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Certificate Of Mailing (Intestate) Form. This is a Nevada form and can be use in Clark County.
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Tags: Certificate Of Mailing (Intestate), Nevada County, Clark
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CERT
_____________________________
Name
_____________________________
Address
_____________________________
City, State, Zip Code
_____________________________
Telephone number/ E-Mail Address
IN PROPER PERSON
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DISTRICT COURT
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CLARK COUNTY, NEVADA
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In the Matter of the Estate of: )
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) Case No. P__________
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) Dept. No. PC-1
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Deceased.
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CERTIFICATE OF MAILING
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I HEREBY CERTIFY that service of the Notice of Hearing re:
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Petition to Set Aside the Estate Without Administration was made
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this ____ day of ___________________ (month), 20_____ (year), by
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depositing a copy of the same in the U.S. Mail, postage prepaid,
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regular mail, addressed to:
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Welfare and all beneficiaries and heirs)
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State of Nevada Dept. of Health and Human Services,
Medicaid Estate Recovery, 1000 East Williams Street, #102,
Carson City, NV 89701
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___________________________________________________________
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___________________________________________________________
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4.
___________________________________________________________
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5.
___________________________________________________________
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___________________________________________________________
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(you are required by statute to mail to Nevada State
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T:PACKETS\FORM – Certificate of Mailing.Intestate.doc
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10. ___________________________________________________________
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11. ___________________________________________________________
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12. ___________________________________________________________
DATED this ____ day of ___________, 20_____.
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Respectfully submitted,
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By:
________________________
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(signature)
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________________________
(print name)
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IN PROPER PERSON
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Page 2 of 2
T:PACKETS\FORM – Certificate of Mailing.Intestate.doc
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