Fill and Sign the Notice to Known Creditors Form

TO: Name Address City, state, zip PROOF OF SERVICE I certify that on , I served a copy of this notice on the creditor by personal delivery to the creditor. mailing, with postage prepaid, to the address indicated in this notice. I declare under the penalties of perjury that this proof of service has been examined by me and that its contents are true to the best of my information, knowledge, and belief. Attorney name (type or print) Bar no. Telephone no.Title Name of fiduciary to whom claim should be presented Date The fiduciary believes you may be a creditor of the estate. The attached notice to creditors was published . You have four months from the above date of publication or one month from the date this notice is sent to you, whichever is later, to present your written claim or it will be forever barred. You may use the Statement and Proof of Claim (form PC 579) to submit your claim. The written claim must be timely delivered or mailed to the fiduciary listed below. You may also send it to the probate court for filing along with a filing fee of $20.00. You may also commence a suit against the estate in a court. Signature Date Address City, state, zipAddress City, state, zip STATE OF MICHIGAN PROBATE COURT COUNTY OF PC 578 (9/10) NOTICE TO KNOWN CREDITORS Estate of Do not write below this line - For court use only FILE NO. JIS CODE: NKC Approved, SCAO NOTICE TO KNOWN CREDITORS Date Date MCL 700.3801, MCL 700.3803, MCL 700.3804, MCR 5.208(B)