

Is 5th child biological to or adopted by Decedent?

Biological

Adopted

5th child's address

Street Address City State ZIP Code

5th child's phone number

5th child's email

Name of 5th child's other parent

First Last

5th child's date of birth

5th child's city/state of birth

City State

5th child's date of adoption

5th child's city/state of adoption

City State

6TH CHILD

6th child's name

First Last

Is 6th child biological to or adopted by Decedent?

Biological

Adopted

6th child's address

Street Address City State ZIP Code

6th child's phone number

6th child's email

Name of 6th child's other parent

First Last

6th child's date of birth

6th child's city/state of birth

City State

6th child's date of adoption

6th child's city/state of adoption

City State

7TH CHILD

7th child's name

First Last

Is 7th child biological to or adopted by Decedent?

Biological

Adopted

7th child's address

Street Address City State ZIP Code

7th child's phone number

7th child's email

Name of 7th child's other parent

First Last

7th child's date of birth

7th child's city/state of birth

City State

7th child's date of adoption

7th child's city/state of adoption

City State

8TH CHILD

8th child's name

First Last

Is 8th child biological to or adopted by Decedent?

Biological

Adopted

8th child's address

Street Address City State ZIP Code

8th child's phone number

8th child's email

Name of 8th child's other parent

First Last

8th child's date of birth

8th child's city/state of birth

City State

8th child's date of adoption

8th child's city/state of adoption

City State

9TH CHILD

9th child's name

First Last

Is 9th child biological to or adopted by Decedent?

Biological

Adopted

9th child's address

Street Address City State ZIP Code

9th child's phone number

9th child's email

Name of 9th child's other parent

First Last

9th child's date of birth

9th child's city/state of birth

City State

9th child's date of adoption

9th child's city/state of adoption

City State

10TH CHILD

10th child's name

First Last

Is 10th child biological to or adopted by Decedent?

Biological

Adopted

10th child's address

Street Address City State ZIP Code

10th child's phone number

10th child's email

Name of 10th child's other parent

First Last

10th child's date of birth

10th child's city/state of birth

City State

10th child's date of adoption

10th child's city/state of adoption

City State

5. DECEDENT'S DECEASED CHILDREN

How many Decedent's children are deceased?

1ST DECEASED CHILD

Name of 1st deceased child of Decedent

First Last

date of death 1st child

city & state at death of 1st child of Decedent

City State

link to obituary of 1st deceased child of Decedent

death certificate for 1st deceased child of Decedent

Accepted file types: jpg, gif, png, pdf, hei, Max. file size: 300 MB.

Did 1st deceased child die after Decedent?

Yes

Did 1st deceased child have a will?

Yes

Was 1st deceased child's will probated?

Yes

What was the city and state where the 1st deceased child's will was probated?

City State

was 1st deceased child married at time of death?

Yes

name of 1st deceased child's spouse at time of death

First Last

Is spouse of 1st deceased child living today?

Yes

Did spouse of 1st deceased child have a will?

Yes

Was spouse of 1st deceased child's will probated?

Yes

What was the city and state where the will of the spouse of the 1st deceased child was probated?

City State

Number of children of 1st deceased child (both biological & adopted)

Child 1 of 1st deceased child

First Last

Child 2 of 1st deceased child

First Last

Child 3 of 1st deceased child

First Last

Child 4 of 1st deceased child

First Last

Child 5 of 1st deceased child

First Last

Child 6 of 1st deceased child

First Last

Child 7 of 1st deceased child

First Last

Child 8 of 1st deceased child

First Last

2ND DECEASED CHILD

Name of 2nd deceased child of Decedent

First Last

date of death 2nd child

city & state at death of 2nd child of Decedent

City State

link to obituary of 2nd deceased child of Decedent

death certificate for 2nd deceased child of Decedent

Accepted file types: jpg, gif, png, pdf, hei, Max. file size: 300 MB.

Did 2nd deceased child die after Decedent?

Yes

Did 2nd deceased child have a will?

Yes

Was 2nd deceased child's will probated?

Yes

What was the city and state where the 2nd deceased child's will was probated?

