Form Aoc-830 - 2005 Petition/order To Dispense With Administration Form
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2AOC-830
Doc. Code: PDA & ODA
Rev. 1-05
Case No._____________________
Page 1 of 2
District/Probate
P
/O
T
D
Court________________________
ETITION
RDER
O
ISPENSE
Commonwealth of Kentucky
W
A
ITH
DMINISTRATION
Court of Justice
County_______________________
(Surviving Spouse/
KRS 391.030; 395.455; 396.095
Children/Preferred Creditor)
IN RE: Estate of ______________________________________________________________________________________
(Name of Decedent)
Address:________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
Date of Death: _____________________________
Social Security Number: _________________________
Date of Birth: _____________________________
PETITION
Comes the Petitioner, being first duly sworn, and states as follows:
1.
Decedent died [ ] testate [ ] intestate with residence at the above listed address and on the above date.
2.
At the time of death, decedent left no estate to be administered with the exception of the following assets (include value for
each asset listed):_________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
3.
In relation to the above named decedent, I am the (check all that apply) [ ] surviving spouse [ ] only surviving child
[ ] surviving child whose surviving siblings have signed a waiver on the reverse or attached a waiver [ ] preferred
creditor [ ] preferred creditor of the decedent whose surviving spouse has signed a waiver on the reverse or attached a
waiver [ ] assignee of the preferred creditor.
4.
As a preferred creditor/assignee of decedent, I have paid the following claim(s) against the estate in the following order
(attach receipts):
Claim
Payee
Amount
a.
Funeral expenses
__________________________________
_____________
b.
Debts and taxes with preference
under federal and Kentucky Law
__________________________________
_____________
c.
Other
__________________________________
_____________
5.
I certify that there has been no previous administration of decedent's estate within Kentucky or elsewhere.
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