Free Statement of Claim Pursuant to SCR-PDIP 307 - District of Columbia

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SUPERIOR COURT OF THE DISTRICT OF COLUMBIA PROBATE DIVISION IN RE: ____________________________________ An Adult Intervention Proceeding No.________________

STATEMENT OF CLAIM PURSUANT TO SCR-PDIP 307 Name, address and telephone number of claimant: ____________________________________________________________________________ ____________________________________________________________________________ Amount of Claim: _____________________________________________________________ (Attach supporting documents) ____________________________________________________________________________ ____________________________________________________________________________ Name, address and telephone number of attorney for claimant: ____________________________________________________________________________ ____________________________________________________________________________ _______________________________ Signature of Claimant CERTIFICATE OF SERVICE I hereby certify that a copy of the foregoing statement of claim was delivered/mailed by first class mail postage prepaid to __________________________________ conservator herein. ______________________________ Signature of Claimant __________________________ Date Mailed