STATE OF SOUTH CAROLINA COUNTY OF: ____________________________ IN THE MATTER OF: ________________________________________ (Decedent) TO: Creditor: Address: Telephone: Email: Original Creditor: Address (if different from above) Filed Date of Claim: Claim Amount: Account Number: Other Reference Number: ) ) ) ) ) ) ) IN THE PROBATE COURT NOTICE OF ALLOWANCE/DISALLOWANCE OF CLAIM CASE NUMBER: ____________________________________ Allowance of a claim is evidence the Personal Representative accepts the claim as a valid debt of the Decedent's estate. Allowance of a claim may not be construed to imply the estate will have sufficient assets with which to pay the claim. the claim is allowed. the claim is partially allowed in the amount of $_______________; the balance is disallowed. Explanation (optional) _________________________________________________________________________________________________ the claim is disallowed in full. Explanation (optional): _____________________________________________________ _________________________________________________________________________________________________ The disallowed claim or the disallowed portion of your claim will be forever barred unless you commence a legal proceeding requiring a Summons, a Petition and a filing fee of $150.00 for allowance of the claim in accordance with SCPC 62-3-804(2), within thirty (30) days after the mailing or other service of this Notice of Allowance/Disallowance of Claim. Executed this ______ day of_____________________________, 20_________. Signature: Print Name: Address: Telephone (Work): (Home): (Cell): Email: Attorney: Address: Telephone: Email: FORM #372ES (04/2017) 62-3-704, 62-3-806, 62-3-807 American LegalNet, Inc. www.FormsWorkFlow.com