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02/04/00 afftranspp.wpd
AFFIDAVIT FOR COLLECTION OF PERSONAL PROPERTY
STATE OF ARIZONA )
) ss.
COUNTY OF )
, being duly sworn, on oath deposes and says:
died on , in the County of
, State of , more than thirty days prior to execution of
this Affidavit.
Check either 1(a) or 1(b):
1. (a) Affiant is the successor of the decedent, entitled to decedent’s property by Will or
intestate succession and the value of all of the personal property in the decedent’s
estate, wherever located, less liens and encumbrances, does not exceed Fifty
Thousand Dollars ($50,000).
(b) Affiant is claiming as the surviving spouse dependent child of decedent
and the value of all personal property in the decedents estate, wherever located,
less liens and encumbrances, does not exceed the greater of either Fifty Thousand
Dollars ($50,000) or the total sums permitted as the allowance in lieu of homestead,
exempt property, and the family allowance, pursuant to Arizona Revised Statutes,
in effect on the date of the decedents death.
Check either 2(a) or 2(b):
2. (a) No application or petition for the appointment of a personal representative is
pending or has been granted in any jurisdiction.
(b) A personal representative has been appointed and EITHER has been
discharged OR more than one year has elapsed since a closing statement
was filed AND, as of the date of this Affidavit, Fifty Thousand Dollars ($50,000)
has not been exceeded.
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02/04/00 afftranspp.wpd
3. Decedent owned the following personal property:
4. The affiant is entitled to receive payment of any debt due the decedent and to receive decedent’s
tangible personal property or an instrument evidencing the transfer to affiant of any debt,
obligation, stock or chose in action belonging to decedent.
This Affidavit is made pursuant to A.R.S. §14-3971, as amended, for the purpose of making claim to
property of the decedent under said statute.
Date Affiant’s Signature
Affiant’s Printed Name
SUBSCRIBED AND SWORN TO before me on .
My Commission Expires:
Notary Public
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