New York Small Estate Affidavit
This document is prepared in accordance with the New York Estates, Powers & Trusts Law (EPTL) § 13-1.1, allowing for the collection of a deceased person's small estate. It is intended for estates valued at $50,000 or less. Please provide accurate information in all the fields below to ensure the affidavit's validity.
Decedent Information
Full Legal Name: _____________
Date of Death: __/__/____
County of Death: _____________
Last Known Address: _____________
Affiant Information
Full Legal Name: _____________
Relationship to Decedent: _____________
Address: _____________
Phone Number: _____________
Email Address: _____________
Asset Information
List all assets belonging to the decedent that you seek to collect using this affidavit.
- Asset Description: _____________, Value: $_________
- Asset Description: _____________, Value: $_________
- Asset Description: _____________, Value: $_________
Debts and Liabilities
List all known debts and liabilities of the decedent below.
- Creditor Name: _____________, Amount Owed: $_________
- Creditor Name: _____________, Amount Owed: $_________
- Creditor Name: _____________, Amount Owed: $_________
Declaration
I, _________ (Affiant’s Name)_________, declare under penalty of perjury that the information provided in this document is true and accurate to the best of my knowledge. I understand that this affidavit is being made for the purpose of collecting the decedent's assets valued at $50,000 or less and that this document does not serve as a substitution for a will or other legal processes that may be required under New York law.
Signature
Affiant's Signature: _____________
Date: __/__/____
Notarization (If Required)
This section to be completed by a Notary Public.
State of New York )
County of ____________ )
Subscribed and sworn to (or affirmed) before me on this __ day of ___________, 20__, by ____________________, proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me.
Notary Public Signature: _____________
Printed Name: _____________
Commission Number: _____________
My Commission Expires: __/__/____