Notice To Franchise Tax Board {PR021}

ATTORNEY OR PARTY WITHOUT ATTORNEY (NAME, STATE BAR NUMBER AND ADDRESS) FOR COURT USE ONLY TELEPHONE NUMBER: FAX NO. (Optional): EMAIL ADDRESS (Optional): ATTORNEY FOR (Name): SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN LUIS OBISPO STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME: 1035 Palm Street, Room 385 Same as above San Luis Obispo, CA 93408 San Luis Obispo Division ESTATE OF: CASE NUMBER: NOTICE TO FRANCHISE TAX BOARD Probate Code § 9202 (c) 1. You are hereby given notice of administration of the estate of the following person: a. Decedent's Name:_____________________________________________________________. b. Date of Death:________________________________________________________________. c. Social Security Number:_________________________________________________________. 2. A copy of the decedent's death certificate is attached. 3. The party providing you with this notice is as follows: a. Name:_______________________________________________________________________. b. Address:_____________________________________________________________________. c. Telephone:___________________________________________________________________. Estate Attorney Personal Representative. d. Capacity: 4. If you have a claim against the above mentioned estate, please forward documentation to the address indicated in item 3 above. Date:_____________________ ____________________________________________ (Signature of party providing notice) Page 1 of 2 Form Adopted for Optional Use San Luis Obispo Superior Court Local Form PR021 Rev. 1/1/15 NOTICE TO FRANCHISE TAX BOARD Probate Code §9202 Probate Code § 9202(c) American LegalNet, Inc. www.FormsWorkFlow.com Insert case name: CASE NUMBER PROOF OF SERVICE 1. I am over the age of 18 and am not a party to this case. I live or work in the county where the mailing occurred. 2. My (the servers) home or business address is as follows: 3. I served the foregoing NOTICE OF ADMINSTRATION, FRANCHISE TAX BOARD by enclosing a copy in an envelope addressed to: Franchise Tax Board P.O. Box 2952, MS A-454 Sacramento, California 95812-9974 4. Date mailed: _______________, Place mailed (city, state): ________________________ . I declare under penalty of perjury under the laws of the State of California that the information above is true and correct. _________________ ________________________________ ___________________________ (Date signed) (Print Name) (Signature) Page 2 of 2 Form Adopted for Optional Use San Luis Obispo Superior Court Local Form PR021 Rev. 1/1/15 NOTICE TO FRANCHISE TAX BOARD Probate Code §9202 Probate Code § 9202(c) American LegalNet, Inc. www.FormsWorkFlow.com