Death Certificate

THIS DEATH CERTIFICATE is executed on [execution_date] at [place]

 

BETWEEN

[party1_name], resident of [party1_address] (First Party)

 

AND

 

[party2_name], resident of [party2_address] (Second Party).

 

The parties hereby agree to the terms recorded in this Death Certificate on the date above.

 

IN WITNESS WHEREOF the parties have signed this Death Certificate on the day and year first above written.

 

_________________________ _________________________

First Party Second Party