Form AOC-E-203B "Affidavit for Collection of Personal Property of Decedent (For Decedents Dying on or After Jan. 1, 2012)" - North Carolina

What Is Form AOC-E-203B?

This is a legal form that was released by the North Carolina Superior Court - a government authority operating within North Carolina. Check the official instructions before completing and submitting the form.

Form Details:

  • Released on May 1, 2012;
  • The latest edition provided by the North Carolina Superior Court;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of Form AOC-E-203B by clicking the link below or browse more documents and templates provided by the North Carolina Superior Court.

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Download Form AOC-E-203B "Affidavit for Collection of Personal Property of Decedent (For Decedents Dying on or After Jan. 1, 2012)" - North Carolina

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File No.
(TYPE OR PRINT IN BLACK INK)
STATE OF NORTH CAROLINA
In The General Court Of Justice
Superior Court Division
County
Before The Clerk
IN THE MATTER OF THE ESTATE OF:
AFFIDAVIT FOR COLLECTION OF
Name, Street Address, City, State And Zip Code Of Decedent
PERSONAL PROPERTY OF DECEDENT
(For Decedents Dying On Or After Jan. 1, 2012)
INTESTATE
TESTATE
Social Security No. (Last Four Digits)
County Of Domicile At Time Of Death
G.S. 28A-25-1; 28A-25-1.1
Date Of Death
Date Of Will
Place Of Death (If Different From County Of Domicile)
Name, Street Address, PO Box, City, State And Zip Code Of Affiant 1
Name, Street Address, PO Box, City, State And Zip Code Of Affiant 2
Telephone No.
Telephone No.
Legal Residence (County, State)
Legal Residence (County, State)
Attorney Bar No.
Name, Street Address, PO Box, City, State And Zip Code Of Attorney
Telephone No.
I, the undersigned affiant, being first duly sworn, say that:
1.
I am
an heir.
an executor named in the will.
a devisee named in the will.
the public administrator
a creditor of the decedent. I am not disqualified under G.S. 28A-4-2.
2.
At least thirty (30) days have passed since the date of the decedent's death.
3.
The decedent died
intestate.
testate.
(a)
The decedent died on or after 10/1/09 and the value of all personal property owned by the decedent less liens and
4.
emcumbrances thereon, and less the spousal allowance under G.S. 30-15,
does not exceed $20,000.
(b)
I am the surviving spouse and sole heir devisee of the decedent, the decedent died on or after 10/1/09, and the value of
all personal property, less liens and encumbrances thereon, and less the spousal allowance under G.S. 30-15, does
not exceed $30,000.
5.
Decedent's will dated as shown above has been probated in each county in which is located any
(Check if decedent died testate.)
real property owned by the decedent as of the date of death; and a certified copy of the decedent's will is attached to this
Affidavit.
6.
No application or petition for appointment of a personal representative is pending or has been granted in any jurisdiction.
7.
After diligent inquiry, I have determined that the persons listed below are all the persons entitled to share in the decedent's
estate. (
If there is a court-appointed guardian for any such person(s), list the guardian's name and address on an attachment.)
NAME
AGE
RELATIONSHIP
MAILING ADDRESS
Original - File
Copy - Fiduciary
Copy - Clerk Mails Copy To Each Person Listed In Item No. 7
(Over)
AOC-E-203B, Rev. 5/12
© 2012 Administrative Office of the Courts
File No.
(TYPE OR PRINT IN BLACK INK)
STATE OF NORTH CAROLINA
In The General Court Of Justice
Superior Court Division
County
Before The Clerk
IN THE MATTER OF THE ESTATE OF:
AFFIDAVIT FOR COLLECTION OF
Name, Street Address, City, State And Zip Code Of Decedent
PERSONAL PROPERTY OF DECEDENT
(For Decedents Dying On Or After Jan. 1, 2012)
INTESTATE
TESTATE
Social Security No. (Last Four Digits)
County Of Domicile At Time Of Death
G.S. 28A-25-1; 28A-25-1.1
Date Of Death
Date Of Will
Place Of Death (If Different From County Of Domicile)
Name, Street Address, PO Box, City, State And Zip Code Of Affiant 1
Name, Street Address, PO Box, City, State And Zip Code Of Affiant 2
Telephone No.
Telephone No.
Legal Residence (County, State)
Legal Residence (County, State)
Attorney Bar No.
Name, Street Address, PO Box, City, State And Zip Code Of Attorney
Telephone No.
I, the undersigned affiant, being first duly sworn, say that:
1.
I am
an heir.
an executor named in the will.
a devisee named in the will.
the public administrator
a creditor of the decedent. I am not disqualified under G.S. 28A-4-2.
2.
At least thirty (30) days have passed since the date of the decedent's death.
3.
The decedent died
intestate.
testate.
(a)
The decedent died on or after 10/1/09 and the value of all personal property owned by the decedent less liens and
4.
emcumbrances thereon, and less the spousal allowance under G.S. 30-15,
does not exceed $20,000.
(b)
I am the surviving spouse and sole heir devisee of the decedent, the decedent died on or after 10/1/09, and the value of
all personal property, less liens and encumbrances thereon, and less the spousal allowance under G.S. 30-15, does
