Form PC-3.4 "Acceptance/Declination" - Rhode Island

What Is Form PC-3.4?

This is a legal form that was released by the Rhode Island Secretary of State - a government authority operating within Rhode Island. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on July 1, 2017;
  • The latest edition provided by the Rhode Island Secretary of State;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form PC-3.4 by clicking the link below or browse more documents and templates provided by the Rhode Island Secretary of State.

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Download Form PC-3.4 "Acceptance/Declination" - Rhode Island

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State of Rhode Island and Providence Plantations
DATE FILED
Probate Court
FOR
ACCEPTANCE/DECLINATION
COURT USE ONLY
RIGL 33-8-4
STATE OF RHODE ISLAND
Select County
County of
PROBATE COURT OF THE
Select City or Town
Estate of
City or Town of
Alias
No.
The undersigned named (check one):
Executor(s)/Executrix(trices)
Administrator(s)/Administratrix(trices)
Other
Fiduciary
Name
Street
Address
City/Town
State
Zip
Code
Email
Phone
Number
Co-Fiduciary
Name
Street
Address
City/Town
State
Zip
Code
Email
Phone
Number
Decline(s) said trust:
Signature of Person Declining
PERSON DECLINING SIGN HERE
Notary:
Name of Notary
State
County
On
day of
, 20
the person declining, known to me or proved through satisfactory evidence,
signed the document in my presence and swore or affirmed the statement(s) in the documents is/are truthful and accurate.
Signature of Notary Public
Date
NOTARY SIGN HERE
Commission ID#
Commission Expiration Date
Notary Seal
PC-3.4 ( Rev. 07/17)
Page 1 of 2
State of Rhode Island and Providence Plantations
DATE FILED
Probate Court
FOR
ACCEPTANCE/DECLINATION
COURT USE ONLY
RIGL 33-8-4
STATE OF RHODE ISLAND
Select County
County of
PROBATE COURT OF THE
Select City or Town
Estate of
City or Town of
Alias
No.
The undersigned named (check one):
Executor(s)/Executrix(trices)
Administrator(s)/Administratrix(trices)
Other
Fiduciary
Name
Street
Address
City/Town
State
Zip
Code
Email
Phone
Number
Co-Fiduciary
Name
Street
Address
City/Town
State
Zip
Code
Email
Phone
Number
Decline(s) said trust:
Signature of Person Declining
PERSON DECLINING SIGN HERE
Notary:
Name of Notary
State
County
On
day of
, 20
the person declining, known to me or proved through satisfactory evidence,
signed the document in my presence and swore or affirmed the statement(s) in the documents is/are truthful and accurate.
Signature of Notary Public
Date
NOTARY SIGN HERE
Commission ID#
Commission Expiration Date
Notary Seal
PC-3.4 ( Rev. 07/17)
Page 1 of 2
Decline(s) said trust:
Signature of Person Declining
PERSON DECLINING SIGN HERE
Notary:
Name of Notary
State
County
On
day of
, 20
the person declining, known to me or proved through satisfactory evidence,
signed the document in my presence and swore or affirmed the statement(s) in the documents is/are truthful and accurate.
Signature of Notary Public
Date
NOTARY SIGN HERE
Commission ID#
Commission Expiration Date
Notary Seal
Accepts said trust:
Signature of Executor/Executrix or Adminstrator/Administratrix
Date
EXECUTOR/EXECUTRIX OR ADMINISTRATOR/ADMINISTRATRIX SIGN HERE
Notary:
Name of Notary
State
County
On
day of
, 20
the executor/executrix or administrator/administratrix, known to me or proved
through satisfactory evidence, signed the document in my presence and swore or affirmed the statement(s) in the documents is/are
truthful and accurate.
Signature of Notary Public
Date
NOTARY SIGN HERE
Commission ID#
Commission Expiration Date
Notary Seal
Accepts said trust:
Signature of Executor/Executrix or Adminstrator/Administratrix
Date
EXECUTOR/EXECUTRIX OR ADMINISTRATOR/ADMINISTRATRIX SIGN HERE
Notary:
Name of Notary
State
County
On
day of
, 20
the executor/executrix or administrator/administratrix, known to me or proved
through satisfactory evidence, signed the document in my presence and swore or affirmed the statement(s) in the documents is/are
truthful and accurate.
Signature of Notary Public
Date
NOTARY SIGN HERE
Commission ID#
Commission Expiration Date
Notary Seal
PC-3.4 ( Rev. 07/17)
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