Affidavit For Collection Of Personal Property Pursuant To Small Estate Proceeding Download Free Print-Only PDF OR Purchase Interactive PDF Version of this Form
Affidavit For Collection Of Personal Property Pursuant To Small Estate Proceeding Form. This is a South Carolina form and can be use in Probate Court Statewide.
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Tags: Affidavit For Collection Of Personal Property Pursuant To Small Estate Proceeding, 420PC, South Carolina Statewide, Probate Court
STATE OF SOUTH CAROLINA
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COUNTY OF:
IN THE MATTER OF:
IN THE PROBATE COURT
AFFIDAVIT FOR COLLECTION OF PERSONAL
PROPERTY PURSUANT TO SMALL ESTATE
PROCEEDING
CASE NUMBER:
AFFIANT:
1.
Nature of interest of undersigned:
2.
Decedent’s Information:
Name:
Social Security Number:
Date of Birth:
Date of Death:
Age at date of Death:
Domicile at death:
3.
Venue for this proceeding is proper in this county because:
Decedent was domiciled in this county at date of death.
Decedent was not domiciled in this county, but property of Decedent was located in this county at date of
death.
4.
No Application or Petition for the appointment of a Personal Representative is pending or has been granted in any
jurisdiction. More than thirty (30) days have passed since the decedent’s death. The value of the entire probate
estate, less liens and encumbrances, does not exceed $10,000.
5.
This affidavit is pursuant to Section 62-3-1201 of the South Carolina Probate Code (Supp. 1990). The successor(s)
named herein is/are entitled to the payment of any sums of money due and owing to the decedent, and to the
delivery of all tangible personal property belonging to the decedent and in the possession of another, and to the
delivery of all instruments evidencing a debt, obligation, stock, or chose in action belonging to the decedent, in the
following respective proportions. Names and addresses of the decedent’s spouse, children, heirs and devisees,
including minors’ dates of birth are:
Name
6.
Age
Address
Relation
Percentage
Interest
The property of the decedent consists of:
Cash:
Automobile:
Life Insurance:
Other Property:
Form #420PC (2/2004)
62-3-1201
$
$
$
$
(attach list if necessary)
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VERIFICATION
The undersigned, being sworn, states: That the facts set forth in the foregoing statement are true to the best of the
undersigned's knowledge, information and belief; and the undersigned hereby submits to the Court's jurisdiction in this
matter.
SWORN to before me this
day of
Signature:
Name:
Address:
, 20
Notary Public for South Carolina
My Commission Expires:
Telephone (O):
(H):
E-mail:
ORDER FOR PAYMENT OR DELIVERY
It appears from the foregoing affidavit, the original of which is on file with the probate court of this county, that
payment or delivery of the property described herein should be made as follows:
Name of Successor
Executed this
Address
day of
Relationship
, 20
Percentage
Interest
.
, Probate Court Judge
Form #420PC (2/2004)
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