City State

was 2nd deceased child married at time of death?

Yes

Name of 2nd deceased child's spouse at time of death

First Last

Is spouse of 2nd deceased child living today?

Yes

Did spouse of 2nd deceased child have a will?

Yes

Was spouse of 2nd deceased child's will probated?

Yes

What was the city and state where the will of the spouse of the 2nd deceased child was probated?

City State

Number of children of 2nd deceased child (both biological & adopted)

Child 1 of 2nd deceased child

First Last

Child 2 of 2nd deceased child

First Last

Child 3 of 2nd deceased child

First Last

Child 4 of 2nd deceased child

First Last

Child 5 of 2nd deceased child

First Last

Child 6 of 2nd deceased child

First Last

Child 7 of 2nd deceased child

First Last

Child 8 of 2nd deceased child

First Last

3RD DECEASED CHILD

Name of 3rd deceased child of Decedent

First Last

date of death 3rd child

city & state at death of 3rd child of Decedent

City State

link to obituary of 3rd deceased child of Decedent

death certificate for 3rd deceased child of Decedent

Accepted file types: jpg, gif, png, pdf, hei, Max. file size: 300 MB.

Did 3rd deceased child die after Decedent?

Yes

Did 3rd deceased child have a will?

Yes

Was 3rd deceased child's will probated?

Yes

What was the city and state where the 3rd deceased child's will was probated?

City State

was 3rd deceased child married at time of death?

Yes

name of 3rd deceased child's spouse at time of death

First Last

Is spouse of 3rd deceased child living today?

Yes

Did spouse of 3rd deceased child have a will?

Yes

Was spouse of 3rd deceased child's will probated?

Yes

What was the city and state where the will of the spouse of the 3rd deceased child was probated?

City State

number of children of 3rd deceased child (both biological & adopted)

Child 1 of 3rd deceased child

First Last

Child 2 of 3rd deceased child

First Last

Child 3 of 3rd deceased child

First Last

Child 4 of 3rd deceased child

First Last

Child 5 of 3rd deceased child

First Last

Child 6 of 3rd deceased child

First Last

Child 7 of 3rd deceased child

First Last

Child 8 of 3rd deceased child

First Last

4TH DECEASED CHILD

Name of 4th deceased child of Decedent

First Last

date of death 4th child

city & state at death of 4th child of Decedent

City State

link to obituary of 4th deceased child of Decedent

death certificate for 4th deceased child of Decedent

Accepted file types: jpg, gif, png, pdf, hei, Max. file size: 300 MB.

Did 4th deceased child die after Decedent?

Yes

Did 4th deceased child have a will?

Yes

Was 4th deceased child's will probated?

Yes

What was the city and state where the 4th deceased child's will was probated?

City State

was 4th deceased child married at time of death?

Yes

Name of 4th deceased child's spouse at time of death (if any):

First Last

Is spouse of 4th deceased child living today?

Yes

Did spouse of 4th deceased child have a will?

Yes

Was spouse of 4th deceased child's will probated?

Yes

What was the city and state where the will of the spouse of the 4th deceased child was probated?

City State

Number of children of 4th deceased child (both biological & adopted)

Child 1 of 4th deceased child

First Last

Child 2 of 4th deceased child

First Last

Child 3 of 4th deceased child

First Last

Child 4 of 4th deceased child

First Last

Child 5 of 4th deceased child

First Last

Child 6 of 4th deceased child

First Last

Child 7 of 4th deceased child

First Last

Child 8 of 4th deceased child

First Last

5TH DECEASED CHILD

Name of 5th deceased child of Decedent

First Last

date of death 5th child

city & state at death of 5th child of Decedent

City State

link to obituary of 5th deceased child of Decedent

death certificate for 5th deceased child of Decedent

Accepted file types: jpg, gif, png, pdf, hei, Max. file size: 300 MB.

Did 5th deceased child die after Decedent?

Yes

Did 5th deceased child have a will?

Yes

Was 5th deceased child's will probated?

Yes

What was the city and state where the 5th deceased child's will was probated?

City State

was 5th deceased child married at time of death?

