Disclaimer Of Interest
ADVERTISEMENT
1STATE OF MICHIGAN
FILE NO.
PROBATE COURT
DISCLAIMER OF INTEREST
COUNTY OF LEELANAU
Estate of _____________________________________________, decedent
1.
I am interested in this matter as
payer of funeral/burial expenses
surviving spouse
heir
of the decedent.
2.
I have an interest in the estate of the decedent pursuant to a Petition and Order for Assignment
filed by _________________________________________under MCL 700.3982.
3.
I declare that I have received a copy of the petition, and I hereby disclaim
reimbursement of funeral and burial expenses paid by me.
any and all interest in the estate of the decedent.
Date
Signature
Name (type or print)
Address
City,State,Zip
Telephone No.
Do not write below this line – For court use only
DISCLAIMER OF INTEREST (LCPC 4/13)
MCL 700.2902, MCL 700.2903, MCL 700.3982
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