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To protect against the possibility of others accessing your confidential
information, do not complete these forms on a public workstation.
AFFIDAVIT OF SUCCESSOR
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The "Affidavit of Successor" may be used if the decedent left no will and the estate was not probated.
Living heirs have certain rights according to Washington State laws of Descent and Distribution. One
heir may claim and distribute to other heirs with their written approval. Please note this affidavit is
only to be used for personal property. The transfer of real estate or real property is not allowed.
The undersigned, being first duly sworn, on oath deposes and says:
1. That the name and address of the undersigned successor, is as follows:
Decedent Name:
Successor Name:
Phone:
Address:
City:
State:
Zip:
2. That the undersigned claimant is a "successor", as defined in RCW 11.62.005.
3. That the decedent was, at the time of his or her death, a resident of the State of Washington. Attached
to this affidavit is a photocopy of the decedent's death certificate.
4. That the value of the entire estate of the decedent subject to probate, wherever located, (not including
any surviving spouse's community property interest in any assets which are subject to probate in the
decedent's estate), less liens and encumbrances, does not exceed $100,000.00.
5. That forty days have elapsed since the death of the decedent.
6. That no application or petition for the appointment of a personal representative is pending or has
been granted in any jurisdiction.
7. That all debts of the decedent including funeral and burial expenses have been paid or provided for.
8. That the undersigned successor claims the following personal property, which property is subject to
probate:
Company Reporting Property
Property/Amount Claimed
9. That the undersigned successor has given written notice, either by personal service or by mail,
identifying his or her claim, and describing the property claimed, to all other successors of the
decedent, and that at least ten days have elapsed since the service or mail of such notice.
10. That the undersigned successor is: (One box MUST be checked for affidavit to be valid)
Personally entitled to full payment or delivery of the property above described as sole surviving
heir or,
Accepting full payment or delivery of the property above described on behalf and with written
authority of all other successors who have an interest therein.
Dated this _____ day of ________, _________(yr.)
Subscribed and Sworn (or affirmed) to by:
____________________ (Successor) before me this
(Successor Signature)
_________ day of ____________, __________(yr.)
(Notary Signature)
Notary in and for the State of __________________
(Seal)
My commission expires ______________________
Residing at ________________________________
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REV 80 0029e (a)-1 (08/04/06)