NOTICE TO CREDITORS

PART A: NOTICE FOR PUBLICATION

NOTICE TO CREDITORS OF ESTATE

IN THE [PROBATE/SURROGATE'S/SUPERIOR] COURT
[COUNTY] COUNTY, [STATE]

Case Number: [________________________________]

IN THE MATTER OF THE ESTATE OF:

[DECEDENT FULL LEGAL NAME]

Also Known As: [________________________________]

DECEASED

NOTICE IS HEREBY GIVEN that the undersigned has been appointed and has qualified as [☐ Executor ☐ Administrator ☐ Personal Representative] of the Estate of [DECEDENT NAME], Deceased, late of [CITY], [COUNTY] County, [STATE], who died on [DATE OF DEATH].

All persons having claims against the Estate are required to present them to the undersigned at the address below, or to the Clerk of the above-named Court, within [____] months from the date of the first publication of this Notice, or said claims will be forever barred.

[// GUIDANCE: Claim periods vary by state - typically 3-4 months from first publication. UPC § 3-803 provides 4 months. California = 4 months; Texas = 4 months; Florida = 3 months; New York = 7 months from Letters]

All claims must be in writing and must indicate:
1. The name and address of the claimant
2. The basis for the claim
3. The amount claimed
4. If the claim is not yet due, when it will become due
5. If the claim is contingent or unliquidated, the nature of the uncertainty
6. If the claim is secured, a description of the security

[PERSONAL REPRESENTATIVE NAME]
[☐ Executor ☐ Administrator ☐ Personal Representative]
Estate of [DECEDENT NAME], Deceased

Mailing Address:
[________________________________]
[________________________________]
[________________________________]

Telephone: [(___)___-____]

Attorney for [Executor/Administrator/Personal Representative]:

[ATTORNEY NAME]
[FIRM NAME]
[ADDRESS]
[CITY, STATE ZIP]
Telephone: [(___)___-____]
State Bar No.: [________________________________]

First Publication Date: [__/__/____]

PART B: INDIVIDUAL NOTICE TO KNOWN CREDITORS

[// GUIDANCE: UPC § 3-801(b) requires actual notice to known or reasonably ascertainable creditors. This notice must be mailed or delivered, not just published.]

[DATE]

VIA [☐ CERTIFIED MAIL, RETURN RECEIPT REQUESTED ☐ FIRST CLASS MAIL ☐ PERSONAL DELIVERY]

[CREDITOR NAME]
[CREDITOR ADDRESS]
[CITY, STATE ZIP]

RE: Estate of [DECEDENT NAME], Deceased
Case Number: [________________________________]
Date of Death: [__/__/____]

Dear [Creditor Name]:

NOTICE OF ADMINISTRATION AND REQUIREMENT TO FILE CLAIMS

Please be advised that the undersigned has been appointed [Executor/Administrator/Personal Representative] of the Estate of [DECEDENT NAME], who died on [DATE OF DEATH].

According to the books and records of the Decedent, you may have a claim against this Estate. This letter serves as formal notice of the administration of the Estate.

DEADLINE TO FILE CLAIMS:

You must file your claim against the Estate on or before [DEADLINE DATE], which is the later of:

☐ [____] months from the date of first publication of the Notice to Creditors ([DATE])

☐ [____] days from the date this notice was mailed or delivered to you

[// GUIDANCE: Under UPC § 3-803, the later of 4 months from first publication or 60 days from actual notice. State laws vary.]

FAILURE TO FILE A TIMELY CLAIM MAY RESULT IN THE CLAIM BEING FOREVER BARRED.

HOW TO FILE A CLAIM:

Your claim must be in writing and must include:

1. Your full name and current mailing address
2. The nature and basis of your claim
3. The amount of your claim (if known)
4. Copies of any documentation supporting your claim
5. Whether the claim is secured, and if so, a description of the security
6. Whether the claim is contingent, unliquidated, or not yet due

Send your claim to:

[Personal Representative Name]
[Address]
[City, State ZIP]

AND file a copy with:

Clerk of the [Probate/Surrogate's] Court
[Court Address]
[City, State ZIP]

If you have any questions regarding this matter, please contact the undersigned or the attorney for the Estate.

