Indiana Small Estate Affidavit
In accordance with the Indiana Small Estate Law, IC 29-1-8-1, this document facilitates the transfer of assets for estates where the total value does not exceed the statutory limit established by the State of Indiana.
This affidavit is intended for individuals asserting their right to collect property of a deceased person. The affidavit cannot be used until 45 days have passed since the decedent’s death.
1. Decedent Information
Full Name of Decedent: ________________________________________________________
Date of Death (MM/DD/YYYY): _____________
County of Decedent’s Residence at Time of Death: __________________________________
Last Four Digits of Decedent’s Social Security Number: ____________________________
2. Affiant Information
Full Name of Affiant (Person Filling Out This Form): ___________________________________________
Relationship to Decedent: ___________________________________________
Address: __________________________________________________________________________
Phone Number: ________________________
Email Address: ___________________________________
3. Property Information
List all property that is being claimed through this affidavit. Include a description of each item, the value of each item, and, if applicable, information identifying the account or property (account numbers, VIN, etc., if available).
- Description of Property: _______________________________________________________________________________
- Value: $________________
- Identifying Information (if applicable): ________________________________________________________________
Repeat the above steps for each piece of property being claimed.
4. Declaration
I, _____________________________ (name of affiant), declare under penalty of perjury under the laws of the State of Indiana that:
- The information provided in this affidavit is true and correct to the best of my knowledge and belief.
- The deceased did not leave a Will, to my knowledge.
- I am legally entitled to collect the property described.
- The value of the entire estate subject to administration, wherever located, less liens and encumbrances, does not exceed Indiana’s statutory limit for small estates.
- No application or petition for the appointment of a personal representative is pending or has been granted in any jurisdiction.
- All debts, including funeral and burial expenses, taxes, and medical expenses, have been paid or will be paid from the assets of the estate.
Signature of Affiant: ___________________________
Date: _____________
This document must be signed in the presence of a Notary Public.
Notary Public Section
State of Indiana )
__________________ ) ss:
County of ___________ )
On this ____ day of __________, 20____, before me, a Notary Public in and for said State, personally appeared ________________________________________, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowledged that they executed the same for the purposes therein contained.
In witness whereof, I hereunto set my hand and official seal.
Signature of Notary Public: ________________________________________
Printed Name: ____________________________
My Commission Expires: ___________________