Rev. 11/2019 KSJC 1 K.S.A. 59-1507b
Small Estates Affidavit/Estates under $40,000
PURSUANT TO K.S.A. 59-1507b
) ss:
_______________________(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):
Property Value
Rev. 11/2019 KSJC 2 K.S.A. 59-1507b
Small Estates Affidavit/Estates under $40,000
(6) Affiant has the right to succeed to the personal property of the decedent, and
affiant is over 18 years of age and is legally competent in all respects to make this affidavit
and to receive the above mentioned personal property, apportioned among the
beneficiaries or heirs, if more than one, as follows:
SUBSCRIBED AND SWORN to (or affirmed) before me on (date).
Notary Public
My Appointment Expires:
K.S.A. 53-601; 59-1507b.
Any time after death.
Notes on Use
This affidavit may be used to obtain the transfer, to a decedent’s successor in interest, of
certain personal property that would be transferrable to the decedent, without obtaining letters of
administration or letters testamentary, where the total value of the estate subject to probate does not
exceed $40,000. The transfer is treated as one to the personal representative of the decedent, and
the receipt of the transfer operates as a full discharge and release of the transferor.
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