Form 4 Affidavit as to alias Intestacy – SOUTH AUSTRALIA IN THE SUPREME COURT TESTAMENTARY CAUSES JURISDICTION In the Estate of Miriam Sarah Smith otherwise Sarah Smith deceased I [full SWEAR ON OATH/DO TRULY AND name, address and occupation of deponent] SOLEMNLY AFFIRM [delete THAT: whichever is inapplicable] 1 I am the intended administrator of the estate of Miriam Sarah Smith otherwise Sarah Smith late of [address] deceased (“the deceased”) who died at …………… on …………… 20… intestate. 2 [Here e.g.: The establish the identity of the deceased under the alternative names is Miriam Sarah Smith but that she usually referred to herself as deceased’s correct name Sarah Smith and was generally known by that name.] 3 [Here set out details of property justifying the issue of the grant in the alternative names e.g.: The deceased effected a policy of assurance on her own life in the name of Sarah Smith in the X Insurance Company Ltd. A letter signed by the Manager of the Company verifying the name in which the policy is held is annexed hereto and marked “A”. and 4 The deceased is registered in the name of Miriam Sarah Smith as the proprietor of an estate in fee simple in the whole of the land comprised in Certificate of Title Register photocopy of the Certificate of Title is annexed hereto Book Volume ….. Folio ….. A and marked as the case may be in the case of real estate see Note 2 to this “B” [or – Form].] 5 In order to deal with the above property it is desired that the grant should issue in the names of Miriam Sarah Smith otherwise Sarah Smith deceased. Sworn/Affirmed [delete whichever is inapplicable] by the abovenamed deponent at [place]
Form 4 Affidavit as to alias – Intestacy SOUTH AUSTRALIA IN THE SUPREME COURT TESTAMENTARY CAUSES JURISDICTION In the Estate of Miriam Sarah Smith otherwise Sarah Smith deceased I [full name, address and occupation of deponent] SWEAR ON OATH/DO TRULY AND SOLEMNLY AFFIRM [delete whichever is inapplicable] THAT: 1 I am the intended administrator of the estate of Miriam Sarah Smith otherwise Sarah Smith late of [address] deceased (“the deceased”) who died at …………… on …………… 20… intestate. 2 [Here establish the identity of the deceased under the alternative names e.g.: The deceased’s correct name is Miriam Sarah Smith but that she usually referred to herself as Sarah Smith and was generally known by that name.] 3 [Here set out details of property justifying the issue of the grant in the alternative names e.g.: The deceased effected a policy of assurance on her own life in the name of Sarah Smith in the X Insurance Company Ltd. A letter signed by the Manager of the Company verifying the name in which the policy is held is annexed hereto and marked “A”. and 4 The deceased is registered in the name of Miriam Sarah Smith as the proprietor of an estate in fee simple in the whole of the land comprised in Certificate of Title Register Book Volume ….. Folio ….. A photocopy of the Certificate of Title is annexed hereto and marked “B” [or as the case may be – in the case of real estate see Note 2 to this Form].] 5 In order to deal with the above property it is desired that the grant should issue in the names of Miriam Sarah Smith otherwise Sarah Smith deceased. Sworn/Affirmed [delete whichever is inapplicable] by the abovenamed deponent at [place]
Form%204%20-%20Affidavit%20as%20to%20alias%20%E2%80%93%20Intestacy.docx