NAME, ADDRESS, AND TELEPHONE NUMBER OF ATTORNEY OR PARTY WITHOUT ATTORNEY: Reserved for Clerk’s File Stamp STATE BAR NUMBER ATTORNEY FOR (Name): SUPERIOR COURT OF CALIFORNIA, COUNTY OF LOS ANGELES COURTHOUSE ADDRESS: Estate of: CASE NUMBER: AFFIDAVIT OR DECLARATION FOR FINAL DISCHARGE AND ORDER The undersigned, as ______________________________________ of the above-entitled estate, declare(s) that distribution has been made of all estate property as required by the order(s) for distribution made in this proceeding, and that all required acts have been performed as follows: (check all that apply) All personal property, including but not limited to, money, stocks, bonds and other securities, have been delivered to the distributee(s) as ordered herein; that the receipt(s) of the distributee(s) is/are now on file. No personal property is on hand for distribution. The personal representative’s statement, with respect to real property, is on file identifying the date and place of the recording and other appropriate recording information for the court order for distribution or the personal representative's deed. No real property is on hand for distribution. The Affiant(s)/Declarant(s) is/are the sole distributee(s). I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date: ____________________ ___________________________________________ Signature of Affiant or Declarant ___________________________________________ Print Name of Affiant or Declarant ORDER FOR FINAL DISCHARGE It appearing that all acts of above named Affiant/Declarant were performed as required by law; IT IS ORDERED, ADJUDGED AND DECREED: That ______________________________________ as _____________________________________________ be discharged as such and sureties are herby released from liability for all acts subsequent hereto. Date: ____________________ __________________________________________________ Judge of the Superior Court AFFIDAVIT OR DECLARATION FOR FINAL DISCHARGE AND ORDER PRO 002 01-02 Probate Code §§ 11753(a)(b) and 12250(a) 2002 © American LegalNet, Inc.