Closing Statement And Proof Of Mailing - Delivery Closing Statement

FOR CLERK'S USE ONLY Name of Person Filing: _______________________________________ Mailing Address: _______________________________________ City, State, Zip Code: _______________________________________ Day/Evening Telephone: _______________________________________ ATLAS Number (if applicable) _______________________________________ Attorney Bar Number (if applicable) __________________________________ Representing: Self Petitioner Respondent SUPERIOR COURT OF ARIZONA MOHAVE COUNTY Case No. ______________________________ In the Matter of the Estate of: ___________________________________ Name of person who died CLOSING STATEMENT and PROOF OF MAILING/DELIVERY CLOSING STATEMENT I am the Personal Representative of this Estate, and I make these statements under oath. 1. Appointment as Personal Representative. I was appointed as the Personal Representative of this Estate on ________________________(date), more than four months before the date of this Closing Statement. Notice to Creditors. The Notice to Creditors was published according to law. The first publication occurred on ________________________(date), more than four months before the date of this Closing Statement. Administration of Estate. The Estate has been fully administered by making payment, settlement or other disposition of all expenses of administration, and all taxes and claims that have accrued against the Estate with the following exceptions: (List the exceptions.) _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ Distribution of Assets. I have distributed all of the assets of the Estate to the persons entitled to distribution. Mailing Closing Statement. I am sending a copy of this Closing Statement to all of the people to whom I distributed property of this Estate, to all people whose interests are affected by the administration of the Estate, and to all creditors or other claimants whose claims against the Estate are not barred or were not paid. Accounting. I have mailed or delivered a copy of the full written accounting of the Estate to the people whose interests are affected by the administration of the Estate, including guardians ad litem, conservators and guardians. Claims. With respect to any claim listed above in paragraph 3 that has not been paid and that is not barred, I have distributed the Estate subject to possible liability, with the agreement of all those entitled to distribution, or the following arrangements have been made to accommodate outstanding liabilities: (List arrangements) _____________________________________________________________________________________ _____________________________________________________________________________________ 2. 3. 4. 5. 6. 7. 12/29/06 Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com Case No,______________________________ STATE OF ARIZONA County of Mohave ) ) ss. ) I, ____________________________being duly sworn, state that I am the Personal Representative for the above Estate, and that the statements in the Closing Statement are accurate and complete to the best of my knowledge and belief. I also state that a copy of this Closing Statement was mailed to the following individuals on the date(s) and at the address(es) below. ________________________________________ Signature of Personal Representative Subscribed and sworn to before me this _____________day of____________,______, by the above named person. My Commission Expires:________________________ ________________________________________ Notary Public / Deputy Clerk A copy of the Closing Statement Was mailed to the following individuals: Name Address Date Mailed/Delivered _______________________________/________________________________________/___________________ _______________________________/________________________________________/___________________ _______________________________/________________________________________/___________________ _______________________________/________________________________________/___________________ _______________________________/________________________________________/___________________ _______________________________/________________________________________/___________________ 12/29/06 Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com