Name of Person Filing: Street Address: City, State, Zip Code: Telephone Number: Email Address: ATLAS Number (if applicable) Representing Self (No Attorney) If Attorney, Bar Number: or Represented by Attorney SUPERIOR COURT OF ARIZONA PINAL COUNTY In the Matter of the Estate of CASE NUMBER: PB 2 PROOF OF DELIVERY OR MAILING OR PUBLISHING NOTICE TO CREDITORS OF INFORMAL APPOINTMENT OF PERSONAL REPRESENTATIVE AND/OR INFORMAL REBATE OF A WILL an Adult a Minor, deceased HONORABLE: STATE OF ARIZONA County of Pinal 1. ) ) ss. Notice. I delivered or mailed by first class mail, postage prepaid a copy of the Notice to Creditors to the following known creditors entitled to such notice (if you need more room, attach a sheet of paper): Name Address Date Mailed or Delivered 2. Publication. The Notice to Creditors was published in the following newspaper on the following dates. The Affidavit of Publication is filed separately. Name of newspaper: Dates of publication: A. / / B. / / C. / / Page 1 of 2 PB_APR_COSCPinal_03.07.12 Use only most current version American LegalNet, Inc. www.FormsWorkFlow.com Signature: Print Name: SUBSCRIBED AND SWORN TO before me this My Commission Expires: By day of 20 (Deputy Clerk / Notary Public) Page 2 of 2 PB_APR_COSCPinal_03.07.12 Use only most current version American LegalNet, Inc. www.FormsWorkFlow.com