LOUISIANA AFFIDAVIT OF SMALL SUCCESSION

STATE OF LOUISIANA

PARISH OF

BEFORE ME, the undersigned Notary Public, personally came and

appeared (The full appearance clause inserted here.)

who after being duly sworn did depose and say that:

Affiants make this affidavit pursuant to C.C.P. Art. 3431 et seq

(name of decedent) died intestate on (date of

death) while a resident of and domiciled at (last
residence address), in the Parish of , State of Louisiana. The decedent’s
social security number was . The decedent was married to

(insert full name, address, domicile and location of last residence here).

The following are the names and addresses, and social security numbers of the
heirs and their relationship to the decedent.
Name Address Relationship

(repeat as necessary)

The following heirs cannot be located after the exercise of reasonable diligence and
therefore has not signed this affidavit:

(insert name of heirs; repeat as necessary)

The following heirs were given ten (10) days’ notice by U.S. mail of the affiants’
intent to execute an Affidavit for Small Succession and did not object:

(insert name of heirs; repeat as necessary)

The decedent left no immovable property other than small succession immovable
property. (remember it cannot be greater than $75,000 when added to any movable
property of decedent.)

The following is a brief description of the property left by the decedent showing the
value of each and the aggregate value of all the property belonging to the estate at
the time of the decedent’s death

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DESCRIPTION SEPARATE PROPERTY 50% OF COMMUNITY
PROPERTY
ASSETS:
$ $
(repeat as necessary)

DEBT:
$ $
(repeat as necessary)

TOTAL $ $

TOTAL AGGREGATE VALUE $

Heir #1 has a % interest in the succession property and a legal usufruct of the
surviving spouse does / does not attach to said property.

Heir #2 has a % interest in the succession property and a legal usufruct of the
surviving spouse does / does not attach to said property.
(Repeat as necessary for however many heirs exist.)

Each heir hereby acknowledges and accepts the succession of the deceased as
evidenced by the heir’s attached signature.

Each heir hereby acknowledges and swears, under penalty of perjury that the
information contained in this affidavit is true, correct, and complete to the best of
their knowledge, information and belief.

Sworn to and subscribed before me, the undersigned Notary, duly commissioned in
the State of Louisiana, Parish of on this day of ,
20 .

Heir/Affiant #1 Heir/Affiant #2

(printed name of notary here) Notary Public

(Repeat for as many heirs that exist and are appearing to sign the affidavit.)

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