4B-502

STATE OF NEW MEXICO

IN THE PROBATE COURT

_______________ COUNTY

IN THE MATTER OF THE ESTATE OF                            No. ___________

______________________, DECEASED.

VERIFIED STATEMENT OF THE PERSONAL REPRESENTATIVE¹

I, ____________________, state that:

1.         I am the personal representative of the decedent's estate;

2.         The probate was filed more than three (3) months ago and the time for the presentation of creditor's claims has expired;

3.         I have completed my work on this estate. In order to do this, I:

            A.        inventoried and estimated the value in writing of all of the decedent's property and encumbrances on this property;

            B.        resolved all claims that were presented to me, either by paying them or otherwise taking care of them;

            C.        paid all the expenses of administration;

            D.        paid federal and state taxes that were due, including estate tax, inheritance or other death taxes and income taxes; and

            E.        distributed all the remaining assets, including decedent's real property, if any, to the people who were entitled to receive them, taking into account the family and personal property allowances allowed by law. The distributions were in the appropriate amounts;

4.         I mailed a copy of this document to anyone entitled to a distribution from the estate. I also mailed a copy of the accounting of this estate to anyone entitled to a distribution from this estate whose interests were affected by the accounting;

5.         As far as I know, there are no other actions pending in any court;

6.         By this closing statement, I am indicating to the court that I am closing the estate.

_____________________________________

Signature of personal representative

_____________________________________

Printed name

_____________________________________

Street address

_____________________________________

City, state and zip code

_____________________________________

Telephone number

STATE OF NEW MEXICO                          )

)ss.

COUNTY OF __________________            )

I, ______________________, am the personal representative. I state, upon oath, that the document set forth above, and the statements in it, are true and correct as far as I know and believe.

____________________________________

Signature of personal representative

SIGNED AND SWORN TO before me this ___ day of _____________, ____ by ___________________________

___________________________

Notary Public

(Seal)                                      My commission expires: ____________

USE NOTE

1.         WARNING: do not submit this form to the court until you have completed ALL estate work. Once this form is filed with the court, the personal representative no longer has authority to act on behalf of the decedent's estate.