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Small Estate Affidavit

Through the execution of this form, an applicant declares under oath that the value of her/his estate is below $50,000. Assessed value disregards location but considers liens and encumbrances. A copy of the affidavit must be forwarded to the Department of Revenue. Inheritance tax dues must also be paid. Download

Extracted Text for Proper Search

1	
SMALL ESTATE AFFIDAVIT
Collection of Personal Property	
South Dakota	
I, ____________________________________________________________________, upon
being duly sworn, state on my oath that:
1. My post office address is:  ___________________________________________________
2. My residence address is:  ___________________________________________________
4. Thirty days have elapsed since the death of the decedent;
5. No application or petition for the appointment of a personal representative is pending or	
has been granted in any jurisdiction.	
7. A copy of the affidavit will be furnished to the Department of Revenue and any inheritance	
tax due will be paid; and	
8. The claiming successor is entitled to payment or delivery of the property.
9. The decedent's name is ____________________________________________________	
and the decedent resided at ________________________________________________.	
10. I am entitled to payment or delivery of the property hereby claimed.	
THE FOREGOING STATEMENT IS MADE UNDER THE PENALTIES OF PERJURY.	
________________________________________	
Signature of Affiant	
State of South Dakota	       )	
County of	____________	 )  	
       
3. The value of the entire estate, wherever located, less liens and encumbrances, does not	
exceed	 fifty thousand dollars	 ($50	,000	);	
6. The  decedent  has  not  incurred  any  indebtedness  to  the  	South  Dakota  	Department  of 	
Social  Services  for medical  assistance  for  nursing  home  or  other  medical  institutional 
care;

2	
Acknowledgment of Individual
STATE OF SOUTH DAKOTA
COUNTY OF _________________	
On this ____ day of _________________, in the year __________, before me	
personally appeared ______________________________________, known to me (or
proved to me on the oath of ______________________________) to be the person who is
described in, and who executed the within instrument and acknowledged to me that
______________ he/she/they executed the same.	
______________________________
Notary Public
Printed Name: _________________	
My Commission Expires:
_____________________	
Disclaimer	
This  form  is  provided  without  any  warranty,  express  or  implied,  as  to  its  legal  effect  and
completeness.  Please use at your own risk.  If you have a serious legal problem, we suggest that
you consult an attorney.
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