Claim Against Estate
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Claim Against Estate Form. This is a Missouri form and can be use in 23rd Circuit (Jefferson County) Local Circuit Courts.
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Tags: Claim Against Estate, Missouri Local Circuit Courts, 23rd Circuit (Jefferson County)
IN THE CIRCUIT COURT OF JEFFERSON COUNTY, MISSOURI
AT
IN THE ESTATE OF
Deceased.
ESTATE NUMBER
,
Protectee.
CLAIM AGAINST ESTATE
(See. 473.360 and 475.205 RSMo)
The undersigned states that claimant is
of
Street in State of
and is a
(corporation) (partnership) (individual) and that there is due claimant from this estate the sum of $
on account of
.
(describe nature of claim)
An itemized statement of claim showing dates and amounts is attached hereto and incorporated herein by
this reference as Exhibit A.
The claimant holds security for said claim as follows:
.
(If none, so state; otherwise describe.)
Affiant states affiant is (claimant) (agent) (attorney) (officer) for claimant and that claimant has given credit
to said estate for payments and offsets to which it is entitled and that the balance claimed as above stated is justly
due.
The undersigned swears that the matters set forth in the foregoing pleading are true and correct
according to the undersigned's best knowledge and belief and subject to penalty for making a false affidavit or
declaration.
Dated:
Affiant:
Address:
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*
Service of all notice is waived:
*
Consent for immediate hearing is given:
*
Consent is given to judgment allowing claim for $
part not agreed to.)
*
Strike words not applicable.
(If signed, strike any
Personal Representative
Date of first publication:
Conservator
. Claim allowed on
, in the amount of $
and placed in Class
Judge
Commissioner
INSTRUCTIONS AS TO CLAIMS AGAINST ESTATE
For instructions as to making claims against estate, see Sec. 473.360 RSMO, et seq. as to decedent's estates and Sec.
475.205 et seq. as to conservator ship estates.
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