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Estate Claim
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Description
Estate of _________________________________________________________________ Deceased, To Dr. STATE OF INDIANA, _________________________________________ COUNTY, SS: BEFORE the Clerk of the Circuit / Superior Court of said County and State personally appeared ________________________________________________________ who being by me duly sworn, says that (person filing claim) the above account, in favor of _________________________________________________________________ (name of claimant) against the estate of _________________________________________________________________________ (name of deceased) deceased, is correct; that no payments have been made thereon except the credits thereon given; that there are no set-offs against the same to his knowledge; that the balance shown in said account, to wit: ____________________________________________________________________________ DOLLARS, (amount of claim) is now justly due and owing to _________________________________________________________________ (name of claimant) all of which he verily believes. _____________________________________________ (Signature) Subscribed and sworn to before me, on the __________ day of ____________________, ___________ ________________________________________ Clerk. American LegalNet, Inc. www.FormsWorkFlow.com
