Return of Claims and List of Notified Creditors CONNECTICUT PROBATE COURTS PC - 237 REV. 7 /1 8 Return of Claims and List of Notified Creditors PC - 237 Page 1 of 2 Instructions: 1) A claim is a debt incurred during the decedent222s lifetime and unpaid at the time of death. 2)A fiduciary may use this form to list all claims against the estate presented to the fiduciary pursuant toC.G.S. section 45a-361 and to list all persons notified pursuant to C.G.S. section 45a-357. A fiduciary may also use this form as a fiduciary222s report in an insolvent estate pursuant to C.G.S. section 45a-380. 3)The fiduciary is required to file a return and list of claims within 60 days of the expiration of the 150-dayclaims period under C.G.S. section 45a-361. 4)List the name and address of the claimant and provide a short description of the claim, the totalamount of the claim, the amount disallowed (if any) and the date of written disallowance, and the amount allowed. If the assets of the estate are insufficient to pay administration expenses and claims against the estate allowed by the fiduciary, refer to insolvency procedures under C.G.S. section 45a-376 et seq. 5)For more information, see C.G.S. section 45a-353 et seq. 6) Type or print the form in ink. Use an additional sheet , or PC - 180, if more space is needed . Probate Court Name District Number Estate of Fiduciary INITIAL RETURN AND LIST OF CLAIMS SUBSTITUTE OR CORRECTED SUPPLEMENTAL THE FIDUCIARY(IES) represents that: All claims presented to the fiduciary against the estate are set forth below. The names of all creditors who were notified by certified or registered mail in accordance with C.G.S. section 45a-357 (a) (solvent estates) or C.G.S. section 45a-378 (insolvent estates) are attached hereto and made a part hereof. Name and Address of Claimant Description of Claim Total Amount of Claim Amount Disallowed, if any Date of Written Disallowance Amount Allowed 1. 2. 3. American LegalNet, Inc. www.FormsWorkFlow.com Return of Claims and List of Notified Creditors CONNECTICUT PROBATE COURTS PC - 237 REV. 7 /1 8 Return of Claims and List of Notified Creditors PC - 237 Page 2 of 2 Name and Address of Claimant Description of Claim Total Amount of Claim Amount Disallowed, if any Date of Written Disallowance Amount Allowed 4 . 5 . 6 . 7 . 8 . 9 . Total Amount Allowed: The representations contained herein are made under the penalty of false statement. Signature of Fiduciary Type or Print Name Date Signature of Fiduciary Type or Print Name Date American LegalNet, Inc. www.FormsWorkFlow.com