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Petition for Summary Assignment (Formal Administration) PR-1840 - Wisconsin
| Petition for Summary Assignment (Formal Administration) Form. This is a Wisconsin form and can be used in Probate Circuit Court Statewide . |
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STATE OF WISCONSIN, CIRCUIT COURT, COUNTY Amended For Official Use IN THE MATTER OF THE ESTATE OF Petition for Summary Assignment with Special Administration (Formal Administration) Case No. UNDER OATH, I STATE: 1. The decedent, with date of birth was domiciled in address of and date of death County, State of , , with a mailing . 2. The petitioner is interested as . 3. The estate is one properly settled under summary assignment in that the estate, less the amount of the debts for which any property in the estate is security, does not exceed $50,000 in value and cannot be summarily settled under §867.01, Wis. Stat. 4. The estate of the decedent started under formal administration or summary settlement, meets the requirements for termination under summary assignment of small estates. 5. After reasonable search A. a will dated B. no will of the decedent was found. was filed or accompanies this petition. 6. A detailed statement of all property subject to administration including any encumbrance, lien, or other charge against See attached each is as follows: Description of Property Value of Decedent's (Include real estate, stocks or bonds, licensed motor vehicles and all other property) Interest at Date of Death A. Total value of property subject to administration $ B. Minus total value of encumbrances, liens or other charges against each item of property ($ ) C. Net value of property subject to administration TOTAL (Value from Section A less total from Section B) $ Property will be provided by affidavit at a later date. PR-1840, 10/10 Petition for Summary Assignment (Formal Administration) §867.02, Wisconsin Statutes Page 1 of 3 American LegalNet, Inc. www.FormsWorkFlow.com This form shall not be modified. It may be supplemented with additional material. Petition for Summary Assignment (Formal Administration) Page 2 of 3 Case No. 7. The decedent had a life estate or interest as a joint tenant or there is property which is security for a debt in which decedent had such interests for which a certificate has not been issued. Any real estate in which the decedent had See attached this interest is described as follows: Decedent's Interest Description of Property 8. The names and mailing addresses of all creditors of the decedent or the decedent's estate of whom the petitioner has See attached knowledge and the amounts of their claims are as follows: Claim Amount Mailing Address Name of Creditor $ Creditors will be named by affidavit at a later date. 9. The names and mailing addresses of all persons interested, so far as known to petitioner or ascertainable by the See attached petitioner with reasonable diligence are as follows: (Indicate persons with disabilities, also list any guardian of estate; for any person in the military; also list attorney or attorney in fact; and for any minor, list date of birth.) Name Relationship Mailing Address If Minor, Date of Birth 10. The decedent did not did did not did did did was did not did not was not receive Medical Assistance/Medicaid. receive Family Care and/or Partnership benefits (through a Managed Care Organization MCO/CMO). receive benefits from the Community Options Program (COP). receive benefits from Wisconsin Chronic Disease Program. a patient or inmate of a state or county hospital or institution, or responsible for any person owing an obligation to the state or county. Explain: The affiant lacks information to complete this section. See attached.) 11. If the decedent was ever married, complete the following: (If more than one spouse, deceased) Name of spouse ( living or Divorced from decedent at time of decedent's death. Married to decedent did not receive benefits from the Community Options Program (COP). did The spouse did not receive benefits from the Wisconsin Chronic Disease Program. did The spouse The affiant lacks information to complete this section. PR-1840, 10/10 Petition for Summary Assignment (Formal Administration) . §867.02, Wisconsin Statutes Page 2 of 3 American LegalNet, Inc. www.FormsWorkFlow.com This form shall not be modified. It may be supplemented with additional material. Petition for Summary Assignment (Formal Administration) Page 3 of 3 Case No. 12. It is necessary to appoint a special administrator with the following powers: 13. Other: I REQUEST THE COURT: 1. Assign the property to the persons entitled to it as follows: Description of Property Person(s) Entitled to Receive See attached (Include real estate, stocks or bonds, licensed motor vehicles and all other property) Value $ 2. Order any person indebted to or holding money or other property of the decedent to pay the indebtedness or deliver the property to the persons found to be entitled to receive it. 3. Certify the termination of any life estate or the right of survivorship of any joint tenant in the property described. 4. Order termination of the estate commenced under Chapter 856, discharge the personal representative and cancel any bond. 5. Appoint (Name) whose mailing address is as special administrator with the powers requested. , 6. Other: State of County of Subscribed and sworn to before me on Petitioner Name Printed or Typed Notary Public/Court Official Address Name Printed or Typed My commission/term expires: Form completed by: (Name) Telephone Number Address Date Telephone Number Bar Number PR-1840, 10/10 Petition for Summary Assignment (Formal Administration) §867.02, Wisconsin Statutes Page 3 of 3 American LegalNet, Inc. www.FormsWorkFlow.com This form shall not be modified. It may be supplemented with additional material.
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