Rev. 11/2019 KSJC 1 K.S.A. 59-1507b
Small Estates Affidavit/Estates under $40,000
SMALL ESTATES AFFIDAVIT — TRANSFERRING CERTAIN
PERSONAL PROPERTY IN ESTATES UNDER $40,000
PURSUANT TO K.S.A. 59-1507b
STATE OF KANSAS )
COUNTY OF )
_______________________(name of affiant), being duly sworn states:
(1) On (date), (year), (decedent) died
☐ testate or ☐ intestate at (location), leaving
an estate not exceeding $40,000 in value, and I have attached a certified copy of the
death certificate to this affidavit.
(2) No petition for the appointment of an executor or administrator of the
decedent’s estate is pending or has been granted.
(3) All unpaid debts, claims or demands against the decedent or the decedent’s
estate and all estate and inheritance taxes due, if any, on the property transfers involved
have been or will be paid.
(4) That the following are the names, ages, relationships and addresses of the
beneficiaries under the decedent’s will or heirs of the decedent:
Name Age Relationship Address
(5) The decedent’s estate consists of the following personal property: (include the
proceeds from insurance policies payable to the estate and identify the policy by number):