AFFIDAVITFORCOLLECTIONOFPERSONALPROPERTYSTATE OF ARIZONA) ) ss.COUNTY OF), being duly sworn, on oath deposes and say : died on, in the County of, State of, more than thirty days prior to execution ofthis Affidavit.Checkeither1(a)or1(b):1.(a)Affiant is the successor of the decedent, entitled to decedents property by Will or intestate succession and the value of all of the personal property in the decedents estate, wherever located, less liens and encumbrances, does not exceed Fifty Thousand Dollars ($50,000).(b)Affiant is claiming as thesurvivingspousedependentchildof decedentand the value of all personal property in the decedents estate, wherever located, less liens and encumbrances, does not exceed the greater of either Fifty Thousand Dollars ($50,000) or the total sums permitted as the allowance in lieu of homestead, exempt property, and the family allowance, pursuant to Arizona Revised Statutes, in effect on the date of the decedents death.Checkeither2(a)or2(b):2.(a)No application or petition for the appointment of a personal representative is pending or has been granted in any jurisdiction.(b)A personal representative has been appointed and EITHERhas beenmore than one year has elapsed since a closing statementdischarged ORwas filed AND, as of the date of this Affidavit, Fifty Thousand Dollars ($50,000) has not been exceeded.1 of 2 02/04/002001 © American LegalNet, Inc.3.Decedent owned the following personal property:4.The affiant is entitled to receive payment of any debt due the decedent and to receive decedents tangible personal property or an instrument evidencing the transfer to affiant of any debt, obligation, stock or chose in action belonging to decedent.This Affidavit is made pursuant to A.R.S. §14-3971, as amended, for the purpose of making claim to property of the decedent under said statute.DateAffiants SignatureAffiants Printed NameSUBSCRIBED AND SWORN TO before me on.My Commission Expires:Notary Public2 of 2 02/04/002001 © American LegalNet, Inc.
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