California Small Estate Affidavit
Pursuant to the California Probate Code §13100-13116, this affidavit is executed by an entitled successor in interest for the collection of certain small estate assets not exceeding $166,250. This document is not valid unless at least 40 days have elapsed since the decedent's death, and there is no acting executor or administrator over the estate.
Decedent Information:
- Full Name of Decedent: _________________________
- Date of Death (MM/DD/YYYY): ___________________
- Last Known Address: ___________________________
- County of Death: _____________________________
- Case Number (if applicable): __________________
Affiant Statement:
I, _____________________, residing at ____________________________, being of legal age, under penalty of perjury, declare that I am the successor in interest of the decedent’s property as described below, and that:
- The value of the decedent's entire estate subject to disposition by will or intestacy does not exceed $166,250.
- At least 40 days have elapsed since the death of the decedent, as shown by the attached certified copy of the decedent’s death certificate.
- No proceedings for administration of the decedent’s estate have been commenced or finalized in the courts of any jurisdiction.
- I am entitled to the payment or delivery of the property on behalf of all other successors with an interest.
- The decedent owned the described property:
Property Description:
_______________________________________________________
_______________________________________________________
Creditor's Claim (if applicable):
I affirm that the described property includes no items for which a creditor of the estate has a lawful claim, or if such claims exist, adequate provision has been made to pay those claims.
Affiant's Signature: ___________________________ Date: ________
Acknowledgment
State of California
County of _________________
On ____________________, before me, ____________________________ (insert name and title of the officer), personally appeared __________________________, who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct.
WITNESS my hand and official seal.
Signature ________________________(Seal)