Affidavit of Domicile
State of [State]
County of [County]
I, [Affiant’s Name], residing at [Address], [City], [State] [ZIP Code], the [Relationship] of the deceased person (the "Decedent"), being duly sworn, testify and state as follows:
The Decedent:
- Full legal name: [Decedent’s Name]
- Date of death: [Date of Death]
- Last known legal residence: [Address], [City], [State] [ZIP Code]
Domicile certification. I hereby confirm that the Decedent, [Decedent’s Name], was a legal resident of [City], [State] at the time of death.
Purpose. This Affidavit is executed to [Affidavit Purpose], namely [Securities or Account], to the [Transfer Recipient].
Legal acknowledgment. I, [Affiant’s Name], solemnly confirm and declare that the information provided in this Affidavit is true and accurate to the best of my knowledge. I understand that any false statements may have legal consequences.
This Affidavit was made on [Signing Date].
____________________________
[Affiant’s Name]
(Affiant’s Signature)
Party 1
________________
Signature
Date: ________________
Party 2
________________
Signature
Date: ________________
What Is a Affidavit of Domicile?
An Affidavit of Domicile in the United States confirms specified facts through a signed declaration sworn before a commissioner for oaths or notary.
The affidavit is primarily used in the context of estate administration following a death. Transfer agents such as Computershare, EQ Shareowner Services, and brokerage firms require an Affidavit of Domicile before transferring securities owned by a decedent. The requirement exists because the decedent's domicile determines which state has jurisdiction over the estate, which state's inheritance or estate tax laws apply, and whether the transfer requires court authorization.
The legal significance of domicile extends to taxation under state estate tax laws. States with estate or inheritance taxes (such as New York, Massachusetts, New Jersey, and Maryland) impose taxes based on the decedent's domicile. Under the principle established in Texas v. Florida (306 U.S. 398, 1939), when multiple states claim a decedent as a domiciliary, an interpleader action or voluntary arbitration may be necessary. The Affidavit of Domicile provides evidence that helps resolve these jurisdictional questions by documenting where the decedent lived, voted, paid taxes, and maintained community ties.
When Do You Need a Affidavit of Domicile?
An Affidavit of Domicile is most commonly required when transferring stocks, bonds, mutual funds, or other securities owned by a deceased person. Transfer agents and brokerage firms will not process the transfer of assets from a decedent's account to an estate, trust, or beneficiary without this affidavit. This is standard practice across the financial services industry, mandated by the transfer agents' own compliance requirements.
Estate administrators and executors need this affidavit when filing the final estate tax return (IRS Form 706) and state estate or inheritance tax returns. The domicile determination affects which state's tax rates and exemptions apply, potentially representing significant tax savings or obligations.
Probate proceedings typically begin in the state where the decedent was domiciled. If the decedent owned property in multiple states, ancillary probate proceedings may be required in each additional state. The Affidavit of Domicile helps establish the proper forum for the primary probate proceeding.
Insurance companies processing life insurance claims may request this affidavit to determine the applicable state insurance regulations and to verify the claimant's relationship to the decedent. Banks closing accounts of deceased account holders also commonly require it as part of their estate settlement process.
Without an Affidavit of Domicile, the transfer of securities can be delayed indefinitely, estate tax filings may be challenged, and financial institutions may refuse to release funds -- all of which can significantly delay the distribution of estate assets to rightful heirs.
What to Include in Your Affidavit of Domicile
The decedent's full legal name, including any aliases, maiden names, or name variations under which they held assets, must be stated precisely. Transfer agents match the name on the affidavit against the name on the securities, and any discrepancy will delay processing.
The decedent's date of death and last permanent address (domicile) are the most critical elements of the affidavit. The domicile address should be supported by evidence such as the address used for voter registration, driver's license, tax filings, and vehicle registration. The duration of residency at the domicile address strengthens the affidavit's evidentiary value.
The affiant -- typically the executor, administrator, or surviving spouse -- must state their relationship to the decedent and affirm that they have personal knowledge of the decedent's domicile. A statement that the decedent did not maintain a domicile in any other state at the time of death helps prevent conflicting claims from other states. This is particularly important for individuals who divided their time between two or more states.
A statement regarding whether the estate is subject to probate, and if so, which court has jurisdiction, provides context for the transfer agent. The affidavit should also indicate whether a will exists and whether Letters Testamentary or Letters of Administration have been issued.
