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Affidavit As To Small Estate - Tennessee
| Affidavit As To Small Estate Form. This is a Tennessee form and can be used in General Probate Court Shelby Local County . |
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IN THE PROBATE COURT OF SHELBY COUNTY, TENNESSEE IN RE: ESTATE OF _________________________ DOCKET NO: ______________ DECEASED AFFIDAVIT AS TO SMALL ESTATE The undersigned, _____________________________________(Affiant), pursuant to the provisions of Tennessee Code Annotated 30-4-101, et seq., would respectfully state under oath as follows: A. ___________________________________________________(Decedent), age _____, died on the _________ day of _________________, 20_____, and was a resident of Shelby County Tennessee, at the date of death. The Decedents address at date of death was:____________________________________________________________________ . B. CHECK APPROPRIATE PROVISION: _______The Decedent left no will. O r _______The Decedent left a will and the will is attached to this Affidavit as Exhibit A. C. The name, age, address, and relationship of each heir at law or beneficiary entitled to receive any of the Decedents property, including Affiant, are as follows: Name Address A ge Relationship _____________________ ___________________________ _______ ___________ _____________________ ___________________________ _______ ___________ _____________________ ___________________________ _______ ___________ _____________________ ___________________________ _______ ___________ _____________________ ___________________________ _______ ___________ _____________________ ___________________________ _______ ___________ _____________________ ___________________________ _______ ___________ <<<<<<<<<********>>>>>>>>>>>>> 2D. The following is an itemized description and the value of all the Decedents property, excluding real estate. The names and addresses of all persons known to have possession of any of the Decedents property are included. Insurance pocies on decedents life thli at are payable to the Decedents estate are also included. Additionally included are: bank accounts, cash, vehicles, stocks, bonds, equipment, furniture and furnishings, and all other assets of the Decedent. Assets that pass automatically by operation of law, such as joint accounts, are not included here. Items of Property Location V alue ______________________ _________________________________ ___________ ______________________ _________________________________ ___________ ______________________ _________________________________ ___________ ______________________ _________________________________ ___________ ______________________ _________________________________ ___________ ______________________ _________________________________ ___________ ______________________ _________________________________ ___________ ______________________ _________________________________ ___________ (If necessary, attach separate sheet) Total value of Probate Estate $__________ E. The following is a list of unpaid debts left by the Decedent and the name and address of each creditor and the amount due. Creditor Address Amount ______________________ _________________________________ ___________ ______________________ _________________________________ ___________ ______________________ _________________________________ ___________ ______________________ _________________________________ ___________ ______________________ _________________________________ ___________ ______________________ _________________________________ ___________ (if other debts attach separate sheet) TotalDebt of Estate $________________ <<<<<<<<<********>>>>>>>>>>>>> 3F. Affiant elects to give notice to creditors in the manner required on regular administrations. ________Yes ________No (If elected, all provisions of T.C.A. 30-2-306 through 30-2-321 shall apply) Affiant evidences by signature hereto, subject to the penalties for perjury, that the statements contained in this Affidavit are true, are neither false nor misleading, and that the Affiant is mindful of all duties imposed by law. Affiant agrees to collect and presve all asseer ts of the estate and to file tax returns as required by law. Affiant also agrees to pay or reimburse funeral expenses, administration expenses, and creditors fom the assets of the estate. Furthermore, r Affiant agrees to distribute the remainder of the estate in accordance with the decedents valid will, or if no will, then according to the laws of descent and distribution of the State of Tennessee. Affiant makes oath that the facts contained in the foregoing Affidavit are true and correct to the best of the Affiants belief. Sworn to this ________ day of __________________, _________. ____________________________________ A ffiant ____________________________________ ____________________________________ A ddress ____________________________________ Telephone No. STATE OF TENNESSEE, SHELBY COUNTY The Affiant personally appeared before mChris Thome, as, Clerk of the Probate Court of Shelby County Tennessee, after being duly sworn, stated under oath, that the facts averred in the above affidavit are true to the best of affiants knowledge, information, and belief. This ________ day of _______________________, _________ CHRIS THOMAS, CLERK By___________________________D. C. NOTE: Bond shall be made for the total value of the estate as shown in (C) above, provided however that bond may be waived by a Judge of the Probate Court iall heirs at law request in writing that tf he bond be waived for the affiant. Since the will is not being proved and therefore is not admitted to Probate, a waiver requested by the will cannot be granted.
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