Small Estate Affidavit
State of
County of
In the matter of the estate of
Decedent's information
Full name:
Date of death:
Last address:
Affiant's information
Full name:
Relationship to the Decedent:
Address:
Estate information
The total estimated value of the Decedent's estate is approximately . The assets and debts of the estate are as follows:
List of assets and property
List of debts and liabilities
The heirs
All heirs, devisees, or possible beneficiaries of the Decedent (the "Heirs") are listed below:
Name:
Relationship:
Address:
Transfer of the property
Based on the information given in this Affidavit, the Decedent's assets and property shall be distributed between the Decedent's Heirs as follows:
Affidavit statements
I, the undersigned Affiant, being of legal age, duly sworn, declare that to the best of my knowledge and belief, the Decedent's estate meets the legal criteria for a small estate as defined by the laws of the State of .
I further declare that I am entitled to receive the assets of the Decedent's estate. I am willing to accept responsibility for distributing these assets to the rightful Heirs and creditors. I also declare that there is no pending administration of the Decedent's estate, and there is no reasonable expectation that probate of the Decedent's estate will soon or ever commence.
Sworn and subscribed
I swear, under penalty of perjury, that the information provided in this Small Estate Affidavit is true and accurate to the best of my knowledge.
This Affidavit was made on .
_______________________________
(Place for signature)
State of
Acting in the county of
On , before me, , personally appeared , who proved to me, based on satisfactory evidence, to be the person whose name is subscribed to the within instrument and acknowledged to me that they executed the same in their authorized capacities and that by their signature on the instrument, the person or the entity upon behalf of which the person acted, executed the instrument. I certify, under the penalty of the laws of the governing state, that the foregoing paragraph is true and correct.
Witness my hand and the official seal.
___________________________________
Place for signature
______________________________________
Notary public's name and seal