Sincerely,

_________________________________
[PERSONAL REPRESENTATIVE NAME]
[Executor/Administrator/Personal Representative]
Estate of [DECEDENT NAME], Deceased

Telephone: [(___)___-____]
Email: [________________________________]

PART C: PROOF OF PUBLICATION

AFFIDAVIT OF PUBLICATION

STATE OF [________________________________]
COUNTY OF [________________________________]

I, [PUBLISHER/AUTHORIZED REPRESENTATIVE NAME], being duly sworn, depose and say:

1. I am [☐ the publisher ☐ an authorized representative of the publisher] of [NEWSPAPER NAME], a newspaper of general circulation published in [COUNTY] County, [STATE].

2. The Notice to Creditors, a true copy of which is attached hereto as Exhibit A, was published in said newspaper on the following dates:

• First Publication: [__/__/____]
• Second Publication: [__/__/____]
• Third Publication: [__/__/____]
• Fourth Publication: [__/__/____]

[// GUIDANCE: Number of publications varies by state - typically once per week for 3-4 consecutive weeks]

3. The newspaper meets all statutory requirements for publication of legal notices in this jurisdiction.

_________________________________
[Publisher/Authorized Representative Name]

Subscribed and sworn to before me this [____] day of [____________], [20____].

_________________________________
Notary Public
My Commission Expires: [____________]

PART D: PROOF OF MAILING TO KNOWN CREDITORS

DECLARATION OF MAILING OF NOTICE TO CREDITORS

I, [PERSONAL REPRESENTATIVE NAME], declare:

1. I am the [Executor/Administrator/Personal Representative] of the Estate of [DECEDENT NAME], Deceased.

2. On [DATE], I caused the Notice to Creditors to be mailed by [☐ Certified Mail, Return Receipt Requested ☐ First Class Mail] to the following known or reasonably ascertainable creditors:

3. I made reasonable efforts to identify all known creditors by reviewing:
   ☐ Decedent's mail and correspondence
   ☐ Decedent's financial records and bank statements
   ☐ Decedent's bills and invoices
   ☐ Credit reports
   ☐ Tax returns
   ☐ Other: [________________________________]

I declare under penalty of perjury under the laws of the State of [STATE] that the foregoing is true and correct.

Executed on [DATE] at [CITY], [STATE].

_________________________________
[Personal Representative Name]

CREDITOR CLAIM DEADLINES - STATE REFERENCE

[// GUIDANCE: Common state creditor claim deadlines]

SPECIAL NOTICES

Notice to Medicare/Medicaid

[// GUIDANCE: Required notice to CMS for potential Medicare/Medicaid claims]

☐ Decedent was a Medicare beneficiary - Notice sent to:
Medicare Secondary Payer Recovery Contractor (MSPRC)
P.O. Box 138897
Oklahoma City, OK 73113-8897

☐ Decedent was a Medicaid beneficiary - Notice sent to:
[State Medicaid Agency]
[Address]

Notice to Department of Social Services

☐ Not applicable
☐ Notice sent on [__/__/____] to [________________________________]

Notice to Tax Authorities

☐ IRS Notice filed
☐ State Tax Department Notice filed

TIMELINE CHECKLIST

☐ Letters [Testamentary/of Administration] issued: [__/__/____]

☐ Creditor search conducted: [__/__/____]

☐ Notice to Creditors drafted: [__/__/____]

☐ Notice submitted to newspaper: [__/__/____]

☐ First publication date: [__/__/____]

☐ Individual notices mailed to known creditors: [__/__/____]

☐ Last publication date: [__/__/____]

☐ Proof of publication received: [__/__/____]

☐ Creditor claim deadline: [__/__/____]

☐ File proof of publication and mailing with Court: [__/__/____]

END OF NOTICE TO CREDITORS PACKAGE