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Free Indiana Small Estate Affidavit Form

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Use this template/form as a Small Estate Affidavit Form in the State of Indiana

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Text version of this Form

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SMALL ESTATE AFFIDAVIT
Collection of Personal Property
Indiana Code Section 29-1-8

State of Indiana
County of ______________

I, ____________________________________________________________________,
upon duly sworn, state on my oath that:

1. My post office address is: ___________________________________________________

2. My residence address is: ___________________________________________________

3. I am a successor to the decedent or a claimant entitled to the payment or property of the
named decedent. All successors, including myself, of the decedent are listed as follows:

Name/Relationship Address Share

4. The decedent’s name is ___________________________________________________.

5. The date of the decedent’s death was ____________________________________, more
than forty-five days have elapsed since the death of the decedent, and I have attached a
copy of the death certificate hereto. Note: At any time after forty-five or more days from
the date of a decedent’s death, any person who is indebted to or who has possession of any
personal property or an instrument evidencing a debt, obligation, stock, chose in action, or
stock brand belonging to the decedent, shall pay such indebtedness or deliver such personal
property, or so much of either as is claimed, to a person claiming to be a successor of the
decedent or entitled to payment or delivery of the property belonging to the decedent upon
being presented an affidavit made by said person.

6. That the value of the gross probate estate, wherever located, less liens and encumbrances,
does not exceed twenty-five thousand dollars ($25,000.00).

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7. That at least forty-five (45) days have elapsed since the death of the decedent.

8. That no application or petition for the appointment of a personal representative is pending
or has been granted in any jurisdiction.

THE FOREGOING STATEMENT IS MADE UNDER THE PENALTIES OF PERJURY.

________________________________________
Signature of Affiant

STATE OF INDIANA

COUNTY OF ________________

Before me, _____________________, (title of officer) this ____ day of _______________,
____, ________________ acknowledged the execution of the annexed ___________________
(name of instrument).

___________________________________

Notary Public, State of _________________

Printed Name: ________________________

Commission Expires: _________________

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Notes:

Chapter 8. Dispensing With Administration

IC 29-1-8-1
Sec. 1. (a) Forty-five (45) days after the death of a decedent and upon being presented an
affidavit that complies with subsection (b), a person:
(1) indebted to the decedent; or
(2) having possession of personal property or an instrument evidencing a debt, an
obligation, a stock, or a chose in action belonging to the decedent;
shall make payment of the indebtedness or deliver the personal property or an instrument
evidencing a debt, an obligation, a stock, or a chose in action to a person claiming to be entitled
to payment or delivery of property of the decedent.
(b) The affidavit required by subsection (a) must be an affidavit made by or on behalf of the
claimant stating that:
(1) the value of the gross probate estate, wherever located (less liens and encumbrances),
does not exceed twenty-five thousand dollars ($25,000);
(2) forty-five (45) days have elapsed since the death of the decedent;
(3) no application or petition for the appointment of a personal representative is pending or
has been granted in any jurisdiction; and
(4) the claimant is entitled to payment or delivery of the property.
(c) If a motor vehicle or watercraft (as defined in IC 9-13-2-198.5) is part of the estate,
nothing in this section shall prohibit a transfer of the certificate of title to the motor vehicle if
five (5) days have elapsed since the death of the decedent and no appointment of a personal
representative is contemplated. A transfer under this subsection shall be made by the bureau of
motor vehicles upon receipt of an affidavit containing a statement of the conditions required by
subsection (b)(1) and (b)(4). The affidavit must be duly executed by the distributees of the estate.
(d) A transfer agent of a security shall change the registered ownership on the books of a
corporation from the decedent to a claimant upon the presentation of an affidavit as provided in
subsection (a).
(e) For the purposes of subsection (a), an insurance company that, by reason of the death of
the decedent, becomes obligated to pay a death benefit to the estate of the decedent is considered
a person indebted to the decedent.

Disclaimer
This form is provided without any warranty, express or implied, as to its legal effect and completeness. Please use at
your own risk. If you have a serious legal problem, we suggest that you consult an attorney.

Form #0002009

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