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Wyoming Affidavit of Collection of Estate Assets Form

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Wyoming Affidavit of Collection of Estate Assets Form
Wyoming Affidavit of Collection of Estate Assets Form
WYOMING AFFIDAVIT OF COLLECTION OF ESTATE ASSETS
In accordance with Wyo. Stat. Ann. ยงยง 2-1-201 and 2-1-202
Certified Copy of Decedent's Use of this form does not constitute legal advice by any
Death Certificate to be attached deputy of the County Clerk's Office. Affiant was
To this Affidavit/Declaration advised that he/she may seek legal advice.
STATE OF WYOMING )
) s s
COUNTY OF____________________ )
I,___________________________________________(Name of person signing this affidavit)
the undersigned first being duly sworn upon oath, state:
1. I am the claiming successor of the decedent, because I am the_________________________________ of
the decedent.
2. Name of the decedent:
3. Date of death:
4. State of decedent's residence at date of death: ___________________
5. Place of death:___________________________ (city and state)
6. The value of the entire estate, wherever located, less liens and encumbrances, does not exceed $200,000.00
7. At least thirty (30) days have elapsed since the death of the decedent as shown in a certified or authenticated copy of
the decedent's death certificate attached to the affidavit.
8. There are no other distributees of the decedent having a right to succeed to the property under probate proceedings.
9. No application or petition for the appointment of a personal representative is pending or has been granted in
Wyoming.
10. I am entitled by law to payment or delivery of the property, and I request that the following described property be
paid, delivered, or transferred to me:
_____________________________________________________________________________________________
11. All statements in this affidavit are true and correct and I acknowledge that any false statement may subject the
person or persons herein claiming to penalties relating to perjury under the laws of the State of Wyoming and any
other applicable law.
Signature of Affiant making the above statements
Name (type or print)
Address
City, state, zip
Subscribed and sworn to before me by _____________________________,
this _______ day of _______________________________, 20__________.
____________________________________________ _______________
Notary Public Notary Seal
(describe relationship to decedent)
Wyoming Affidavit of Collection of Estate Assets Form