Fill and Sign the Certificate of Descent Form

PR-1947, 10/10 Certificate of Descent §867.05, W isconsin Statutes This form shall not be modified. It may be supplemented with additional mater ial. STATE OF WISCONSIN, CIRCUIT COURT, COUNTY IN THE MATTER OF THE ESTATE OF Amended Certificate of Descent Case No. A Petition for a Certificate of Descent of Property was filed. A hearing was held without not ice. THE COURT FINDS: Based upon the evidence presented, 1. the decedent, with date of birth , and date of death , was domiciled in County, State of , with a mailing address of . Decedent has no domicile in Wisconsin. Property of decedent is located in this county. 2. the decedent died intestate. 3. this estate was not administered, and six years or more have elapsed since the decedent’s death. The Department of Revenue’s Certificate Determining Inheritance T ax, is on file with the court. 4. Other: THE COURT CERTIFIES DESCENT AS FOLLOWS: See attached description Name of Heir/Grantee Interest in Property Other: BY THE COURT: Form completed by: (Name) Circuit Court Judge/Circuit Court Commissioner Title (Print or Type Name if not eSigned) Date Address Telephone Number Bar Number