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This document is an Affidavit of Facts Concerning the Identity of Heirs for a decedent who did not leave a probated will or have any court determination regarding their estate. The affiant must personally appear before an authority, be sworn in, and provide personal knowledge about the decedent's family and marital history.

Key information required includes:

1. Affiant’s name and address.
2. Personal familiarity with the decedent's family and marital history.
3. Details of the affiant's relationship with the decedent, including dates known to them and place of death.
4. Decedent's residence at the time of death, including city, state, and county.
5. Marital history: spouse’s name, marriage date, divorce date (if applicable), or spouse’s death date.
6. Information on deceased’s children: names, birth dates, other parent’s name, current address, and death date (if applicable).
7. Details of grandchildren born to the decedent's children: names, birth dates, parents' names, addresses, and death dates (if applicable).
8. If no marriage or children existed, information on deceased’s parents.
9. Information on deceased’s siblings: names, birth dates, current address, and death date (if applicable).
10. Details of nieces/nephews born to the decedent's siblings: names, birth dates, current addresses, and deceased parent’s name.

The affidavit must be filed in the county clerk’s record, signed by the affiant, and notarized with a seal and commission expiration date noted.