Free PC-237* - Connecticut

RETURN OF CLAIMS AND LIST OF NOTIFIED CREDITORS PC-237 REV. 5/99

STATE OF CONNECTICUT COURT OF PROBATE [Type or print in black ink.]

RECORDED:

TO: COURT OF PROBATE, DISTRICT OF ESTATE OF FIDUCIARY

DISTRICT NO.

THE FIDUCIARY HEREBY CERTIFIES that the names and addresses of all creditors who were notified by certified or registered mail in accordance with C.G.S. §45a-357(a) are attached hereto and made a part hereof. THE FIDUCIARY HEREBY CERTIFIES that all claims exhibited to the fiduciary against said estate are set forth below. CLAIMANT AND ADDRESS OF CLAIMANT DESCRIPTION OF CLAIM [If disallowed in whole or in part, indicate total amount claimed and date of written disallowance.] AMOUNT ALLOWED

TOTAL

The representations contained herein are made under the penalties of false statement.
Date: ............................................................................. Fiduciary: RETURN OF CLAIMS AND LIST OF NOTIFIED CREDITORS PC-237

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