Claim Against Decedents Estate And Or Revocable Trust
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Claim Against Decedents Estate And Or Revocable Trust Form. This is a District Of Columbia form and can be use in Superior Court Statewide.
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SUPERIOR COURT OF THE DISTRICT OF COLUMBIA
PROBATE DIVISION
Estate of
Adm. No.
Trust of
TR. No.
CLAIM AGAINST DECEDENT’S ESTATE and/or REVOCABLE TRUST
The claimant named below certifies that (check the applicable box[es])
The claimant makes claim for_______________________________________.
The claimant makes claim for costs of administration of the settlor decedent’s estate in
the amount of________________for____________________________.
The claimant makes claim for the expenses of the settlor decedent’s funeral and
disposal of remains in the amount of____________________________________.
The claimant makes claim for the homestead allowance, or a portion thereof in the
amount of_____________ ,as provided by D.C. Code § 19-101.02.
The claimant makes claim for the exempt property allowance, or a portion thereof in
the amount of______________ , as provided by D.C. Code § 19-101.03.
The claimant makes claim for the family allowance, or a portion thereof in the amount
of______________, as provided by D. C. Code § 19-101.04.
On behalf of the claimant named below, I do solemnly declare and affirm under penalty
of law that the contents of the foregoing document are true and correct to the best of my
knowledge and belief.
Decedent died on ______________________ and was a resident of ________________
_________________________
Name of Claimant
________________________
_____________________________
Signature of claimant or person
authorized to make verification on
behalf of Claimant
Address
_____________________________________
_____________________________________
All claims presented to the Register of Wills must be accompanied by check or money
order in the amount of $ 5.00.
I hereby certify that I have delivered or mailed, return receipt requested, a copy hereof to
the personal representative of the estate
of______________________________________and/or___________________________
_____________________trustee of the revocable trust
of________________________this_________day of___________, 200_.
_________________
Claimant
For Register of Wills Use Only
Date Filed:
By______________________
Deputy Register of Wills
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