STATE OF WISCONSIN, CIRCUIT COURT, WASHINGTON COUNTY, PROBATE IN THE MATTER OF AFFIDAVIT OF NO PROBATE _______________________________ Case No: Deceased Under oath, I state that: 1. _____________________________ died a resident of Washington County, Wisconsin. Name of Deceased 2. His/her a. Post Office address was: ______________________________________________ Street Address, City, State, Zip Code b. Date of birth was: __________________________________________ c. Date of death was: _________________________________________ 3. Attached to this Affidavit is: the original Last Will and Testament of the decedent dated: ____________________ a Codicil to the Last Will and Testament dated: ______________________________ 4. I am: One of the heirs of the decedent: spouse son daughter ___________ The person nominated as the personal representative in the Last Will. 5. Said Last Will is being filed with the Probate Court pursuant to Sec. 856.05, Wis. Stats., as there is no need for probate of the same because: (please check any that apply) All jointly held property in which the decedent had an interest at the time of death is being transferred pursuant to Wisconsin Statutes. Decedent owned property subject to administration valued at less than $50,000 which is being transferred by Affidavit as provided under Sec. 867.03, Wis. Stats. Other probate proceedings are being commenced to dispose of the estate assets. All of decedent’s assets were held in a living trust/revocable trust. Other: (explain) Subscribed and sworn to before me On Notary Public, Wisconsin/Court Official My Commission expires: Signature Name Printed or Typed Date PR-3003 (Local) Washington County – Affidavit of No Probate Form.DOC (Rev. 8/06/12) American LegalNet, Inc. www.FormsWorkFlow.com