Claim Against Estate Form. This is a Missouri form and can be use in 22nd Circuit (St. Louis City) Local Circuit Courts.
Tags: Claim Against Estate, Missouri Local Circuit Courts, 22nd Circuit (St. Louis City)
MISSOURI CIRCUIT COURT, TWENTY-SECOND JUDICIAL CIRCUIT PROBATE DIVISION, CITY OF ST. LOUIS In the estate of _____________________________________________ No. _______________________ Deceased/Disabled CLAIM AGAINST ESTATE Claimant, _____________________________________________________, makes a claim against this estate for $ ___________________________________, in accordance with the ATTACHED ITEMIZED STATEMENT describing the nature and amount of the claim. Claimant holds security as follows: The undersigned, having knowledge of the facts, states that to the best of undersigned’s knowledge and belief, claimant has given the estate credit for all payments and offsets to which it is entitled, the balance claimed is justly due, the allegations herein are made under oath or affirmation, and the representations are true and correct to the best of undersigned’s knowledge and belief, subject to the penalties of making a false affidavit or declaration. Signed this ______ day of _____________________, _______. ________________________________ Full Firm Name By: _____________________________ _______________________________ Signature of Individual Claimant _______________________________ Name of Individual Claimant (Typed) Title: ____________________________ ________________________________________________________________________ Street Address City State Zip Code ________________________________________________________________________ Claimant’s Attorney Street Address City State Zip Code WAIVER OF SERVICE OF NOTICE OF CLAIM; CONSENT TO ALLOWANCE (Check applicable statements) ( ) Service of notice of the above claim is hereby waived. ( ) Consent to allow the claim in the amount of $ __________________ is hereby given. Signed this ________ day of _______________________, 20________. _________________________________ ________________________________ Signature of Attorney Signature of Personal Rep./Conservator ORDER ALLOWING CLAIM This ___________ day of ___________________, 20 _______, the court ALLOWS the claim of ________________________________________________ in the amount of $ _______________________. ___________________________________ JUDGE/COMMISSIONER/DEPUTY COMMISSIONER American LegalNet, Inc. www.FormsWorkflow.com CERTIFICATE OF SERVICE I hereby certify that I sent, by ordinary mail, a true Copy of this claim to the Personal Representative/Conservator of Said estate on the _____________________________ day of __________________________, 20 _________. Patrick J. Connaghan Clerk of the Probate Division By _____________________________________ Deputy Clerk American LegalNet, Inc. www.FormsWorkflow.com