not exceed $30,000.
5.
Decedent's will dated as shown above has been probated in each county in which is located any
(Check if decedent died testate.)
real property owned by the decedent as of the date of death; and a certified copy of the decedent's will is attached to this
Affidavit.
6.
No application or petition for appointment of a personal representative is pending or has been granted in any jurisdiction.
7.
After diligent inquiry, I have determined that the persons listed below are all the persons entitled to share in the decedent's
estate. (
If there is a court-appointed guardian for any such person(s), list the guardian's name and address on an attachment.)
NAME
AGE
RELATIONSHIP
MAILING ADDRESS
Original - File
Copy - Fiduciary
Copy - Clerk Mails Copy To Each Person Listed In Item No. 7
(Over)
AOC-E-203B, Rev. 5/12
© 2012 Administrative Office of the Courts
PRELIMINARY INVENTORY
(Give values as of date of decedent's death. Continue on separate attachment if necessary.)
PART I. PROPERTY OF THE ESTATE
Est. Market Value
1.
Accounts in sole name of decedent
(List bank, etc., each account no. and balance.)
$
2.
Joint accounts without right of survivorship
(List bank, etc., each account no., balance and joint owners.)
% Owned By Dec.
% Owned By Dec.
% Owned By Dec.
% Owned By Dec.
3.
Stocks/bonds/securities in sole name of decedent or jointly owned without
% Owned By Dec.
right of survivorship.............................................................................................
4.
Cash and undeposited checks on hand.........................................................................................................
5.
Household furnishings....................................................................................................................................
6.
Farm products, livestock, equipment and tools..............................................................................................
7.
Vehicles (include or attach descriptions)
8.
Interest in partnership or sole proprietor businesses......................................................................................
9.
Insurance, Retirement Plan, I.R.A., etc., payable to Estate...........................................................................
10.
Notes, judgments, and other debts due decedent..........................................................................................
11.
Miscellaneous personal property....................................................................................................................
12.
Real estate willed to the Estate....................................................................
$
13.
Estimated annual income of Estate................................................................................................................
TOTAL PART I.
$
(Base bond on this amount, if applicable.)
PART II. PROPERTY WHICH CAN BE ADDED TO ESTATE IF NEEDED TO PAY CLAIMS
1.
Joint accounts with right of survivorship
(List bank, etc., each account no., balance and joint owners.)
$
2.
Stocks/bonds/securities registered in beneficiary form and immediately transferred on death or jointly
owned with right of survivorship .....................................................................................................................
3.
Other personal property recoverable G.S. 28A-15-10 ...................................................................................
4.
Real estate owned by decedent and not listed elsewhere
.................................................
(attach description)
TOTAL PART II.
$
PART III. OTHER PROPERTY
There
is
is not entireties real estate owned by decedent and spouse ..........................................
1.
2.
There
are
are not Insurance, Retirement Plan, I.R.A., accounts, etc., payable to named
beneficiaries....................................................................................................................................................
Signature Of Collector By Affidavit 1
Signature Of Collector By Affidavit 2
Name (Type Or Print)
Name (Type Or Print)
SWORN/AFFIRMED AND SUBSCRIBED TO BEFORE ME
SWORN/AFFIRMED AND SUBSCRIBED TO BEFORE ME
Date
Signature Of Person Authorized To Administer Oaths
Date
Signature Of Person Authorized To Administer Oaths
Deputy CSC
Assistant CSC
Clerk Of Superior Court
Deputy CSC
Assistant CSC
Clerk Of Superior Court
Date Commission Expires
Date Commission Expires
Notary
Notary
County Where Notarized
County Where Notarized
SEAL
SEAL
CERTIFICATION
I certify that the foregoing is a true and accurate copy as taken from and compared with the original on record in this office.
Date
Signature
SEAL
Deputy CSC
Assistant CSC
Clerk Of Superior Court
NOTE:
This Affidavit for Collection of Personal Property of Decedent authorizes the named collector by affidavit to receive and administer ALL of the personal property
belonging to the named decedent pursuant to G.S. Chapter 28A, Article 25.
AOC-E-203B, Side Two, Rev. 5/12
© 2012 Administrative Office of the Courts
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