Free Microsoft Word - 411PC.dot - South Carolina

STATE OF SOUTH CAROLINA COUNTY OF: IN THE MATTER OF:

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IN THE PROBATE COURT APPLICATION FOR DISCHARGE OF LEINS AND SURETIES CASE NUMBER:

Applicant(s): 1. 2. Nature of interest of undersigned: was named the Personal Representative of the estate, and his/her appointment terminated on . He/she appears to have fully administered the estate (closing documents attached as appropriate). I ask that the court deliver to me a certificate to that effect, evidencing the discharge of his/her sureties and of any lien on any property given by him/her in lieu of a Bond. As far as I know, no action concerning the above estate is pending in any court.

3.

VERIFICATION The undersigned, being sworn, states: That the facts set forth in the foregoing statement are true to the best of the undersigned's knowledge, information and belief.

SWORN to before me this , 20

day of

Signature: Name: Address: Telephone (O): (H): Signature: Name: Address: Telephone (O): (H):

Notary Public for South Carolina My Commission Expires:

FORM #411PC (9/87) 62-3-1007

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ORDER FOR DISCHARGE OF LIENS AND SURETIES IT IS FURTHER ORDERED that the application be APPROVED DISAPPROVED as follows:

IT IS FURTHER ORDERED that the Personal Representative that office and that any sureties or liens securing his/her performance Executed this day of

IS ARE

IS NOT released and discharged from ARE NOT released. , 20 .

, Probate Court Judge

FORM #411PC (9/87)

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