Statement Of Personal Representative
Download a blank fillable Statement Of Personal Representative in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Statement Of Personal Representative with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2District Court
Denver Probate Court
___________________________________ County, Colorado
Court Address:
In the Matter of the Estate of:
COURT USE ONLY
Deceased
Attorney or Party Without Attorney (Name and Address):
Case Number:
Phone Number:
E-mail:
FAX Number:
Atty. Reg. #:
Division
Courtroom
STATEMENT OF PERSONAL REPRESENTATIVE
CLOSING SMALL ESTATE PURSUANT TO §15-12-1204, C.R.S
I,
(Personal Representative of this estate) state the following:
1. The value of the entire estate of the Decedent, less liens and encumbrances, did not exceed the value of
personal property held by or in the possession of the Decedent as fiduciary or trustee, exempt property, family
allowance, costs and expenses of administration, reasonable funeral expenses, and reasonable and
necessary medical and hospital expenses of the last illness of the Decedent.
2. The undersigned has fully administered this estate by disbursing and distributing it to the persons entitled.
3. The undersigned has sent a copy of this Statement to all distributees of this estate and to all creditors or other
claimants to whom the undersigned is aware whose claims are neither paid nor barred and has furnished a
full account in writing of the undersigned’s administration to the distributees whose interests are affected.
4. No Court order prohibits the informal closing of this estate. Administration of this estate is not supervised.
This Statement is filed for the purpose of closing this estate.
The appointment of the Personal
Representative will terminate one year after this Statement is filed with the Court if no proceedings
involving the undersigned are then pending.
VERIFICATION
I (Personal Representative) verify that the facts set forth in this document are true as far as I know or am
informed. I understand that penalties for perjury follow deliberate falsification of the facts stated herein. (§15-10-
310, C.R.S.)
____________________________________________
Signature of Personal Representative
Date
______________________________________
Signature of Attorney
Date
NOTE:
This form is to be used only if a probate estate has been opened and a Personal Representative has been
appointed.
JDF 966
1/09
STATEMENT OF PERSONAL REPRESENTATIVE CLOSING SMALL ESTATE
Page 1 of 2
ADVERTISEMENT
0 votes
Related Articles
Related forms
Form 18 - Statement Of Informal Appointment Of Personal Representative - Intestacy Form - North Dakota
Legal
Application Of Personal Representative For Determination Of Maine Estate Tax And For Discharge Of Personal Liability For Any Deficiency In Maine Estate Tax Subsequently Found To Be Due
Financial
Application Of Personal Representative For Determination Of Maine Estate Tax And For Discharge Of Personal Liability - Maine Revenue Services
Financial
Arizona Form 74 - Report Of Personal Representative Of Decedent - Arizona Department Of Revenue
Financial
Related Categories
Parent category: Legal