Free STATE OF COLORADO - Colorado

STATE OF COLORADO

COUNTY OF _______________________

COLLECTION OF PERSONAL PROPERTY BY AFFIDAVIT PURSUANT TO §15-12-1201, C.R.S.
1. I, __________________________________, swear/affirm under oath that the following statements are true and correct: 2. At least ten days have elapsed since the death of (Decedent).

3. That the total fair market value of all property owned by the Decedent and subject to disposition by will or intestate succession at the time of the Decedent's death, wherever that property is located, less liens and encumbrances, does not exceed $50,000.00. 4. That no Application or Petition for the appointment of a personal representative is pending or has been granted in any jurisdiction. I understand that I am answerable and accountable to any subsequently appointed personal representative of the estate or any other person having a superior right to the estate. 5. The Successor(s), listed below, is/are entitled to the payment of any sums of money due and owing to the Decedent, and to the delivery of all tangible personal property belonging to the Decedent and in the possession of another, and to the delivery of all instruments evidencing a debt, obligation, stock or chose in action (right to bring legal action) belonging to the Decedent, in the following respective proportions: Name of Successor Proportion/Value

_____________________________ Signature of Affiant _____________________________ Signature of Affiant Note:

_______________________________ Signature of Affiant _______________________________ Signature of Affiant

This Affidavit can be used either by one Affiant on behalf of all Successors or by all Successors as Affiants, or any combination thereof. It cannot be used to transfer the title to real property.

Subscribed and affirmed, or sworn to before me in the County of _______________, State of ___________________, this ________ day of _________________, 20_____. My Commission Expires: _________ _______________________________ Notary Public

JDF 999

1/09

COLLECTION OF PERSONAL PROPERTY BY AFFIDAVIT PURUSANT TO §15-12-1201, C.R.S.