Los Angeles local probate form — EX PARTE PETITION TO CLAIM

Los Angeles local probate form — 1993-LASC PRO 096.pdf¶

Source: https://lascpubstorage.blob.core.windows.net/forms/Forms%20Comprehensive%20List/1993-LASC%20PRO%20096.pdf

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NAME AND ADDRESS OF ATTORNEY OR PARTY WITHOUT ATTORNEY: STATE BAR NUMBER FOR COURT USE ONLY

TELEPHONE NO.:

E-MAIL ADDRESS (Optional): ATTORNEY FOR (Name): SUPERIOR COURT OF CALIFORNIA, COUNTY OF LOS ANGELES COURTHOUSE ADDRESS:

CASE NAME:

EX PARTE PETITION TO CLAIM FUNDS ON DEPOSIT CASE NUMBER:
WITH THE COUNTY TREASURY
(Probate Code Section 11854)

• This ex parte petition is intended for a party to claim money on deposit with the Los Angeles County Treasurer that was
deposited there by prior court order. The petition must be filed by the person whose money was deposited with the County
Treasurer or an heir or beneficiary of that person. There are areas of the petition below to specify that information.
• Before filing the petition with the court, you must check with the County Treasurer to confirm that the finds are on deposit
there. Funds get transferred to the State of California over time and may no longer be on deposit with the County Treasurer
if time has passed since the deposit there. If the funds have transferred to the State of California then this petition should
not be filed with the court and instead a party seeking those funds must apply to the California State Controller-Unclaimed
Property to claim the funds.
• A hearing (begin underline)underline)be set when this petition is filed with the court. The petition will be considered by the court and ruled
upon without hearing.
• If the court is satisfied that the claimant has a right to the property claimed, the court will make an order establishing the
right to a claim. A (begin underline)copy of that order then can be presented to the County Treasury for recovery of the funds on
deposit there.

Petitioner(s) alleges(s):

1. Petitioner(s) name _________________________________________________________________________
(Your Name)
2. A copy of a government ID for each applicant is attached to this petition.
3. The court previously made the following order to deposit money to the County Treasurer that otherwise would
have been distributed to a missing heir or beneficiary:

a. Case Name: __________________________________

b. Case Number: ________________________________

c. Date of Prior Order: ____________________________

d. Amount to be Distributed per Prior Order: _________________

e. Person Whose Money Was Deposited with County Treasurer per Prior Order:
______________________________________________________________________

EX PARTE PETITION TO CLAIM FUNDS ON DEPOSIT WITH THE COUNTY TREASURY SCLAC PRO 096 NEW 04/26 For Mandatory Use Probate Code Section 11854

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A copy of the prior order is attached to this petition (required).

The documents required by the prior order (if any) are attached to this petition.

4. Petitioner(s) are entitled to release of the funds on deposit with the County Treasurer on the following basis
(complete Paragraph 5):

5. Check one (a, b, or c):

a. I am the heir or beneficiary named in paragraph 1 of this petition;

b. I am the appointed personal representative of the estate of the heir or beneficiary named in
paragraph 1 of this petition (certified copy of letters are attached);

c. I/we am/are the successor(s) to the deceased heir or beneficiary named in paragraph 1 of this
petition (complete the remainder of this section below).

i. Relationship of each petitioner to the heir or beneficiary named in paragraph 1 of this
petition:

_______________________________________________________________________________

ii. If you are NOT the heir or beneficiary listed in paragraph 1 who is entitled to distribution, a
copy of the death certificate of the deceased heir or beneficiary named in paragraph 1 is
attached to this petition.
iii. There is is not a current probate proceeding commenced for the deceased heir or
beneficiary named in paragraph 1. If so, a certified copy of the letters issued to Petitioner(s) as
the personal representative is attached to this petition.

6. Petitioner(s) claim(s) $________________ (AMOUNT) of said sum based upon the following facts: *

_______________________________________________________________________________

EX PARTE PETITION TO CLAIM FUNDS ON DEPOSIT WITH THE COUNTY TREASURY

SCLAC PRO 096 NEW 04/26 For Mandatory Use Probate Code Section 11854

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*Set forth facts that establish your right to receive the money claimed. Attach extra pages and/or exhibits if necessary. You must also submit certified copies of birth certificates, death certificates and marriage certificates or other documentary evidence that may be required to prove your relationship to the deceased and/or to prove you are the person(s) you claim to be. See the complete list of required facts in the information box at the end of this document.

7. Petitioner requests that the Court issue an order releasing funds on deposit with the County Treasurer to the
Petitioner(s). The address of the warrant is to be mailed to is as follows (address must match the address on
identification):

____________________________________________

I/We declare under penalty of perjury under the laws of the State of California that the foregoing is true and
correct.

Executed this day of , 20 ____, at _.
(City and State)

SIGN

Petitioner

SIGN

Petitioner

THE FOLLOWING FACTS ARE REQUIRED TO CLAIM FUNDS ON DEPOSIT AS A SUCCESSOR TO THE ORIGINAL HEIR OR BENEFICIARY (Probate Code section 11854(a), Code of Civil Procedure section 1355):

• The full name, and the place and date of birth of the decedent whose estate, or any part thereof, is claimed.

EX PARTE PETITION TO CLAIM FUNDS ON DEPOSIT WITH THE COUNTY TREASURY

SCLAC PRO 096 NEW 04/26 For Mandatory Use Probate Code Section 11854

Exceptions & meaning →

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• The full name of such decedent's father and the maiden name of his mother, the places and dates of their respective births, the place and date of their marriage, the full names of all children the issue of such marriage, with the date of birth of each, and the place and date of death of all children of such marriage who have died unmarried and without issue.

• Whether or not such decedent was ever married, and if so, where, when and to whom.

• How, when and where such marriage, if any, was dissolved.

• Whether or not said decedent was ever remarried, and, if so, where, when and to whom.

• The full names, and the dates and places of birth of all lineal descendants, if any, of said decedent; the dates and places of death of any thereof who died prior to the filing of such petition; and the places of residence of all who are then surviving, with the degree of relationship of each of such survivors to said decedent.

• Whether any of the brothers or sisters of such decedent ever married, and, if so, where, when and whom.

• The full names, and the places and dates of birth of all children who are the issue of the marriage of any such brother or sister of the decedent, and the date and place of death of all deceased nephews and nieces of said decedent.

• Whether or not said decedent, if of foreign birth, ever became a naturalized citizen of the United States, and, if so, when, where, and by what court citizenship was conferred.

• The post-office names of the cities, towns or other places, each in its appropriate connection, wherein are preserved the records of the births, marriages and deaths hereinbefore enumerated, and, if known, the title of the public official or other person having custody of such records.

• The nationality of each of the heirs of the decedent.

• The street address of each of the heirs of the decedent.

EX PARTE PETITION TO CLAIM FUNDS ON DEPOSIT WITH THE COUNTY TREASURY

SCLAC PRO 096 NEW 04/26 For Mandatory Use Probate Code Section 11854

Exceptions & meaning →