Affidavit Of No Administration Template - Indiana Code Section 29-1-8
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1AFFIDAVIT OF NO ADMINISTRATION
Indiana Code Section 29-1-8
I ____________________________________________________________, state as follows:
1. That _______________________________________________ (the Decedent) died on
___________________, 20__, in _____________________________ County, Indiana, and at the time death
was a resident of _______________________________ County, Indiana.
2. That no Petition for Appointment of a personal representative for the Estate of the Decedent is pending or has
been granted in either Monroe County, Indiana, or elsewhere.
3. That more than forty-five (45) days have elapsed since the death of the Decedent.
4. That the value of the gross probate estate, wherever located (less liens and encumbrances), of the Decedent
did not exceed the sum of Fifty Thousand Dollars ($50,000.00).
5. That I am a successor to the Decedent or a claimant entitled to the payment of the Decedent. All successors,
including myself, of the Decedent are listed below:
Name/Relationship
Address
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______________________________
___________________________________________________ ____
______________________________
___________________________________________________ ____
______________________________
___________________________________________________ ____
______________________________
___________________________________________________ ____
Attach a sheet listing any additional successors or claimants
6. That I have notified each person identified in this affidavit of my intention to present an affidavit under this
section.
7. That I am entitled to payment on behalf of each person identified in this affidavit.
THE FOREGOING STATEMENT IS MADE UNDER PENALTIES OF PERJURY
Signature of Affiant
Type or Print name of Affiant
STATE OF INDIANA
)
)
SS
____________COUNTY )
Before me, the undersigned, a Notary Public in and for said County and State, personally appeared
_________________________________________________ and having first been duly sworn upon his/her oath
stated that each of the above and foregoing statements was true and correct, and thereupon signed his/her
name to the above and foregoing Affidavit of No Administration.
Dated this __________ day of _________________________, 20___.
______________________________________
My Commission Expires:
Notary Public Signature
Resident of
County
______________________________________
Printed Name
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