Statement Disallowing Claims {PC-7.5}

PC-7.5 (11/02, formerly SW-33) Statement Disallowing Claims Date filed: _____________________ Court us e only STATE OF RHODE ISLAND County of ___________________________________ PROBATE COURT OF THE Estate of ____________________________________ _________________________________________________ Alias _______________________________________ Alias _______________________________________ No. ____________________ ____________________ Date STATEMENT DISALLOWING CLAIMS The undersigned hereby disallows the following claims filed in the office of the clerk. CLAIMANT AMOUNT OF CLAIM ______________________________________ ______________________________________ Signature of Fiduciary Signature of Fid uciary ______________________________________ ______________________________________ Title of Fiduciary Title of Fiduciary