Fillable AFFIDAVIT IN RELATION TO SETTLEMENT OF ESTATE UNDER ARTICLE 13, SCPA (NY Courts)

Fill Online, Printable, Fillable, Blank AFFIDAVIT IN RELATION TO SETTLEMENT OF ESTATE UNDER ARTICLE 13, SCPA (NY Courts) Form

Use Fill to complete blank online NYS UNIFIED COURT SYSTEM DIVISION OF TECHNOLOGY (NY) pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

AFFIDAVIT IN RELATION TO SETTLEMENT OF ESTATE UNDER ARTICLE 13, SCPA (NY Courts)

On average this form takes 15 minutes to complete

The AFFIDAVIT IN RELATION TO SETTLEMENT OF ESTATE UNDER ARTICLE 13, SCPA (NY Courts) form is 3 pages long and contains:

  • 0 signatures
  • 0 check-boxes
  • 59 other fields

Country of origin: US
File type: PDF

U.S.A. forms for NYS Unified Court System Division of Technology

BROWSE NYS UNIFIED COURT SYSTEM DIVISION OF TECHNOLOGY (NY) FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
SURROGATE’S COURT OF THE STATE OF NEW YORK
COUNTY OF __________________________
----------------------------------------------------------------------------X AFFIDAVIT IN RELATION TO
VOLUNTARY ADMINISTRATION, Estate of SETTLEMENT OF ESTATE UNDER
ARTICLE 13, SCPA
_______________________________________, File No. ________________________________
(as of 1/2009)*
Deceased.
---------------------------------------------------------------------------X
(INSTRUCTIONS: In completing this form,
STATE OF NEW YORK ) answer each question. This may be done in
some instances by crossing out words
COUNTY OF ____________________________) ss.: in parentheses and in some instances by
inserting the required information.)
I, ___________________________________________________________________, being duly sworn, depose and say
(1) My permanent address is:
__________________________________________________________________________
(Street Address) (City/Town/Village)
(County (State) (Zip) (Telephone Number)
My mailing address is: ______________________________________________________________________________
(If different from permanent address)
(2) My interest is: [ ] Distributee of decedent _______________________________________________________
(Relationship)
[ ] Other (Specify) _____________________________________________________________
(3) The name, permanent address, date, place of death, and citizenship of the decedent, to whose estate this proceeding
relates, are as follows:
Name of Decedent (a/k/a, if applicable):
__________________________________________________________________
Permanent Address:
_________________________________________________________________________________
(Street Address) (City/Town/Village) (County) (State)
Date of Death: ___________________________Place of Death: _____________________________________________
(City/Town/Village) (State)
Citizenship: _________________________________
(4) Decedent died: [ ] Intestate (without a will)
[ ] Testate (the original will is attached)
(5) A search of the records of the Court shows that no application has been made in the estate of the decedent for
voluntary administration, letters of administration or for probate of a will, and your affiant is informed and verily believes
that no such application ever has been made to any other Surrogate’s Court in this state.
SE-3A *For use only where decedent died on or after January 1, 2009
SE-3A -1-
(6) The names and addresses of the decedent’s distributees under New York law, including non-marital children and
descendants of predeceased non-marital children, and their relationships to the decedent, are as follows: (If more space
is needed, add a sheet of paper)
Post Office Relationship
Name Address (Including Zip) Indicate if non-marital)
_____________________ ____________________________ _________________________
_____________________ ____________________________ _________________________
_____________________ ____________________________ _________________________
(7) (If decedent had a will) The names and addresses of all beneficiaries in the will of the decedent filed herewith are as
follows: (If more space is needed, add a sheet of paper)
Post Office
Name Address (Including Zip) Bequest
_____________________ ____________________________ __________________________
_____________________ ____________________________ ___________________________
_____________________ _____________________________ ___________________________
8) The value of the entire personal property, wherever located, of the decedent, exclusive of joint bank accounts, trust
accounts, U.S. savings bonds POD (payable on death), and jointly owned personal property, or property exempt under
the EPTL §5-3.1, does not exceed $30,000.00.
9) The following, exclusive of joint bank accounts, trust accounts, U.S. savings bonds POD (payable on death), and jointly
owned personal property, or property exempt under EPTL §5-3.1, is a complete list of all personal property owned by the
decedent, either standing in his/her own name or owned by him/her beneficially and including items of value in any safe
deposit box. (If more space is needed, add a sheet of paper)
Items of Personal Property
Separately Listed Value of Each Item
___________________________________________ _____________________________
___________________________________________ _____________________________
___________________________________________ _____________________________
TOTAL $
-2-
(10) All the liabilities of the decedent known to me are as follows: (If more space is needed, add a sheet of paper)
Name of Creditor Amount Owed
__________________________________ ____________________________
__________________________________ _____________________________
__________________________________ _____________________________
(11) I undertake to act as voluntary administrator of the decedent’s estate, and to administer it pursuant to Article 13 of the
Surrogate’s Court Procedure Act. I agree to reduce all of the decedent’s assets to possession; to liquidate such assets to
the extent necessary; to open an estate bank account in a bank of deposit or savings bank in this state, in which I shall
deposit all money received; to sign all checks drawn on or withdrawals from such account in the name of the estate by
myself, as voluntary administrator; to pay the expenses of administration, the decedent’s reasonable funeral expenses
and his/her debts in the order provided by law; and to distribute the balance to the person or persons and in the amount or
amounts provided by law. As voluntary administrator, I shall file in this court an account of all receipts and of
disbursements made.
(12) I understand that this proceeding will not determine the estate tax liability, if any, in the event that the decedent had
any interest in real property or any joint bank accounts, trust accounts, U.S. savings bonds POD (payable on death), or
jointly owned or trust property.
(13) If letters testamentary or of administration are later granted, I acknowledge that my powers as voluntary administrator
shall cease, and I shall deliver to the court-appointed fiduciary a complete statement of my account and all assets and
funds of the estate in my possession.
________________________________
Signature of Affiant
_________________________________
Print Name
Sworn to before me on
_________________________, 20 _____
_________________________________
Notary Public
My Commission Expires:
(Affix Notary Stamp or Seal)
Signature of Attorney:
________________________________________________________________________________
Print Name: _______________________________________________________________________________________
Firm Name: _________________________________________________Tel. No.: ______________________________
Address of Attorney: ________________________________________________________________________________
-3-
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

AFFIDAVIT IN RELATION TO SETTLEMENT OF ESTATE UNDER ARTICLE 13, SCPA (NY Courts)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 18 September 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document