Fillable Printable Affidavit for Collection of Personal Property - California
Fillable Printable Affidavit for Collection of Personal Property - California
Affidavit for Collection of Personal Property - California
Affidavit for Collection of Personal Property
California Probate Code Section 13100
The un
dersigned state(s) as follows:
1. _____
__________________________________ died on ___________, 20____, in the County of
_____________________________, State of California.
2. At least 40 days have elapsed since the death of the decedent, as shown in a certified copy of the decedent's
death certificate attached to this affidavit or declaration.
3.
□ No proceeding is now being or has been conducted in California for administration of the decedent's
estate.
OR
□ The decedent's personal representative has consented in writing to the payment, transfer, or delivery to
the affiant or declarant of the property described in the affidavit or declaration.
4. The c
urrent gross fair market value of the decedent's real and personal property in California, excluding the
property described in Section 13050 of the California Probate Code, does not exceed one hundred fifty
thousand dollars ($150,000).
5.
□ An inventory and appraisal of the real property included in the decedent’s estate is attached.
□ There is no real property in the estate.
6. The f
ollowing property to be transferred, delivered, or paid to the affiant under the provisions of California
Probate Code section 13100:
7. The successor(s) of the decedent, as defined in Probate Code Section 13006 is/are:
8. The
undersigned
□ The affiant or declarant is the successor of the decedent (as defined in Section 13006 of the California
Probate Code) to the decedent's interest in the described property.
□ The affiant or declarant is authorized under Section 13051 of the California Probate Code to act on
behalf of the successor of the decedent (as defined in Section 13006 of the California Probate Code) with
respect to the decedent's interest in the described property.
9. No other person has a superior right to the interest of the decedent in the described property.
10. The af
fiant or declarant requests that the described property be paid, delivered, or transferred to the affiant
or declarant.
The af
fiant or declarant affirms or declares under penalty of perjury under the laws of the State of California that
the foregoing is true and correct.
Dated: _
__________________
Signed:
_________________________________________
_________________________________________
_________________________________________
ACKNOWLEDGMENT
S
tate of California
County of _________________________)
O
n _________________________ before me, __________________________________________
(insert name and title of the officer)
per
sonally 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.
S
ignature ___________________________________ (Seal)
A Notary Public or other of ficer completing this
cert if icate verifies only the identity of the individual
who signed the document to which this cert ificate is
att ached, and not t he truthf ulness , accur acy, or
validity of that document.
