Free PC-211 - Connecticut

AFFIDAVIT FOR FILING WILL NOT SUBMITTED FOR PROBATE PC-211 REV. 3/03

STATE OF CONNECTICUT COURT OF PROBATE [Type or print in black ink. File in duplicate.]

RECORDED:

COURT FILE NO.

TO: COURT OF PROBATE, DISTRICT OF IN THE MATTER OF THE LAST WILL AND TESTAMENT OF

DISTRICT NO.
DATE OF DEATH

SOCIAL SECURITY NO.

LATE OF NAME, ADDRESS, AND RELATIONSHIP OF SUBSCRIBER TO DECEASED

,DECEASED
DATE(S) OF INSTRUMENT(S)

The undersigned hereby certifies to his or her best knowledge and belief that: the deceased left no assets to be administered in accordance with the law, or an application has been made for settlement of the estate by affidavit in lieu of administration (C.G.S. § 45a-273) and, therefore, presents said will and codicil(s), if any, to said court for filing only. .................................................................................... Subscriber: Subscribed and sworn to before me on the following date: [Month, day, year] ............................................................................................ Judge, Ass't Clerk, Notary Public, Comm. Sup. Court Receipt of the above will, and codicil(s), if any, is hereby acknowledged. Dated at: ,Connecticut, on [Month, Day, Year] .................................................................................................................. Judge Clerk Ass't Clerk AFFIDAVIT FOR FILING WILL NOT SUBMITTED FOR PROBATE PC-211 RESET