Form Aoc-E-203 - Affidavit For Collection Of Personal Property Of Decedent
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1
2File No.
(TYPE OR PRINT IN BLACK INK)
STATE OF NORTH CAROLINA
In The General Court Of Justice
County
Superior Court Division
Before The Clerk
IN THE MATTER OF THE ESTATE OF:
Name And Address Of Decedent
AFFIDAVIT FOR COLLECTION OF
PERSONAL PROPERTY OF DECEDENT
INTESTATE
TESTATE
Social Security No.
County Of Domicile At Time Of Death
G.S. 28A-25-1; 28A-25-1.1
Date Of Death
Place Of Death (If Different From County Of Domicile)
Name And Mailing Address Of Affiant
Name And Mailing Address Of Co-affiant
Telephone No.
Telephone No.
Legal Residence (County, State)
Legal Residence (County, State)
Name And Mailing Address Of Attorney
Attorney Bar No.
Telephone No.
I, the undersigned affiant, being first duly sworn, say that:
1.
I am
an heir.
an executor named in the will.
a devisee named in the will.
the public administrator.
a creditor of the decedent. I am not disqualified under G.S. 28A-4-2.
2.
At least thirty (30) days have passed since the date of the decedent's death.
3.
The decedent died
intestate.
testate.
4.
(a)
The value of all personal property owned by the decedent less liens and encumbrances thereon, does not
exceed $10,000.
(b)
I am the surviving spouse and sole heir devisee of the decedent, and the value of all personal property, less
liens and encumbrances thereon, does not exceed $20,000.
5.
Decedent's will dated as shown below has been probated in each county in which is
(Check if decedent died testate.)
located any real property owned by the decedent at this time; and a certified copy of the decedent's will is
attached to this Affidavit.
Date Of Will
6.
No application or petition for appointment of a personal representative is pending or has been granted in any
jurisdiction.
7.
After diligent inquiry, I have determined that the persons listed below are all the persons entitled to share in the
decedent's estate.
(If there is a court-appointed guardian for any such person(s), list the guardian's name and address on an
attachment.)
NAME
AGE
RELATIONSHIP
MAILING ADDRESS
Original-File
Copy-Fiduciary
Copy-Revenue
Copy-Each Person Listed In Item 7
AOC-E-203, Rev.7/01
(Over)
2001 Administrative Office of the Courts
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