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Statement Of Claim (Probate) - Florida
| Statement Of Claim (Probate) Form. This is a Florida form and can be used in General Manatee Local County . |
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For your convenience, you may print this creditors Statement of Claim form, shown below, and mail to our office for filing. There is no fee to file this form. Florida Probate Rule 5.490 requires that the Claimin duplicate with one copy containing an be filed original signature. The clerk will mail the copy of the claim to the Attorney for the Personal Representative. American LegalNet, Inc. www.USCourtForms.com<<<<<<<<<********>>>>>>>>>>>>> 2 IN THE CIRCUIT COURT FOR MANATEE COUNTY, FLORIDA CASE NO.___________________ IN RE: ESTATE OF: __________________________________ __________________________________ Deceased. STATEMENT OF CLAIM The undersigned hereby presents for filing against the above estate this Statement of Claim and alleges: 1. The basis of the claim is_______________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ 2. The name and address of the Claimant are_________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ and the name and address of the claimants attorney, if any, are___________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ 3. The amount of the claim$ _______________ is _______________, which amount is now due, or, if not due, will become due on ______________________________________________________ 4. The claim (is) (is not) contingent or unliquidated. If contingent or unliquidated the nature of the uncertainty is _______________________________________________________________________ ______________________________________________________________________________________ 5. The claim (is) (is not) secured. If secured, the security consists of ______________________ ______________________________________________________________________________________ CLERKS USE ONLY Under penalties of perjury, I declare that I have I hereby certify that a copy of the Statement ead the rforegoing, and te hfacts alleged are true, Of Claim has been mailed to the foregoing on to the best of my knowledge and belief. _____________________________________ Signed on__________________________________ Attorney ___________________________________________ ______________________________________ Claimant ______________________________________ ___________________________________________ R. B. SHORE, CLERK OF CIRCUIT COURT Attorney for Claimant MANATEE COUNTY, BRADENTON, FLORIDA Florida Bar #________________________________ By: ____________________________________ Telephone __________________________________ Deputy Clerk American LegalNet, Inc. www.USCourtForms.com
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