Fill and Sign the Michigan Order PDF Form

AFFIDAVIT OF DECEDENT’S SUCCESSOR FOR DELIVERY OF CERTAIN ASSETS OWNED BY THE DECEDENT Estate of       1. I am decedent’s successor as surviving: [ ] spouse [ ] adult child [ ] other heir       (specify) [ ] devisee under will dated       . [ ] fiduciary or representative of       who is an heir or devisee and has a legal incapacity. 2. Decedent died a resident of       on       ____________ . More than 28 days have passed since decedent’s death. 3. No real property is included in the estate. 4. Decedent’ estate, less liens and encumbrances, does not exceed $15,000 (as adjusted for cost of living as provided in MCL 7000.1210. 5. An application /petition for the appointment of a personal representative is not pending or has not been granted in any jurisdiction. A petition for assignment of an estate not exceeding $15,000 (as adjusted for cost of living) has not been filed with a court. 6. I am entitled to delivery or payment of the property described as:       _____ . 7. The name and address of each person entitled to a share of the property and his/her proportion is as follows: NAME ADDRESS RELATIONSHIP SHARE %                                                                                                                         8. A copy of the death certificate is attached. Signature Name (type or print)       Address       City, state, zip Subscribed and sworn to before me on       ,       County, Michigan. My commission expires:       Signature:       Notice: A false statement on this affidavit may subject the person swearing to the statement to prosecution for perjury. 1