Free ______________________County, Colorado District Court - Colorado

District Court Denver Probate Court _________________________________ County, Colorado Court Address: _________________________________ In the Interests of: In the Matter of the Estate of: __________________________________________________ Attorney or Party Without Attorney (Name and Address):
________________________________________ ________________________________________

COURT USE ONLY Case Number:__________________

Phone Number:________________E-mail: ______________ FAX Number:__________________Atty. Reg. #:_______________

Division________Courtroom_______

CLAIM
Name of Claimant: ________________________________ Telephone Number: __________________________ Address: ___________________________________________________________________________________ Claim is made against this estate, itemized as follows: Date(s) Obligation Incurred Type of Service or Basis of Claim Amount

Total

$

_____________________________________________ Signature of Claimant Date Decedent Estate Action: For information on claims not due and contingent or unliquidated claims, see §15-12-810, C.R.S. All claims defined pursuant to §15-10-201(8), C.R.S. must be filed with the Court or presented to the Personal Representative of the estate. If presented to the Personal Representative, either this form or a written statement complying with §15-12804, C.R.S. can be used. If filed with the Court, Rule 6 of the Colorado Rules of Probate Procedure requires that this form be used. If this form is presented to the Personal Representative, it is recommended that the below Receipt be completed. Protected Proceeding Estate Action: This form can be used for the presentation and allowance of claims filed with the Court pursuant to §15-14429, C.R.S.

RECEIPT
I received a copy of this claim on ______________________ (date). _____________________________________________ Signature of Personal Representative Conservator
JDF 726 9/08 CLAIM