The affidavit must be signed by the affiant under penalty of perjury and notarized. Most transfer agents require the notarization to include a Medallion Signature Guarantee or a signature guarantee from a financial institution, which provides an additional layer of identity verification beyond standard notarization. The governing jurisdiction should be stated to establish which state's perjury laws apply to false statements in the affidavit.
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Reference this free template in an article, syllabus, or research note:
Forms Legal. (2026). Affidavit of Domicile (United States) [Legal document template]. Forms Legal. https://forms-legal.com/usa/government/declarations/affidavit-domicile
"Affidavit of Domicile (United States)." Forms Legal, 2026, https://forms-legal.com/usa/government/declarations/affidavit-domicile.
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title = {Affidavit of Domicile (United States)},
year = {2026},
howpublished = {\url{https://forms-legal.com/usa/government/declarations/affidavit-domicile}},
note = {Free legal document template. Based on 28 U.S.C. §1746}
}Also available for these jurisdictions:
Frequently Asked Questions
An Affidavit of Domicile is a sworn statement declaring the legal residence of a deceased person at the time of death, required primarily to transfer securities held in a brokerage or transfer agent account to the estate or heirs. Brokerage firms and transfer agents demand the affidavit before reregistering or releasing stocks, bonds, and mutual fund shares because the decedent's state of domicile determines which state's estate and inheritance tax rules apply. The executor, administrator, or surviving joint owner signs the affidavit under penalty of perjury before a notary public, stating the decedent's name, date of death, and the address that was their permanent home. Financial institutions typically require the affidavit alongside a certified death certificate and a stock power or transfer request. Because the document fixes the taxing jurisdiction, accuracy about the decedent's true permanent residence is essential, particularly for individuals who owned homes in more than one state.
An Affidavit of Domicile is signed by the person legally authorized to act for the decedent's estate or to claim the securities, which is usually the executor, the court-appointed administrator, or a surviving joint account holder. The signer must have personal knowledge of where the decedent permanently resided at the time of death, because the affidavit certifies the state of domicile that controls estate tax treatment. The signature must be made before a notary public, who verifies identity and administers the oath, and many transfer agents additionally require a Medallion Signature Guarantee from a bank or brokerage rather than ordinary notarization. The affiant swears under penalty of perjury that the stated domicile is true, so the executor should confirm the decedent's residence using documents such as the last tax return, driver's license, or voter registration before signing.
Domicile and residence are distinct concepts on an Affidavit of Domicile: domicile is the one fixed, permanent home to which a person intends to return, while residence can include any place a person lives, even temporarily. A decedent could maintain residences in several states yet have only a single legal domicile, and that domicile determines which state may impose estate or inheritance tax and govern the transfer of securities. The affiant must identify the true domicile, considering factors such as where the decedent was registered to vote, held a driver's license, filed state income tax returns, and maintained primary banking and family ties. Choosing the wrong state can trigger disputes with tax authorities or cause a transfer agent to reject the paperwork. For individuals with homes in multiple states, the executor should gather supporting evidence of intent before completing the affidavit.
An Affidavit of Domicile generally requires either notarization or, more often, a Medallion Signature Guarantee, depending on the transfer agent or brokerage handling the securities. Notarization confirms the affiant's identity and that the oath was administered, but most stock transfer agents specifically demand a Medallion Signature Guarantee, a special stamp provided by participating banks and brokerages that guarantees the signer's identity and authority and protects against fraudulent transfers. A Medallion Signature Guarantee is not the same as notarization and cannot be obtained from a notary public; the affiant must visit a financial institution that participates in the Medallion program. Because requirements vary by company, the executor should ask the specific transfer agent which form of authentication it accepts before signing, and should bring the certified death certificate and account details when seeking the guarantee.
An Affidavit of Domicile is typically submitted together with a certified copy of the death certificate, a stock power or transfer request form, and proof of the signer's authority to act for the estate, such as Letters Testamentary or Letters of Administration. The transfer agent uses the package to reregister securities into the names of the heirs or the estate and to apply the correct state tax treatment based on the certified domicile. Surviving joint owners may instead supply documentation showing the survivorship registration of the account. Many transfer agents also require a Medallion Signature Guarantee on the affidavit and the stock power rather than ordinary notarization. Because each institution maintains its own checklist, the executor should request the firm's specific transfer instructions in advance and order multiple certified death certificates, since each transfer agent usually keeps an original copy for its records.
This template is provided for informational purposes only and does not constitute legal advice. Laws vary by jurisdiction and change over time. Consult a qualified attorney for advice specific to your situation.Full disclaimer
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