IN THE PROBATE DIVISION, CIRCUIT COURT, ST. LOUIS COUNTY, MISSOURI
In the matter of ____________________________________________________________ Decedent No. ____________________
AFFIDAVIT FOR COLLECTION OF SMALL ESTATE
Come(s) now __________________________________________________________, being duly sworn on oath and state(s) that ____________________________________________________, whose domicile and last residence address was __________________________________________________________, St. Louis County, Missouri, died on the
Address City State Zip
___ day of ___________, ______ ; that decedent left ___ purported last will and testament (dated the ___ day of ___________ , ______ ); that the entire estate, less liens, debts and encumbrances, does not exceed $40,000.00; that no application for letters testamentary or letters of administration or for refusal of letters is pending or has been granted; that all unpaid debts, claims or demands against the decedent's estate and all estate taxes due, if any, on the property transfers involved, have been or will be paid except that any liability by the affiant for the payment of unpaid claims or demands shall be limited to the value of the property received; and that thirty days have elapsed since the death of the decedent. Affiant further states that the following are the NAMES, ADDRESSES, and RELATIONSHIPS to the decedent of the persons entitled to the property of the decedent pursuant to the laws of descent and distribution of the State of Missouri. OR Affiant further states that the following are the NAMES, ADDRESSES, and RELATIONSHIPS to the decedent of the persons entitled to the property pursuant to the last will and testament of the decedent: HEIRS/LEGATEES OR DEVISEES:
NAME
RESIDENCE ADDRESS
RELATIONSHIP TO DECEDENT
BIRTHDATE IF MINOR_
Affiant further states that the following is an itemized description and valuation of the property of the decedent, and the names and addresses of the persons having possession thereof: Description of Property: Value
Total
$0.00
Subscribed and sworn to before me this ____ day of ____________, ______. _____________________________________________
Affiant's Signature
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Affiant's Name (Typed) (Seal)
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Street Address
________________________________________________ Notary Public Notary Commission expires:
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City State Zip Code
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Telephone No.
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Attorney's Signature
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Attorney's Name (Typed) MBE#
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Street Address
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City Publish __________________________ State Zip Code
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Telephone No.