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Notice To Public Entities RI-PR054 - California

Notice To Public Entities Form. This is a California form and can be used in Probate Riverside Local County .
 Fillable pdf Last Modified 6/20/2014
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SUPERIOR COURT OF CALIFORNIA, COUNTY OF RIVERSIDE INDIO 42-600 Oasis St., Indio, CA 92201 RIVERSIDE 4050 Main St., Riverside, CA 92501 ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar Number and Address) TEMECULA 41002 County Center Dr., #100, Temecula, CA 92591 RI-PR054 FOR COURT USE ONLY TELEPHONE NO.: E-MAIL ADDRESS (Optional): ATTORNEY FOR (Name): IN THE MATTER OF: FAX NO. (Optional): CASE NUMBER: NOTICE TO PUBLIC ENTITIES Probate Code §§ 9200-9201, 19201 ­ Government Code § 811.2 1. You are hereby given notice of death of the following person: a. b. 2. Decedent's Name: Date of Death: The party providing you with this notice is as follows: a. b. c. d. Name: Address: Telephone: Capacity: Estate Attorney, Personal Representative, Trustee 3. A case has been opened for claims to be filed under Probate Code § 9201 or 19201 as follows: a. b. c. Case Name: Case Number: SUPERIOR COURT OF CALIFORNIA, COUNTY OF Riverside STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME: 4. If you have a claim against the above-mentioned estate(s), please forward documentation to the address indicated in item 2 above. Date: (SIGNATURE OF PARTY PROVIDING NOTICE) Page 1 of 2 Approved for Optional Use Riverside Superior Court RI-PR054 [Rev.02/26/14] NOTICE TO PUBLIC ENTITIES Probate Code §§ 9200-9201, 19201 ­ Government Code § 811.2 Probate Code §§ 9200-9201 Government Code § 811.2 riverside.courts.ca.gov/localfrms/localfrms.shtml American LegalNet, Inc. www.FormsWorkFlow.com IN THE MATTER OF: CASE NUMBER: PROOF OF SERVICE BY MAIL 1. 2. I am over the age of 18 and am not a party in this cause. I am a resident of or employed in the county where the mailing occurred. My (the servers) home or business address is : (STREET ADDRESS) (CITY, STATE, ZIP) 3. I served the forgoing Notice to Public Entities by enclosing a copy in an envelope addressed to: Employment Development Department Post Office Box 826880 Sacramento, CA 94280-0001 State Board of Equalization Post Office Box 942879 Sacramento, CA 94279-0001 and depositing the sealed envelope with the United State Postal Service with the postage fully prepaid. 4. Date mailed: Place mailed (city,state): I declare under penalty of perjury under the laws of the State of California that the information above is true and correct. Date: (SIGNATURE OF DECLARANT) Approved for Optional Use Riverside Superior Court RI-PR054 [Rev. 02/26/14] NOTICE TO PUBLIC ENTITIES Probate Code §§ 9200-9201, 19201 ­ Government Code § 811.2 Probate Code §§ 9200-9201 Government Code § 811.2 riverside.courts.ca.gov/localfrms.shtml American LegalNet, Inc. www.FormsWorkFlow.com
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