STATE OF SOUTH CAROLINA
)
IN THE PROBATE COURT
)
COUNTY OF GREENVILLE
)
)
AFFIDAVIT FOR COLLECTION OF PERSONAL PROPERTY
IN THE MATTER OF:
)
PURSUANT TO SMALL ESTATE PROCEEDING
)
(Decedent)
)
CASE NUMBER: __________________
The undersigned states as follows:
1.
Decedent’s Information:
Full Legal Name
(include all known names):
Date of Birth:
Date of Death:
Age at date of Death:
2.
Decedent was domiciled in this county at date of death:
Address: ______________________________________________; County: Greenville; State: South Carolina.
Decedent was not domiciled in South Carolina, but probate property of Decedent was located in this county at
date of death at:
Address: ______________________________________________: County: Greenville; State: South Carolina.
If the above address is the address of a nursing home, a prison, or other residential facility, please give the last address
of the Decedent prior to entering the facility: _____________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
3. More than thirty (30) days have passed since the Decedent’s death.
4. No Application or Petition for the appointment of a Personal Representative is pending or has been granted in any
jurisdiction.
5. This affidavit is pursuant to SCPC 62-3-1201. The successor(s) named herein is/are entitled to the payment of any sums
of money due and owing to the Decedent, and to the delivery of all probate tangible personal property belonging to the
Decedent and in the possession of another, and to the delivery of all instruments evidencing a debt, obligation, stock, or
chose in action belonging to the Decedent in the following proportions. Names and addresses of the Decedent’s successors
(Example: devisees or heirs) are:
Percentage
Year of
Interest/
Name of Successor*
Birth
Address
Relationship
Amount
See attached sheet(s) for additional Successors (check, if applicable).
(*For this purpose, successors include any individual(s) who has/have
paid reasonable funeral expenses; attach proof of payment.)
FORM #420ES (1/2016)
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62-3-1201, 62-3-1202
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