W. Va. Code § 41-5-13
(b) Where a will, relative only to real estate situate within this state, has been proved or probated outside of this state by another state or jurisdiction within the United States of America and no appointment of an ancillary personal representative, executor, or administrator to administer the real estate within this state is necessary for any proper purpose, an authenticated copy thereof and the certificate of probate thereof may be admitted to record in any county of this state in which the real estate is situate by any person having an interest in the real estate, including a personal representative who has qualified in the other state or jurisdiction.
(1) The interested person or personal representative shall also execute and tender for recording in the county an affidavit setting forth in substance:
(c) A document substantially in the form may be used as the affidavit provided in subsection (b) of this section with the effect as prescribed in this section:
THE COUNTY COMMISSION OF _________ COUNTY, WEST VIRGINIA
IN RE: THE ESTATE OF _____________________
DOD: _________________
AFFIDAVIT FOR ANCILLARY ADMINISTRATION
OF WEST VIRGINIA REAL ESTATE
WITHOUT APPOINTMENT
(TESTATE)
STATE OF ____________,
COUINTY OF __________, to-wit:
I, _____________________________, whose address is __________________
_____________________________________________________________________
being first duly sworn, upon oath and under penalty of perjury, do depose an say as follows:
1. The decedent, _____________________________, died testate (with a will) on ________________(date of death), a resident of _____________ County, State of ____________________.
2. On ______________________(date), the following person(s) was/were appointed as the personal representative of the Estate of _________________ by the ____________________(name of the foreign court), of ___________________ (county), ____________________(state),being case number ______________, if applicable:
a. Name:
___________________________________________________________________
Address: _______________________________________________________________________________
b. Name:
___________________________________________________________________
Address: _______________________________________________________________________________
3. An authenticated copy of the Last Will and Testament dated _____________ and the certificate of probate of such other state or jurisdiction is being furnished herewith for recording in the County
4. The Decedent died owning and possessing the following real estate situate in West Virginia:
| Description | County | Assessed Value | Fair Market value | |
| a. | ||||
| b. | ||||
| c. | ||||
| d. | ||||
| Total |
5. Pursuant to the provisions of the Last Will and Testament of _____________________, the decedent devised the aforesaid real estate to the following beneficiaries of the estate:
a. Name: ________________________________________________________
Address: _____________________________________________________
Relationship to Decedent:_____________________________________
Share or percentage: _______________
b. Name: ________________________________________________________
Address: _____________________________________________________
Relationship to Decedent:_____________________________________
Share or percentage: _______________
c. Name: ________________________________________________________
Address: _____________________________________________________
Relationship to Decedent:_____________________________________
Share or percentage: _______________
d. Name: ________________________________________________________
Address: _____________________________________________________
Relationship to Decedent:_____________________________________
Share or percentage: _______________
6. The Estate of ______________, the decedent, will be/has been fully administered by the domiciliary personal representative under the domiciliary proceedings in the other state or jurisdiction. No appointment of an ancillary personal representative to administer the decedent's real estate within the State of West Virginia is necessary for any proper purpose.
7. I have personel knowledge of the above facts and am interested in the Estate of _____________________, the decedent, as the () acting domiciliary personal representative, () surviving spouse, () beneficiary under the decedent's will, () heir at law, or () other ________________________________ (describe relationship or interest). [Check one]
__________________________________
Signature of Affiant
Taken, subscribed, and sworn to before me the undersigned authority by ____________________________, this day of _________________, 20_______.
{seal}
My Commission expires: _______________________________________
______________________________________________________________
Notary Public