700-00027 – Affidavit of No Assets (07/2018) Page 1 of 1
STATE OF VERMONT
SUPERIOR COURT
PROBATE DIVISION
Unit
Docket No.:
In re:
AFFIDAVIT OF NO ASSETS
Petitioner _________________________________________, being duly sworn states as follows:
1. That he/she is the ______________________________ of ___________________________, deceased,
late of _____________________________________, Vermont, who died on __________________, and that
_______________________________ was nominated to be Executor under the purported Last Will and
Testament of the late _______________________________.
2. That the Petitioner is well acquainted with the personal affairs of the late _________________________ and
to the best of his / her knowledge and all information available to him / her, that there are no assets to be
distributed at the time of death.
3. A certified copy of the death certificate is attached to this petition.
Accordingly, I believe the establishment of an estate for ____________________________________ is unnecessary.
_______________________________ ______________________________________________
Date Signature of Petitioner
______________________________________ ______________________________________________
Relationship to Decedent Printed Name
______________________________________ ______________________________________________
Mailing Address Telephone/Email
Signed and sworn to before me: