File No. STATE OF NORTH CAROLINA In The General Court Of Justice Superior Court Division Before The Clerk County IN THE MATTER OF THE ESTATE OF: Name Of Decedent AFFIDAVIT OF NOTICE TO CREDITORS G.S. 28A-14-1, 28A-14-2 NOTE: The second option should be checked only in cases where the decedent had no outstanding debts, or the personal representative has paid in full all known debts. The first option should be checked in all other cases. The undersigned affiant, being first duly sworn, says that: 1. Pursuant to G.S. 28A-14-1, I made a reasonable effort to ascertain all persons, firms and corporations having unsatisfied claims against the decedent and personally delivered or mailed a copy of the Notice to Creditors to all such persons, firms and corporations then known to me, except for those claims that I recognize as valid. 2. No copy of the Notice to Creditors required by G.S. 28A-14-1 was mailed or personally delivered because, after making a reasonable effort within the time provided by law, I am satisfied that there are no persons, firms or corporations having unsatisfied claims against the decedent. (See note below.) NOTE: Signature of only one affiant is necessary. Date Date Signature Of Affiant Signature Of Co-affiant Personal Representative Or Collector Personal Representative Or Collector Attorney For Personal Representative Or Collector Attorney For Personal Representative Or Collector SWORN/AFFIRMED AND SUBSCRIBED TO BEFORE ME SWORN/AFFIRMED AND SUBSCRIBED TO BEFORE ME Date Date Signature Signature Deputy CSC Assistant CSC Date My Commission Expires Clerk Of Superior Court Deputy CSC Assistant CSC Clerk Of Superior Court Date My Commission Expires Notary Notary County Where Notarized SEAL County Where Notarized SEAL AOC-E-307, Rev. 3/07 © 2007 Administrative Office of the Courts American LegalNet, Inc. www.FormsWorkflow.com