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PROBATE
COURT New Estate Memorandum |
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Date:_____________________ |
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1. |
NAME OF DECEASED_____________________________________ |
DATE OF BIRTH:___________ |
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| ADDRESS:____________________________________________________________________________ | |||
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2. |
SOCIAL SECURITY_____________________________________ |
DATE OF DEATH:__________ |
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3. |
PLACE OF DEATH:_____________________________________________________________________ |
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4. |
SAFE DEPOSIT BOX: In decedent's name alone |
YES_________ |
NO___________ |
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5. |
DECEDENT'S MARITAL STATUS:_________________________ |
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| 6. | CLOSE RELATIVES
(name, address, relationship, date of birth if minor; state if any relative
is under the care of a conservator) |
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| _____________________________________________________________________________ | ||||
| _____________________________________________________________________________ | ||||
| _____________________________________________________________________________ | ||||
| _____________________________________________________________________________ | ||||
| _____________________________________________________________________________ | ||||
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7. |
Is any
heir in the MILITARY SERVICE? (If so, give name, address and branch of
military service.) |
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8. |
ATTORNEY:_______________________________________ |
PHONE:_________________________ |
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9. |
CONSERVATOR (if any):_____________________________ |
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10. |
FUNERAL HOME:___________________________________ |
AMOUNT OF BILL: $______________ |
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11. |
ASSETS IN DECEDENT'S NAME ALONE: (include real estate) |
APPROXIMATE VALUE: |
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____________________________________________________ |
$__________________ |
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____________________________________________________ |
$__________________ |
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| ______________________________________________ | $________________ | |||
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12. |
JOINT OR SURVIVORSHIP ASSETS OF DECEDENT: |
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| Real Estate: | ______YES | ______NO | ADDRESS:_______________________________________ | |
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MORTGAGE LENDER: |
____________________________________________________________ |
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BALANCE DUE: |
$___________________________________________________________ |
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OTHER JOINTLY OWNED PROPERTY:_________________________________________________ |
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APPROXIMATE VALUE: $____________________________________________________________ |
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13. |
TRANSFERS WITHIN 3 YEARS OF DEATH:______________________________________________ |
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14. |
STATE AID: |
DECEDENT: |
_______YES |
_______NO |
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SPOUSE: |
_______YES |
_______NO |
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CHILDREN: |
_______YES |
_______NO |
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COMPLETED BY: |
________________________________________ |
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