next of kin document
NEXT OF KIN AFFIDAVIT
That the affiant herein is informed and believes that the sum of $ was due and owing the decedent from the State of New York at
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DS-5511 Affidavit for the Surviving Spouse or Next of Kin
The information on this form is requested to assist U.S. Consular Officers to fulfill the requirements of 22 U.S.C. 2715c and determine the next-of-kin of
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Rules and Regulations on Controlled Substances in NYS
next of kin of the practitioner or, if the next of kin is unable to obtain the prescription forms, by a representative of the estate of the practitioner.
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