<html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 29A-6-432 - Optional form of affidavit of confirmation. </title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2052389Normal { margin-top: 0; margin-bottom: 0; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2052389SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2052389CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2052389Normal-000000 { margin-top: 0; margin-bottom: 0; text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2052389DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2052389CLP { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2052389Normal-000001 { margin-top: 0; margin-bottom: 0; text-indent: 0.25in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2052389000002 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2052389SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2052389SCL-000003 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } body { text-decoration-skip-ink: none; } </style></head><body><div><p dir="ltr" class="s2052389Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=29A-6-432"><span class="s2052389SENU">29A-6-432</span></a><span xml:space="preserve" class="s2052389SENU">. </span><span class="s2052389CL">Optional form of affidavit of confirmation.</span></p><p dir="ltr" class="s2052389Normal-000000"><span class="s2052389DefaultParagraphFont">The following form or a document that contains substantially all of the following information may be used to create the affidavit of confirmation:</span></p><p dir="ltr" class="s2052389Normal"><span xml:space="preserve" class="s2052389CLP">    AFFIDAVIT OF CONFIRMATION AND SURVIVORSHIP FOR TRANSFER ON DEATH DEED</span></p><p dir="ltr" class="s2052389Normal"><span class="s2052389DefaultParagraphFont">State of South Dakota</span></p><p dir="ltr" class="s2052389Normal"><span class="s2052389DefaultParagraphFont">County of _________________</span></p><p dir="ltr" class="s2052389Normal"><span class="s2052389DefaultParagraphFont">I, ________________________, being first duly sworn on oath, state that to my personal knowledge:</span></p><p dir="ltr" class="s2052389Normal-000001"><span class="s2052389DefaultParagraphFont">1. ________________ (Decedent) is the person named in the certified copy of the Certificate of Death attached hereto.</span></p><p dir="ltr" class="s2052389Normal-000001"><span class="s2052389DefaultParagraphFont">2. On the date of death, Decedent was an owner of the property in ______________ County, South Dakota, legally described as follows: ___________________________________ and Decedent was the transferor in a transfer on death deed (Deed) recorded on _____________, as in Book ______ of _____, Page _____, in the office of the register of deeds of ______________ County, South Dakota.</span></p><p dir="ltr" class="s2052389Normal-000001"><span class="s2052389DefaultParagraphFont">3. The name(s) and address(es) of the Designated Beneficiary(ies) named in the Deed who survived the Decedent is(are):</span></p><p dir="ltr" class="s2052389Normal-000001"><span class="s2052389DefaultParagraphFont">_________________________________________________________</span></p><p dir="ltr" class="s2052389Normal-000001"><span class="s2052389DefaultParagraphFont">_________________________________________________________</span></p><p dir="ltr" class="s2052389Normal-000001"><span class="s2052389DefaultParagraphFont">_________________________________________________________</span></p><p dir="ltr" class="s2052389Normal-000001"><span class="s2052389DefaultParagraphFont">4. The name(s) and address(es) of the contingent beneficiary or person who takes under the anti-lapse statutes and who survived the Decedent.</span></p><p dir="ltr" class="s2052389Normal-000001"><span class="s2052389DefaultParagraphFont">_________________________________________________________</span></p><p dir="ltr" class="s2052389Normal-000001"><span class="s2052389DefaultParagraphFont">_________________________________________________________</span></p><p dir="ltr" class="s2052389Normal-000001"><span class="s2052389DefaultParagraphFont">5. The Designated Beneficiary(ies) named in the Deed who did not survive the Decedent is(are):</span></p><p dir="ltr" class="s2052389Normal-000001"><span class="s2052389DefaultParagraphFont">_________________________________________________________</span></p><p dir="ltr" class="s2052389Normal-000001"><span class="s2052389DefaultParagraphFont">_________________________________________________________</span></p><p dir="ltr" class="s2052389Normal"><span class="s2052389DefaultParagraphFont">Certified copies of Certificate(s) of Death for any deceased Designated Beneficiary(ies) is(are) also attached hereto.</span></p><p dir="ltr" class="s2052389Normal-000001"><span class="s2052389DefaultParagraphFont">6. Notice of the death of the Decedent has been given to the South Dakota Department of Social Services and it has been determined that no assistance was provided or that any obligation for reimbursement to the department has been satisfied.</span></p><p dir="ltr" class="s2052389Normal-000001"><span class="s2052389DefaultParagraphFont">Affiant</span></p><p dir="ltr" class="s2052389Normal-000001"><span class="s2052389DefaultParagraphFont">Notary</span></p><p dir="ltr" class="s2052389Normal"><span xml:space="preserve" class="s2052389000002"> </span></p><p dir="ltr" class="s2052389Normal"><span class="s2052389SCL">Source:</span><span xml:space="preserve" class="s2052389SCL-000003"> SL 2014, ch 133, § 32.</span></p></div></body></html>