San Luis Obispo — available from this site

Source: https://www.slo.courts.ca.gov/documents/san-luis-obispo/Affidavit-of-SmallEstate.pdf

Concerning ) DECLARATION FOR THE ) COLLECTION OR TRANSFER OF A _____________________________ ) SMALL ESTATE WITHOUT ) ADMINISTRATION (CALIFORNIA Decedent. ) PROBATE CODE SECTION 13100, ET ______________________________) SEQ.)

1. The decedent, _________________________________________, died on
(name)

________________________ at _____________________________________________. (date) (city and state) 2. At least forty (40) days have elapsed since the death of the decedent, as shown on the certified copy of the decedent’s death certificate attached to this declaration.

3. No proceeding is now being or has been conducted in California for

administration of the decedent’s estate.

4. The current gross fair market value of the decedent’s real and personal

property in California, excluding the property described in Section 13050 of the California Probate Code, does not exceed one hundred fifty thousand dollars ($150,000.00).

5. The property which is claimed under this declaration is:

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6. The declarant is the successor of the decedent (as defined in Section 13006

of the California Probate Code) to the decedent’s interest in the described property.

7. No other person has a superior right to the interest of the decedent in the

described property.

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8. The declarant requests that the described property be paid, delivered, or

transferred to the declarant.

9. The declarant declares under penalty of perjury under the laws of the State

of California that the foregoing is true and correct.

Dated:_________________________ ______________________________
Signature

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Printed Name of Declarant

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Address

____________________________________
City, State, Zip

____________________________________
Telephone

State of ________________________ } County of ______________________ }ss } On_______________________, before me, ____________________________________ Name and Title of Officer (e.g. “Jane Doe, Notary Public”) Personally appeared _______________________________________________________ Name(s) of Signer(s) personally known to me OR proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument under penalty of perjury under the laws of the State of California.

WITNESS MY HAND AND OFFICIAL SEAL

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Signature of Notary Public