Estate of First, middle, and last name 1. � Name was the decedent222s conservator at the time of the decedent222s death. 2. � I am: � � the duly appointed personal representative of the decedent (copy of letters of authority attached). � � a person entitled to delivery of assets under MCL 700.3983 (copy of affidavit attached). � � a person entitled to assignment of property under MCL 700.3982 (copy of order of assignment attached). 3. � I received the following property from the conservator: (describe property received) Date � Signature � Name (type or print) Attorney name (type or print) Bar no. Address City, state, zip Telephone no. American LegalNet, Inc. www.FormsWorkFlow.com