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Application For Administration Of Payments To Clerk E-432 - North Carolina
| Application For Administration Of Payments To Clerk Form. This is a North Carolina form and can be used in Estate Statewide . |
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File No. (TYPE OR PRINT IN BLACK INK) STATE OF NORTH CAROLINA In The General Court Of Justice Superior Court Division County Before the Clerk IN THE MATTER OF THE ESTATE OF: APPLICATION FOR Name Of Decedent ADMINISTRATION BY CLERK (Not To Exceed $5,000) G.S. 28A-25-6Date Of Death Social Security No. Of Decedent Marital Status Of Decedent Yes Will? Married Legally Separated Divorced Single No Name And Address Of Petitioner Name And Address Of Surviving Spouse Has a years allowance been allotted?Yes No HEIRS AGE SSN RELATIONSHIP MAILING ADDRESS PETITION The undersigned petitioner, pursuant to G.S. 28A-25-6, shows the Court that the person/entity named below is indebted to the above-named decedent. No administrator has been appointed and the amount owed the decedent does not exceed $5,000.00 and would not make the aggregate sum, which has come into the Clerks hands, exceed the sum of $5,000.00. The petitioner requests the Clerk to authorize all funds held by the person or entity named below be paid to and administered by the Clerk. ASSETS Bank Accounts (List checking, savings, etc., ea. account no. and balance) AMOUNT $ $ $ Uncashed Checks $ $ TOTAL $ FUNERAL EXPENSES Name and Address of Funeral Home Telephone Number of Funeral Home Tax ID No. Total Funeral Expenses Amount Paid Balance Due $ $ $ Persons Who Paid Any Part Of Funeral Expenses (Name, Address And Social Security Number) (Provide Documentation) Name Address SSN Amount $ TOTAL $ AOC-E-432, New, 7/01 (Over) 2001 Administrative Office of the Courts <<<<<<<<<********>>>>>>>>>>>>> 2 OTHER DEBTS Name, Address And Social Security Number Of Creditors Name Address Tax ID No. Amount $ TOTAL $ CERTIFICATION NOTE TO CLERK: Use AOC-E-431 to authorize payment of funds to the clerk. I hereby certify that the information shown above is true and correct to the best of my knowledge and belief. Signature Of Petitioner SWORN AND SUBSCRIBED TO BEFORE ME Date Name Of Petitioner (Type Or Print) Telephone No.Signature Address Deputy CSC Assistant CSC Clerk Of Superior Court AOC-E-432, Side Two, New 7/01 2001 Administrative Office of the Courts
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