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AFFIDAVIT FOR COLLECTION OF <br />PERSONAL PROPERTY PURSUANT TO <br />SMALL ESTATE PROCEEDING 101340 <br />STATE OF COLORADO <br />SL <br />COUNTY OF EL PASO <br />HELEN NELSON the affiant(jO herein, being <br />sworn, state(s): <br />1. That affiant(sbaad <br />is/ne the successor(siof %ARS D. ISM" deceased. <br />2. That the fair market value of property owned by the decedent and subject to disposition by will or <br />intestate succession at the time of the decedents death, wherever that property is located, less hens and <br />encumbrances, does not exceed twenty thousand dollars. <br />j 3. That at least ten days have elapsed since the death of the decedent. <br />1{ 4. That no Application or Petition for the appointment Of a personal representative is pending or has <br />1 been granted in any jurisdiction. <br />5. Shat the affsantQ I I <br />1 as suecessorfd) of the decedent. is/AK entitled to the payment of any sums of money due and owing to the <br />i ? decedent. and to the delivery of an tangible persona) property belonging to the decedent and in the possession <br />i of another, and to the delivery of all instruments evidencing a debt. obligation, stock or chose in action <br />belong to the decedent, in the following respective proportions: <br />NAME OF SUCCESSOR PROPORTION <br />Helen Nelson Entire Estate <br />i3 <br />4 <br />S�Sna,urt o! Alfum SS­ of Aff— <br />Sisn.1 —of AM.. SW.— d Affvw <br />Snbscaft &sworn to before me on February 25, 1987 <br />�i (11"Wary)`1% rtimissionexpires 12 -23 -87 <br />NOTE= This Affidavit is pursuant to Section 15 -12 -1201 of the Colorado Probate Code as amended effective <br />i July 1, 1981. It can be used either by one affiant on be=half of all successors or by all successors as <br />affiants. It can not be used to tran.:fer the title to an) real property owned by the decadent. <br />CPC Form 40. Rev. 181. AFFIDAVIT FOR COLLECTION OF PtRS0%-4L PRO PS RTy PLRSLANT TO SAI ALL ESTATE PROCEEDING <br />6•MIaA ft"th:y, !t?} N. 4A Ave.. Late.o". CO 50214 -4MI _33 NOD— 451 <br />L <br />} <br />is <br />