Circular Letter No 28 (2001): Attachment - Affidavit in Lieu of Death - dfs ny-2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your full name and current address in the designated fields. Ensure that your telephone number is also included for contact purposes.
3. In the section regarding your relationship to the insured, clearly specify your connection, such as 'spouse' or 'parent'.
4. Provide the name of the insured individual in the appropriate field, ensuring accuracy for verification.
5. Indicate whether the insured was present at one of the specified locations during the events of September 11, 2001, by selecting from the options provided.
6. Affirm that you have not had contact with the insured since September 11, 2001, and explain your inability to secure a death certificate.
7. Review all statements made in the affidavit for accuracy before signing. This is crucial as it affirms under penalties of perjury that your statements are true.
8. Finally, sign and date the affidavit in front of a notary public to complete the process.

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