Instrument Or Deed Of Distribution

For Clerk's Use Only Name of Person Filing: ________________________________________ Mailing Address: ________________________________________ City, State, and Zip Code: ________________________________________ Day/Evening Phone Number: ________________________________________ State Bar Number (if applicable):______________________________________ Self Petitioner Respondent Representing: SUPERIOR COURT OF ARIZONA MOHAVE COUNTY In the Matter of the Estate of Case Number: ________________________ INSTRUMENT OR DEED OF DISTRIBUTION ______________________________________ An Adult a Minor, deceased I was appointed Personal Representative of the Estate on this case on (date) ________________________ to distribute the property of the Estate as required by Title 14 of the Arizona Revised Statues. I hereby assign, transfer and release all right, title and interest to the following property to the following person(s): 1. PERSONS TO WHOM PROPERTY FROM THE ESTATE WAS GIVEN and DESCRIPTION OF PROPERTY: Name Address Property Description ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ 2. MONEY STILL OWED ON PROPERTY. Distribution of the property is subject to the following liability: (if this applies to your case, describe the property, the amount of money still owed on the property, why the property has not been paid for before or in connection with distribution and the closing of the estate, and arrangements that have been made to accommodate outstanding liability; otherwise, write "none") Property Description: ____________________________________________________________________ Money Owed on Property: ________________________________________________________________ Reasons Money Owed: __________________________________________________________________ Arrangements to Pay: ___________________________________________________________________ Property Description: ____________________________________________________________________ Money Owed on Property: ________________________________________________________________ Reasons Money Owed: __________________________________________________________________ Arrangements to Pay: ___________________________________________________________________ 2/10/09 Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com Case No. ___________________________________ Property Description: ____________________________________________________________________ Money Owed on Property: ________________________________________________________________ Reasons Money Owed: __________________________________________________________________ Arrangements to Pay: ___________________________________________________________________ STATE OF ARIZONA ) COUNTY OF MOHAVE ) ss. Signature: _____________________________________________ Date:__________________________ The foregoing instrument was acknowledged before me the this __________, day of ____________, 20________ By:_______________________________________, as Personal Representative of the Estate. My Commission Expires:______________________ _______________________________________ Deputy Clerk / Notary Public 2/10/09 Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com