Yes

Name of 5th deceased child's spouse at time of death (if any):

First Last

Is spouse of 5th deceased child living today?

Yes

Did spouse of 5th deceased child have a will?

Yes

Was spouse of 5th deceased child's will probated?

Yes

What was the city and state where the will of the spouse of the 5th deceased child was probated?

City State

Number of children of 5th deceased child (both biological & adopted)

Child 1 of 5th deceased child

First Last

Child 2 of 5th deceased child

First Last

Child 3 of 5th deceased child

First Last

Child 4 of 5th deceased child

First Last

Child 5 of 5th deceased child

First Last

Child 6 of 5th deceased child

First Last

Child 7 of 5th deceased child

First Last

Child 8 of 5th deceased child

First Last

6. NET WORTH OF DECEDENT'S ESTATE

what is the estimated gross value of Decedent’s estate?

It is not necessary to provide an exact number for the value of Decedent’s estate. You only need to provide an estimated value (e.g., not more than $100,000). The gross value of Decedent’s estate, as defined for federal estate tax purposes, includes the value of Decedent’s interest in all real property, stocks, bonds, mortgages, notes, cash, life insurance, and other assets.

are there any unpaid debts of Decedent's estate?

Yes

Unpaid debts of Decedent’s estate would include things like expenses of Decedent’s funeral, doctor/hospital bills, credit card debt, etc. You do not need to include debts secured by real property that will be paid off as part of at closing

list the amount of each creditor and the amount of the unpaid debt - use the + icon add rows for additional creditors with debt amount

creditor

debt amount

Did Decedent ever apply for or receive any Medicaid benefits for long term care service (e.g., for nursing or hospice care)?(Required)

Yes

If Decedent did ever apply for or receive any Medicaid benefits for long term care service, then you must fill out a Texas Medicaid Estate Recovery Program (MERP) Authorization Form requesting a certification from MERP as to whether they intend to file a claim against Decedent’s estate. You will be sent a MERP Authorization Form once this questionnaire is complete.

Have you received a waiver of any claim from MERP?

Yes

Please attach a copy of your MERP waiver

Accepted file types: jpg, gif, png, pdf, hei, Max. file size: 300 MB.

7. ADDITIONAL INFORMATION

Provide any miscellaneous information that you believe may be relevant below:

This questionnaire provides only the basic information needed to determine the heirs of Decedent’s estate and/or to prepare the Affidavit of Heirship. Once completed and reviewed, it is possible that you will be asked for additional information. If you are unsure whether any additional information is necessary, please contact us to discuss.

How many additional supporting documents - marriage certficates, birth certificates, etc. - do you plan to add to this heirship process?

Description of 1st supporting document

1st supporting document

Max. file size: 300 MB.

Description of 2nd supporting document

2nd supporting document

Max. file size: 300 MB.

Description of 3rd supporting document

3rd supporting document

Max. file size: 300 MB.

Description of 4th supporting document

4th supporting document

Max. file size: 300 MB.

Description of 5th supporting document

5th supporting document

Max. file size: 300 MB.

Description of 6th supporting document

6th supporting document

Max. file size: 300 MB.

Description of 7th supporting document

7th supporting document

Max. file size: 300 MB.

8. AFFIANTS INFORMATION

Provide the names of two disinterested people who knew Decedent and Decedent’s family history well to act as Affiants. The two Affiants must be willing to sign the Affidavit of Heirship after it is prepared and verify that the information contained in the Affidavit of Heirship is true. A “disinterested” person means someone who is not related to the Decedent and does not have an interest in Decedent’s estate either as an heir of Decedent or beneficiary under Decedent’s will.

FIRST AFFIANT

affiant 1

First Last

affiant 1's address

Street Address City State ZIP Code

affiant 1's phone

affiant 1's email

affiant 1's relationship to Decedent

in what year did affiant 1 meet decedent / how long has affiant 1 known decedent

SECOND AFFIANT

affiant 2

First Last

affiant 2's address

Street Address City State ZIP Code

affiant 2's phone

affiant 2's email

affiant 2's relationship to Decedent

in what year did affiant 2 meet decedent / how long has affiant 2 known decedent