Statement As To Death And Presentment Of Instrument In Writing For Probate Download Free Print-Only PDF OR Purchase Interactive PDF Version of this Form
Statement As To Death And Presentment Of Instrument In Writing For Probate Form. This is a Missouri form and can be use in 16th Circuit (Jackson County) Local Circuit Courts.
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Tags: Statement As To Death And Presentment Of Instrument In Writing For Probate, 10050, Missouri Local Circuit Courts, 16th Circuit (Jackson County)
IN THE CIRCUIT COURT OF JACKSON COUNTY, MISSOURI - PROBATE DIVISION
AT
IN THE ESTATE OF
ESTATE NUMBER
,
Deceased.
STATEMENT AS TO DEATH AND PRESENTMENT OF
INSTRUMENT IN WRITING FOR PROBATE
The undersigned states that the above named decedent, who resided at
(street address - city - state - zip code)
died on
at
That the surviving spouse of decedent is
.
(if none, so state)
whose address is
.
That said decedent left
instruments (s) in writing, dated
*
That said instrument dated
is is not self-proved, per Sec. 474.337, RSMO.
*
That said instrument dated
self-proved, per Sec. 474.337, RSMO.
*
That the subscribing witnesses to instrument dated
are
.
*
That the subscribing witnesses to instrument dated
are
.
WHEREFORE, your petitioner prays that after said instrument (s) h
been duly proved, that an order
be entered admitting the same to probate and recorded as the Last Will and Testament of said decedent.
*
Strike out inapplicable statement.
1
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The undersigned swears that the matters set forth are true and correct to the best knowledge and belief of
the undersigned, subject to the penalties of making a false affidavit or declaration.
Date:
.
PETITIONER:
ADDRESS:
TELEPHONE NUMBER:
zip:
(
)
.
ATTORNEY FOR ESTATE; (Give firm name and name of individual attorney who will represent the firm.)
MO Bar No.
ADDRESS:
zip
TELEPHONE NUMBER:
(
)
FAX NUMBER:
(
)
E-MAIL ADDRESS
Form 10050
7/29/96
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