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: _____________________________________ COURT USE ONLY Attorney or Party Without Attorney (Name and Address): ____________________________________________ ____________________________________________ Division ______ Courtroom ________ Phone Number:__________________E-mail: ___________________ FAX Number:___________________ Atty. Reg. #: _______________ Case Number: __________________

WITHDRAWAL OR SATISFACTION OF CLAIM AND RELEASE
I, _____________________________________ (name of claimant), hereby grant a full and final release to the estate and to the fiduciary and any successor for any liability in connection to the claim(s) described below and withdraw the claim. acknowledge that the claim has been satisfied.

Date(s) Obligation Incurred

Type of Claim

Amount

Total

$

Date: _____________________________

____________________________________________ Signature of Claimant

JDF 727

9/08

WITHDRAWAL OR SATISFACTION OF CLAIM AND RELEASE