Affidavit for Collection of Personal Property
The undersigned state(s) as follows:
1. died on , 20, in the County of , State of .
2. At least 40 days have elapsed since the death of the decedent, as shown in a certified copy of the decedent's death certificate attached to this affidavit or declaration.
3. No proceeding is now being or has been conducted in for administration of the decedent's estate.
The decedent's personal representative has consented in writing to the payment, transfer, or delivery to the affiant or declarant of the property described in the affidavit or declaration.
4. The current gross fair market value of the decedent's real and personal property in , excluding the property described in of the , does not exceed one hundred fifty thousand dollars ($150,000).
5. An inventory and appraisal of the real property included in the decedent’s estate is attached.
There is no real property in the estate.
6. The following property to be transferred, delivered, or paid to the affiant under the provisions of :
7. The successor(s) of the decedent, as defined in is/are:
8. The undersigned
The affiant or declarant is the successor of the decedent (as defined in ) to the decedent's interest in the described property.
The affiant or declarant is authorized under to act on
behalf of the successor of the decedent (as defined in ) with
respect to the decedent's interest in the described property.
9. No other person has a superior right to the interest of the decedent in the described property.
10. The affiant or declarant requests that the described property be paid, delivered, or transferred to the affiant or declarant.
The affiant or declarant affirms or declares under penalty of perjury under the laws of the State of that the foregoing is true and correct.
County of )
On before me ,
personally appeared who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of that the foregoing paragraph is true and correct.
WITNESS my hand and official seal.
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