THE STATE OF NEW HAMPSHIRE
Court Name: Case Name: Case Number:
WAIVER OF FULL ADMINISTRATION AFFIDAVIT
I, was appointed fiduciary of the above estate on , and under oath depose and say as follows: 1. 2. 3. To the best of my knowledge and belief, there are no outstanding debts or obligations attributable to the deceased's estate. I certify that six months have passed since my date of appointment (specified above) and that no interested person has petitioned for full administration of this estate. I certify that the following is all the real estate owned by the deceased at the time of his/her death, and that it has passed to LOCATION OF REAL ESTATE COUNTY REGISTRY OF DEEDS BOOK/PAGE / / 4. If real estate is listed in #3 above, I certify that I have notified either the assessor of the city of or the selectmen of the town of
as required by RSA 554:18-a, by providing them with a copy of this form.
Date Telephone Number Surviving Spouse or Child Signature Mailing Address
This instrument was acknowledged before me on My Commission Expires Affix Seal, if any
, County of
Signature of Notarial Officer / Title
ORDER This affidavit is approved.
NHJB-2144-P (10/01/2006) (formerly AOC-215-003)
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