SMALL ESTATE AFFIDAVIT

(Affidavit for Collection of Personal Property of Decedent)

STATE THRESHOLD REFERENCE

[// GUIDANCE: Verify current threshold for your state before using. Common thresholds:]

AFFIDAVIT FOR COLLECTION OF PERSONAL PROPERTY OF DECEDENT

STATE OF [________________________________]

COUNTY OF [________________________________]

I. AFFIANT INFORMATION

I/We, the undersigned, being first duly sworn, state:

Affiant Name(s):

Affiant 1:
Name: [________________________________]
Address: [________________________________]
City: [________________] State: [____] Zip: [________]
Relationship to Decedent: [________________________________]

Affiant 2 (if applicable):
Name: [________________________________]
Address: [________________________________]
City: [________________] State: [____] Zip: [________]
Relationship to Decedent: [________________________________]

II. DECEDENT INFORMATION

Decedent's Full Legal Name: [________________________________]

Also Known As: [________________________________]

Date of Birth: [__/__/____]

Date of Death: [__/__/____]

Age at Death: [____]

Place of Death:
City: [________________] County: [________________] State: [____]

Last Residence/Domicile:
Street: [________________________________]
City: [________________] County: [________________] State: [____] Zip: [________]

Social Security Number: [___-__-____]

III. ELIGIBILITY REQUIREMENTS

The undersigned hereby declares and affirms that all of the following statements are true:

A. Time Requirement

☐ More than [30/40/45] days have elapsed since the death of the Decedent.
Date of Death: [__/__/____]
Date of this Affidavit: [__/__/____]
Days Elapsed: [____]

B. Value Requirement

☐ The gross value of the Decedent's entire estate, excluding the following, does not exceed $[STATE THRESHOLD]:
- Property passing by right of survivorship
- Property held in trust
- Property passing by beneficiary designation (life insurance, retirement accounts, POD/TOD accounts)
- Real property (in most states)
- Vehicles (in some states)
- Amounts excluded by statute (e.g., unpaid wages)

Calculated Estate Value:

☐ The total value is less than the statutory limit of $[____________]

C. Probate Requirement

☐ No application or petition for the appointment of a Personal Representative is pending or has been granted in any jurisdiction.

☐ No Small Estate Affidavit has previously been filed for this Decedent.

D. Entitlement

☐ The undersigned is/are the successor(s) to the Decedent entitled to the property described herein under:
☐ The terms of the Decedent's Will dated [__/__/____]
☐ The laws of intestate succession (Decedent died without a Will)

IV. AFFIANT'S RIGHT TO PROPERTY

A. If Decedent Died WITH a Will (Testate):

☐ The Decedent left a Will.

Date of Will: [__/__/____]

Location of Will: [________________________________]

Under the terms of the Will, the undersigned is entitled to receive:

B. If Decedent Died WITHOUT a Will (Intestate):

☐ The Decedent died intestate (without a valid Will).

The Decedent's heirs at law are:

☐ The undersigned is/are entitled to the property as the sole heir(s) or have the written authorization of all heirs.

V. PROPERTY TO BE COLLECTED

The undersigned requests that the following property be paid, delivered, or transferred to the undersigned:

A. Bank Accounts

B. Securities/Investments

C. Wages/Salary Owed

D. Insurance Proceeds (payable to estate)

E. Safe Deposit Box Contents

F. Tangible Personal Property

G. Other Property

TOTAL VALUE OF PROPERTY TO BE COLLECTED: $[________________________________]

VI. REQUIRED DECLARATIONS

The undersigned hereby declares and certifies:

1. Authority: The undersigned is/are legally entitled to the Decedent's property pursuant to the Decedent's Will or the laws of intestate succession.

2. No Probate: No probate proceeding is pending or has been conducted for the Decedent's estate, and none is necessary.

3. Value Limit: The total value of the Decedent's property subject to this affidavit does not exceed the statutory limit.

4. Waiting Period: The required waiting period following the Decedent's death has elapsed.

5. Debts and Taxes: The undersigned will pay the Decedent's lawful debts and taxes from the property collected, to the extent the property is sufficient to do so.

6. Other Successors: The undersigned will distribute any remaining property to any other successors who are entitled to it.

7. Personal Liability: The undersigned understands that [he/she/they] may be personally liable to any person having a superior right to the property, and to creditors of the Decedent, to the extent of the value of the property collected.

8. Truthfulness: All statements made in this Affidavit are true and correct.

VII. INDEMNIFICATION

The undersigned agrees to indemnify and hold harmless any person, financial institution, or other entity relying on this Affidavit and delivering property to the undersigned from any and all claims, damages, or liability arising from such delivery.

VIII. SIGNATURE AND VERIFICATION

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

Affiant 1:

Signature: _________________________________

Printed Name: [________________________________]

Date: [__/__/____]

Affiant 2 (if applicable):

Signature: _________________________________

Printed Name: [________________________________]

Date: [__/__/____]

IX. NOTARIZATION

STATE OF [________________________________]

COUNTY OF [________________________________]

On [DATE], before me, [NOTARY NAME], a Notary Public, personally appeared [AFFIANT NAME(S)], who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to this instrument and acknowledged that [he/she/they] executed the same.

WITNESS my hand and official seal.

_________________________________
Notary Public Signature

Printed Name: [________________________________]

My Commission Expires: [____________]

[NOTARY SEAL]

X. REQUIRED ATTACHMENTS

☐ Certified copy of Death Certificate

☐ Copy of Decedent's Will (if testate)

☐ Proof of identity of Affiant(s)

☐ Proof of relationship to Decedent (if intestate)

☐ Authorization from other heirs (if applicable)

☐ Other: [________________________________]

XI. INSTRUCTIONS TO HOLDER OF PROPERTY

Pursuant to [STATE STATUTE], you are required to pay, deliver, or transfer the property described herein to the undersigned upon receipt of this Affidavit, a certified copy of the Decedent's death certificate, and proof of the Affiant's identity.

You may rely upon this Affidavit and are discharged from any liability for paying, delivering, or transferring the property to the undersigned.

XII. RECEIPT OF PROPERTY

FOR USE WHEN PROPERTY IS COLLECTED:

I/We hereby acknowledge receipt of the following property:

Signature: _________________________________

Date: [__/__/____]

STATE-SPECIFIC REQUIREMENTS

[// GUIDANCE: Adjust based on jurisdiction]

California (Probate Code § 13100-13116):
- Threshold: $208,850 (as of April 1, 2025)
- Waiting period: 40 days
- Separate procedure for real property under $69,625

Texas (Estates Code § 205):
- Threshold: $75,000
- Waiting period: 30 days
- Small Estate Affidavit can include real property with court approval

Florida (F.S. § 735):
- Summary Administration for estates under $75,000
- Requires court filing, not just affidavit

New York (SCPA § 1301):
- Voluntary Administration for estates under $50,000
- Requires court proceeding

Illinois (755 ILCS 5/25):
- Small Estate Affidavit for personal property under $100,000
- No waiting period

END OF SMALL ESTATE AFFIDAVIT