NEED One certified copy of death certificate Original Will (if by arik17

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									NEED: One certified copy of death certificate Original Will (if there is one) Small Estate Affidavit/form 420PC; (decedent owned no real estate & net assets are less than $10,000) Court cost: $12.50 (assets 0-$99.99); $25 (assets $100-$4,999.99); $45 (assets $5,000-$10,000) For questions or an appointment, call Judicial Assistant, Fran Knight at 864-467-7146.
STATE OF SOUTH CAROLINA COUNTY OF GREENVILLE ) ) PROBATE COURT

IN THE MATTER OF name of deceased person CASE NUMBER (number is assigned by Probate Court)
AFFIDAVIT FOR COLLECTION OF PERSONAL PROPERTY PURSUANT TO SMALL ESTATE PROCEEDING

1.

The undersigned affiant(s), being sworn, state(s) that at the death of the decedent, he/she owned the following described property:
PROPERTY VALUE

List description of asset . . . AND . . . Dollar Value Example: Mellon Bank checking account 1965 Chevrolet Nova 2 shares Great Power Co. Stock Safe Deposit Box $189.00 $200.00 $50.00 -0-

2.

The value of the entire probate estate (the decedent=s property passing under the decedent’s will plus the decedent’s property passing by intestacy), wherever located, less liens and encumbrances, does not exceed ten thousand dollars. At least thirty days have elapsed since the death of the decedent. No Application or Petition for the appointment of a Personal Representative is pending or has been granted in any jurisdiction.

SAMPLE

3. 4. 5.

The successor(s) named herein is/are entitled to the payment of any sums of money due and owing to the decedent, and to the delivery of all tangible personal property belonging to the decedent and in the possession of another, and to the delivery of all instruments evidencing a debt, obligation, stock or chose in action belonging to the decedent, in the following respective proportions. RELATIONSHIP PERCENTAGE NAME OF SUCCESSOR ADDRESS TO DECEDENT INTEREST

“... those persons, other than creditors, who are entitled to property of a decedent under his will or this Code” (Devisees or Heirs-at-Law)
Example: Jane Smith Jean Smith Jim Smith 12 A Street Greenville, SC 29601 111 Gray Street Greenville, SC 29611 210 Fern Street Greenville, SC 29605 Wife Daughter Son 50% 25% 25%

FORM 420PC SCPC 62-3-1201

PAGE 1 OF 2

NAME OF SUCCESSOR

ADDRESS

RELATIONSHIP TO DECEDENT

PERCENTAGE INTEREST

SWORN to before me this ______ day of ________________________, 20_____. ________________________________ Notary Public for South Carolina My commission expires: _____________

Signature: Name: Address: Telephone (W): (H):

SAMPLE

_____sign here before notary_______________________________ _____print name_________________________________________ _____print address_______________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________

This Affidavit is pursuant to Section 62-3-1201 of the SCPC, effective July 1, 1987. It appears from the foregoing affidavit, the original of which is on file in the Probate Court of this county, that payment or delivery of the property should be made as follows:

(The Probate Court will complete this section directing distribution of the assets listed.)

Executed this _____ day of _____________________, 20___

__________________________________________ Debora A. Faulkner, Probate Court Judge
FORM 420PC (1/91)
SCPC 62-3-1201 PAGE 2 of 2


								
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