Connecticut Small Estate Affidavit
This document is prepared in accordance with the Connecticut Probate Court Rules and relevant state laws, specifically the Connecticut Small Estates Act. It is used to facilitate the distribution of a deceased person's estate without formal probate, provided the total value of the estate does not exceed the threshold established by state law.
Please complete the following information:
1. Deceased's Information:
- Full Name: ______________________________________________________
- Date of Death: ___________________________________________________
- Last Known Address: ______________________________________________
- City, State, Zip: _________________________________________________
- Social Security Number: ___________________________________________
2. Affiant's Information (Person filling out this form):
- Full Name: ______________________________________________________
- Relationship to Deceased: _________________________________________
- Address: ________________________________________________________
- City, State, Zip: _________________________________________________
- Phone Number: ___________________________________________________
- Email Address: ___________________________________________________
3. Description of Assets: (List all assets with their estimated value. Attach additional sheets if necessary.)
- Asset 1: _________________________________________________________
- Value: $_________________________________________________________
- Asset 2: _________________________________________________________
- Value: $_________________________________________________________
4. Debts and Liabilities: (List all known debts and liabilities.)
- Creditor 1: ______________________________________________________
- Amount Owed: $___________________________________________________
- Creditor 2: ______________________________________________________
- Amount Owed: $___________________________________________________
5. Heirs and Beneficiaries: (List all individuals entitled to receive property from the estate, including their relationship to the deceased.)
- Name: ___________________________________________________________
- Relationship: ____________________________________________________
- Address: ________________________________________________________
- Name: ___________________________________________________________
- Relationship: ____________________________________________________
- Address: ________________________________________________________
By signing this affidavit, I declare under penalty of perjury that the information provided is true and accurate to the best of my knowledge. I understand that this document is being used to collect property of the deceased without formal probate and that I may be held legally liable if I intentionally provide false information.
Date: ________________________
Signature of Affiant: ___________________________________
This document does not require notarization under Connecticut law.