Fill and Sign the Summary Administration Petition for Small Estates Kentucky Form

AOC-830 Doc. Code: PDA & ODA Rev. 1-15 Page 1 of 2 Commonwealth of Kentucky Court of Justice www.courts.ky.gov KRS 391.030; 394.145; 395.455; 395.470; 396.095 P ETITION /O RDER T O D ISPENSE W ITH A DMINISTRATION (Surviving Spouse/ Children/Preferred Creditor) Case No. ____________________ Court District/Probate County ______________________ Division ______________________ _____________________________________________________________________________________________________ _ IN RE: Estate of ______________________ Address: ______________________ Date of Death: ______________________ ______________________ ______________________ Date of Birth: ______________________ Social Security Number: ______________________ PETITION Comes the Petitioner, being first duly sworn, and states as follows: 1. Decedent died [ ] testate [ ] intestate with residence at the above listed address and on the above date. 2. At the time of death, decedent left no estate to be administered with the exception of the following assets ( include value for each asset listed ): ______________________ ______________________ ______________________ ______________________ 3. In relation to the above named decedent, I am the (check all that apply) [ ] surviving spouse [ ] only surviving child [ ] surviving child whose surviving siblings have signed a waiver herein or attached a waiver [ ] preferred creditor [ ] preferred creditor of the decedent whose surviving spouse has signed a waiver herein or attached a waiver [ ] assignee of the preferred creditor. 4. [ ] (check if applicable) Petitioner applies for Probate of Decedent's Will, filed herewith, which is his/her Last Will and Testament. 5. As a preferred creditor/assignee of decedent, I have paid the following claim(s) against the estate in the following order (attach receipts): Claim Payee Amount a. Cost and Expenses of Administration ______________________ ______________________ b. Funeral expenses ______________________ ______________________ c. Debts and taxes with preference ______________________ ______________________ under federal and Kentucky Law AOC-830 Doc. Code: PDA & ODA Case Number _______________________ Rev. 1-15 Page 2 of 2 d. Other ______________________ ______________________ 6. I certify that I have advertised for creditors of the intestate in accordance with the requirements set forth in KRS 395.470. 7. I certify that there has been no previous administration of decedent's estate within Kentucky or elsewhere. Because the exemption given to the above surviving spouse/child(ren) and/or claim(s) of the above preferred creditor/assignee equals or exceeds the value of the above estate asset(s), I ask this Court to dispense with the administration of the above estate and to transfer the above personal property to me or my designee, ______________________ ______________________ ________ _____________________________________________ Name of Surviving Spouse Waiving Preference Age Signature of Surviving Spouse Waiving Preference ( Please Print ) (If Petitioner is not Decedent’s Spouse) Address/P.O. Box Address: ______________________ _____________________________________________ _____________________________________________ Signature of Surviving Child Waiving Preference Signature of Surviving Child Waiving Preference __________________________________________ Petitioner’s Signature Address: ______________________ Phone Number: ______________________ Subscribed and sworn before me by petitioner on _________________________________, 2_______. My commission expires _____________________. _____________________________________________________ Name/Title ORDER [ ] Upon hearing, the Will offered was proven by _______________________________ and ORDERED PROBATED as the Last Will and Testament of Decedent this _________ day of __________________________________, 2________. The Will shall be probated only and no letters of administration shall be issued. Upon verified petition of the above petitioner, IT IS HEREBY ORDERED that the petition be granted to dispense with the administration of the estate of the above decedent, and the above personal property is transferred to petitioner or his/her designee, _________________________________________________________________________________. ________________________________, 2_______ _____________________________________________ Date Judge’s Signature CERTIFICATE I certify that this petition and order were prepared in accordance with CR 11. ___________________________________________ _____________________________________________ Attorney for Petitioner Address and Phone Number Distribution: Court File Petitioner