STATE OF MISSOURI
COUNTY OF ST. CHARLES )
IN THE CIRCUIT COURT OF ST. CHARLES COUNTY, MISSOURI
IN THE MATTER OF
AFFIDAVIT OF DISTRIBUTEES FOR COLLECTION OF SMALL ESTATE
I, _____________________________________, a person having knowledge of the facts
hereinafter stated, being of lawful age and residing at ___________________________, in
the County of _________________________, State of Missouri, being first duly sworn,
depose and state:
1. One __________________________________, who resides at _______________________
in _______________________________, Missouri, died on the _____ day of ________________,
______ domiciled in and resident of St. Charles County, Missouri and left no surviving
spouse or unmarried minor children.
2. (a) Said decedent left a last will and testament which was duly admitted to
probate by this Court on the __________ day of __________________, ______.
(b) The said decedent died intestate.
That all debts, claims or demands against the said decedent or the estate of
said decedent have been or will be paid except that any liability by the affiant for the
payment of unpaid claims or demands shall be limited to the value of the property
4. The following is an itemized description and appraisement of all of the personal
property left by the said decedent, together with the names and addresses of the persons
having custody and possession of the same:
5. The legal description of and an appraisement of all real estate left by the
decedent, if any, is attached hereto.
6. The names, addresses and relationship to the decedent of the persons entitled to
and who will receive the property are: