Nevada Code § 111.699

Upon the death
of the last grantor of a deed upon death, a declaration of value of property
pursuant to NRS 375.060 and a copy of
the death certificate of each grantor must be attached to a Death of Grantor
Affidavit and recorded in the office of the county recorder where the deed was
recorded. The Death of Grantor Affidavit must be in substantially the following
form:
DEATH
OF GRANTOR AFFIDAVIT
................... (here insert
name of affiant), being duly sworn, deposes and says that...................
(here insert name of deceased), the decedent mentioned in the attached
certified copy of the Certificate of Death, is the same person
as................... (here insert name of grantor), named as the grantor or as
one of the grantors in the deed upon death recorded on...................
(date), as document or file number.........., book.........., at
page.........., records of................... County, Nevada, covering the real
property commonly known as..................., City of...................,
County of..................., State of Nevada, or located in the County
of..................., State of Nevada, and more particularly described as:
(Legal
Description)
................... (here insert
name of affiant) is the beneficiary or at least one of the beneficiaries to
whom the real property is conveyed upon the death of the
grantor................... (here insert name of deceased) or is the authorized
representative of the beneficiary or at least one of the beneficiaries. The
beneficiary or beneficiaries listed in the deed upon death
are....................
THE UNDERSIGNED HEREBY AFFIRMS THAT
THIS DOCUMENT SUBMITTED FOR RECORDING CONTAINS A SOCIAL SECURITY NUMBER OF A
PERSON OR PERSONS.
.................................................. (Date)
.................................................. (Signature)
State of Nevada }
}
ss.
County of................................ }
Subscribed and sworn to on this
.......... day of .............., in the year .........., before me,
................... (here insert name of notary public), by ...................
(here insert name of principal).
On this .......... day of
.............., in the year .........., before me, ................... (here
insert name of notary public), personally appeared ................... (here
insert name of principal) personally known to me (or proved to me on the basis
of satisfactory evidence) to be the person whose name is subscribed to this
instrument, and acknowledged that he or she executed it.
.................................................. (Signature
of Notary Public)
NOTARY SEAL

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