Verification And Certificate Of Notice By Personal Representative Pursuant To Scr-Pd 403(B)(4) Form

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S
C
D
C
UPERIOR
OURT OF THE
ISTRICT OF
OLUMBIA
PROBATE DIVISION
_________ ADM _________
Estate of
________________________________
Deceased
VERIFICATION AND CERTIFICATE OF NOTICE BY
PERSONAL REPRESENTATIVE PURSUANT TO SCR-PD 403(b)(4)
(For estates of decedents dying on or after July 1, 1995)
I do solemnly declare and affirm that I have mailed or caused to be mailed a copy of the notice of
appointment and general information statement as required in D.C. Code, sec. 20-704 (a) and (b) on
the ___________________________ day of _____________________ _______ , to the following
persons:
List names and addresses of all heirs, legatees, and creditors referred to in D.C. Code, sec. 20-704(b)
(Attach additional sheets if necessary)
I do further solemnly declare and affirm under penalty of law that the contents of the foregoing
document are true and correct to the best of my knowledge, information, and belief, that I have
previously filed or file herewith proofs of publication as required by SCR-PD 403(b)(4), and that to the
best of my knowledge and belief the value of the probate estate (remains the same as)
(increased/decreased in the following amount from) that set forth in the petition for probate
previously filed with the Court ( $ ____________________); and that I have paid or tender herewith
court costs pursuant to SCR-PD 425(a)(1) through (4) and in accordance with D.C. Code, sec. 15-
707(a).
__________________________
Dated:
January 2014 – 147.10.v2

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