CREDITOR CREDITORS CLAIM--FORM NO. 83 | THE STATE OF WYOMING, IN DISTRICT COURT } ss. County ofPark | Five (5) Judicial District IN THE MATTER OF THE ESTATE OF | | } CREDITORS CLAIM __________________________________________ | | Deceased. The undersigned, ________ Creditor of _____________________________________ deceased, present _______________________ claim against the Estate of said deceased, with the necessary vouchers for approval as follows, to-wit: Estate of _____________________________________________________, Deceased To _________________________________________ Dr. ===================================================================== 20 ITEMS $ file:///C|/WINDOWS/Desktop/credit1.htm [5/6/2001 5:16:43 PM] >>>> 2 THE STATE OF WYOMING |THE STATE OF WYOMING, } ss.County of Park |___________________________________________________ whose foregoingclaim is herewith presented to the _______________________________________of said deceased being duly sworn, says the amount thereof, to-wit: the sum of _______________________________________________________________________________________________________________________________________is justly due to said claimant __; that no payments have been made thereon which are notcredited, and that there are no offsets to the same, to the knowledge of said affiant ________________________________________________________________________ Subscribed in my presence and sworn to before me this _____ day of _________A.D.20 ______. _________________________________________________ _________________________________________________ =============================================================T he within claim presented to_____________________________________________of said deceased, is allowed and approved for $ ______ this ______ day of ___________20 ______ _________________________________________________________==============================================================Allowed and approved for $________________this ________day of _________20____ __________________________==============================================================T he within claim rejected this _______________ day of ________________, 20_____. _________________________ file:///C|/WINDOWS/Desktop/credit2.htm (1 of 2) [5/6/2001 5:19:21 PM]>>>> 3 THE STATE OF WYOMING==============================================================Filed ___________________________, 20______. ______________________________ Clerk of the District Court. By ______________________________ Deputy Clerk. file:///C|/WINDOWS/Desktop/credit2.htm (2 of 2) [5/6/2001 5:19:21 PM]