IN THE PROBATE COURT OF
COUNTY
STATE OF GEORGIA
IN RE: ESTATE OF
)
ESTATE NO.
)
, )
PETITION FOR YEAR’S SUPPORT
DECEASED
)
EXHIBIT B
LIST OF INTERESTED PERSONS
(To be completed if (1) there is no appointed executor or administrator of the estate, or (2) if the
petitioner has been appointed the executor or administrator of the decedent’s estate)
Petitioner hereby certifies that petitioner has made reasonable inquiry to ascertain the names, last
known addresses, and ages (if under 18) of all the interested persons with respect to the within matter.
Petitioner understands that, for purposes of this affidavit, the term "interested person" refers to the
above-named decedent’s children, spouse, other heirs, beneficiaries, creditors, and any others having a
property right or claim against the estate which may be affected by the above Year’s Support proceeding,
including but not limited to the Tax Commissioner for each county in which there is real property owned
by the decedent. Petitioner hereby certifies that the following are all of the interested persons known to
Petitioner with respect to this matter and that any incapacitated adults are identified as such:
Provide a definitive statement to show to the court that all heirs of the decedent have been named herein
and that there are no heirs of similar or higher degree according to O.C.G.A. §53-2-1. Provide the names
of any deceased heirs and include the date of death for each. (See instructions for further clarification.)
Name
Last Known Address
Age (or over 18)
Relationship
to Decedent
Sworn to and subscribed before
Petitioner
me this
day of
, 20
.
Notary Public, or Clerk, Probate Court
-6-
Effective 8/10
GPCSF 10 Petitioner