Free pc556.pmd - Michigan

Approved, SCAO

JIS CODE: PER, OAA

STATE OF MICHIGAN PROBATE COURT COUNTY OF Estate of

FILE NO. PETITION AND ORDER FOR ASSIGNMENT

, decedent XXX-XXLast four digits of SSN

PETITION I,
Name and relationship

, represent that: .
Date

1. Decedent died on 2. Decedent was a resident of
City/Township

in this county.

Decedent lived outside of Michigan and left an estate within this county to be administered. 3. Funeral and burial expenses are $ . The following persons have paid the following amounts toward the funeral and burial expenses: (statements and receipts are attached) NAME AMOUNT NAME AMOUNT

The amount of funeral and burial expenses remaining unpaid is $ . The total value of the decedent's property remaining after payment of funeral and burial expenses does not/will not exceed $15,000 as adjusted for cost of living. 4. The decedent's property and its gross value is as follows: (attach separate sheet if necessary) DESCRIPTION OF PROPERTY VALUE

Total SEE SECOND PAGE
Do not write below this line - For court use only

0.00

PC 556 (9/07)

PETITION AND ORDER FOR ASSIGNMENT

MCL 700.1210, MCL 700.1302, MCL 700.3982

5. The name, age, relationship, and address of each heir is as follows: NAME AGE RELATIONSHIP ADDRESS

6. I REQUEST that the property listed above be assigned as follows: a. for funeral and burial expenses: $ to
Name

to

Name

,$ to
Name

, and $

. .

b. to the surviving spouse, c. to the following heirs in the stated proportions:

I declare under the penalties of perjury that this petition has been examined by me and that its contents are true to the best of my information, knowledge, and belief.
Attorney signature Name (type or print) Address City, state, zip Telephone no. Bar no. Date Petitioner signature Address City, state, zip Telephone no.

ORDER ASSIGNING ASSETS 7. IT IS ORDERED that the property described above is assigned as follows: a. for funeral and burial expenses: $ to
Name

to

Name

,$ to
Name

, and $

. .

b. to the surviving spouse, c. to the following heirs in the stated proportions:

For 63 days from the date of this order, the share of each heir other than a surviving spouse or minor child shall be subject to any unsatisfied debt of the decedent up to the value of property received through this order.
Date Judge Bar no.

I certify that I have compared this copy with the original on file and that it is a correct copy of the original.
Date Deputy register