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What is a Statement of Claim Against Estate?

This document can be used to notify the representative's of a deceased person's estate that you are owed money by the deceased person.

When to use a Statement of Claim Against Estate:

  • You have a claim against a deceased person's estate.

Sample Statement of Claim Against Estate

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In the matter of the estate of


Case Number:




1. The undersigned states that the Claimant is a creditor of the estate of .


2. The Claimant hereby states that said estate is indebted to said creditor in the amount of for:


3. The following documents are attached hereto and incorporated herein by this reference as Exhibits shows proof of this claim:



4. The Claimant holds security for said Claim as follows: .


5. Affiant states that Affiant is Claimant and that Claimant has given credit to said estate for payments and offsets to which it is entitled and that the balance claimed as above stated is justly due.


6. The undersigned swears that the matter set forth in the foregoing pleading are true and correct according to the best knowledge and belief of the undersigned, and subject to penalty for making a false affidavit or declaration.




_________________________________________ ________________________




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