Statement Of Claim (Page 2 of 2) in pdf

Statement Of Claim Page 2

INSTRUCTIONS

1.) Inapplicable words or statements may be stricken, but all information indicated in the form must be given. The

nature and extent of the claim should be stated in the spaces provided if sufficient detail to advise the personal

representative of the estate of full particulars in order that the validity of the claim may be determined.

2.) An exact copy of this claim must be filed with the Clerk of the Court at the time of filing.

WARNING TO CLAIMANTS:

The personal representative of the estate or any party interested in the estate has the right to object to any claim. If

objection is filed, suit in a court of competent jurisdiction must be filed within the time allowed by law, or this claim

will be barred. See Section 733.705, Florida Statutes.

Even if the objection is filed, a claim will be barred at the expiration of one (1) year from the date the claim is filed

if the claim has not been paid, settled, or otherwise disposed of, and no proceeding is then pending for the

enforcement or compulsory payment of it. See Section 733.709, Florida Statutes.

Revised: 09/12/2002

Statement Of Claim Page 2