INFORMAL FINAL SETTLEMENT:
AFFIDAVIT, MOTION, AND ORDER
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AOC-850 Doc. Code: AFF & SETI
Rev. 2-17
Page 1 of 2
Commonwealth of Kentucky
Court of Justice www.courts.ky.gov
KRS 395.605
IN RE: Estate of __________________________________________________________________________________
Date of Death: ___________________________________ Social Security Number: _________________________
(month, day, year)
AFFIDAVIT/MOTION
Comestheafant,beingrstdulysworn,andstatesasfollows:
1. Sixmonthshavepassedsincemyappointmentasduciarytotheaboveestate.
2. q Iamsolebeneciary.
q Iamnotsolebeneciary,butIhaveattachedaveriedwaiverfromeachbeneciary(AOC-851). (No
veriedwaiverisrequiredofthe“nonresiduarylegatee,”abeneciarywhohasreceivedandreceipted
forhis/hersharepursuanttoaspecicwillprovision.Thecancelledcheckorsignedreceiptisattachedas
evidence of satisfaction.)
3. The estate is solvent.
4. q All legal claims and debts have been paid.
q All legal claims and debts have not been paid, but have been provided for in the following manner:
___________________________________________________________________________________
__________________________________________________________________________________.
5. All inheritance, estate or similar death taxes have been paid. A duplicate or photocopy of such tax releases is
attached, if available.
6. All court costs have been paid.
7. q My attorney's fee is _________________________. His/her name and address:
Name: _______________________________________________________________________
Address: _____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
q I do not have an attorney.
8. Eachbeneciaryhasreceived his/her share.
Case No. ____________________
Court ____________________
County ____________________
Division ____________________