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SMALL ESTATE AFFIDAVIT Collection of Personal Property Alaska Statues Section 13.16.680
State of Alaska County of ______________ I, ____________________________________________________________________, of the following address, ______________________________________________________, after being duly sworn, hereby attest to the following: 1. I am a successor to the decedent, ______________________________________, identified below. All additional successors, including myself, of the decedent are listed as follows: Name/Relationship
Address
2. The decedent's name is __________________________________________________ 3. The date of the decedent's death was ____________________________________, as evidenced by the decedent’s death certificate attached hereto. 4. The value of the entire estate, wherever located, less liens and encumbrances, does not exceed fifteen thousand dollars ($15,000.00). 5. At least thirty (30) days have elapsed since the death of the decedent. 6. No application or petition for the appointment of a personal representative is pending or has been granted in any jurisdiction. 7. That I, _______________________, as a successor to the deceased, am entitled to demand and receive from any person indebted to the decedent or having possession of tangible personal property or an instrument evidencing a debt, obligation, stock, or chose in action belonging to the decedent, the indebtedness or tangible personal property or instrument evidencing a debt, obligation, stock, or chose in action.
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Subscribed and sworn to on this the ___________ day of _______________, 20______, ________________________________________ Signature of Affiant
State of Alaska ________________ Judicial District (or County of ________________)
The foregoing instrument was acknowledged before me this ____________ day of ___________, ________________ by ____________________________________________ (signing party) ___________________________________ (marital status). ____________________________________ Notary Public Print Name __________________________ Serial Number, if any: _________________
My commission expires: ___________________
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Form #0002002
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