Fill and Sign the I Am the Personal Representative of This Estate and I Make These Statements under Oath Form

Name:_________________________________________________Address:_______________________________________________City, State. Zip:_________________________________________Telephone:_____________________________________________State Bar Code:_________________________________________Client:_________________________________________________ IN THE SUPERIOR COURT OF THE STATE OF ARIZONA In and for the County of ___________________ ___________________________________________IN THE MATTER OF THE ESTATE OF : CASE NO. CLOSING STATEMENT OF PERSONAL REPRESENTATIVE AND PROOF OF MAILING Deceased.__________________________________________________________________________________PB15INI am the Personal Representative of this Estate, and I make these statements under oath.1. On ______________________, more than four months ago, I or my predecessor was appointed Personal Representative of this Estate. I file this verified Statement for the purpose of closing this Estate pursuant to ARS 14-3933.2. This Estate is not being administered in supervised administration, and closing of this Estate is not prohibited by Court Order.3. I have, or a prior personal representative whom I have succeeded has Published Notice to Creditors as provided by ARS 14-3801. The first publication of this Notice occurred more than four months prior to the date of this Statement. The first publication occurred on ____________________________. 4. The Estate has been fully administered by making payment, settlement or other disposition of all expenses of administration, and all taxes and claims that have accrued against the Estate with the following exceptions: ________ __________________________________________________________________________________________ ____________________________________________________________________________________________________________________________________________________________________________________ ___5. I am sending a copy of this Closing Statement to all of the people to whom I distributed property of this Estate, to all people whose interests are affected by the administration of the Estate, and to all creditors or other claimants whose claims against the Estate are not barred or were not paid. 6. I have mailed or delivered a copy of the full written accounting of the Estate to the people whose interests are affected by the administration of the Estate, including guardians ad litem, conservators and guardians.7. With respect to any claim listed above that has not been paid and that is not barred, I have distributed the Estate subject to possible liability, with the agreement of the distributees, or the following arrangements have been made to accommodate outstanding liabilities: _____________________________________________________________ ____________________________________________________________________________________________________________________________________________________________________________________ I, being duly sworn, state that I am the Personal Representative for the above Estate, and that the statements in the Closing Statement are accurate and complete to the best of my knowledge and belief. I state that a copy of this Closing Statement was mailed to the following individuals on the date(s) and at the address(es) below. STATE OF ARIZONA ) )ss___________________________________ County of _______________) Filing PartyNotary Public ______________________________________________ ( seal )A copy of the Closing Statement was mailed to the following individuals:NAME ADDRESS DATE MAILED_________________________ __________________ ________________ __________________ ______ _________________________ __________________ __________________________________ ______ _________________________ __________________ __________________________________ ______ _________________________ __________________ __________________________________ ______ _________________________ __________________ __________________________________ ______