Claim Against Estate

Name of Person Filing Document: __________________________________ Your Address ___________________________________________________ Your City, State, Zip Code: ________________________________________ Your Telephone Number: __________________________________________ Attorney Bar No. & Representing: ___________________________________ SUPERIOR COURT OF ARIZONA PINAL COUNTY ) ) ) ) ) ________________________________) [ ] an Adult or [ ] a Minor, deceased 1. My name and address are: In the Matter of Estate of PB 2_____________________ CLAIM AGAINST AN ESTATE [570] __________________________________________________ __________________________________________________ __________________________________________________ 2. 3. The Estate is indebted to me in the amount of $______________________________________. The basis of may claim is: ___________________________________________________ ___________________________________________________ ___________________________________________________ ___________________________________________________ NOTE: Complete number 4 or 5 only if either applies to your claim. 4. 5. The claim is not yet due. It will become due on (date): ________________________________ The claim is secured by the following property (describe): _______________________________ _____________________________________________________________________________ _____________________________________________________________________________ 6. I am mailing a copy of the Claim Against an Estate to the Personal Representative, if one has been appointed. DATED: ________________________________________ _________________________________________ Signature _________________________________________ Print Name © Superior Court of Arizona in Pinal County November 22, 2004 ALL RIGHTS RESERVED Page 1 of 1 PB5 Claim Against Estate Use only most current version American LegalNet, Inc. www.FormsWorkflow.com