Pennsylvania Small Estate Affidavit Template
This Small Estate Affidavit is prepared in accordance with the Pennsylvania Probate, Estates and Fiduciaries Code, 20 Pa.C.S. § 3101 et seq.
Affidavit of Small Estate
State of Pennsylvania
County of ______________________
Before me, the undersigned authority, personally appeared:
Affiant Name: _______________________________
Address: _______________________________
Phone Number: _______________________________
who, being duly sworn, deposes and says:
- The decedent, Name of Decedent: _______________________________, died on Date of Death: _______________________________.
- The decedent was a resident of County: _______________________________.
- The value of the estate does not exceed $50,000 (or $100,000 if the surviving spouse is the sole heir).
- There are no pending claims against the estate, and all debts have been paid or will be paid from the estate assets.
- The undersigned is entitled to the property of the decedent as follows:
- _____________________________________________
- _____________________________________________
- _____________________________________________
Affiant hereby requests that the appropriate financial institutions and entities transfer the assets of the decedent to the undersigned.
Affiant understands that any false statement made in this affidavit may result in criminal penalties.
Executed this ____ day of ____________, 20__.
Signature of Affiant: _______________________________
Printed Name of Affiant: _______________________________
Sworn to and subscribed before me this ____ day of ____________, 20__.
Notary Public: _______________________________
My Commission Expires: _______________________________