North Dakota Small Estate Affidavit
This affidavit is executed pursuant to the North Dakota Century Code 30.1-23-01, for the purpose of collecting the assets of a deceased individual who was a resident of North Dakota at the time of death. It is designed for use when the total value of the estate does not exceed the amount specified by state law, allowing for the transfer of assets without a formal probate process.
Section 1: Deceased Information
Full Name of Deceased: ___________________________________________________________
Date of Death (MM/DD/YYYY): ________________________
Last Known Legal Address: ________________________________________________________
County of Residence at Time of Death: _____________________________________________
Section 2: Affiant Information
Full Name of Affiant (Person completing this affidavit): ________________________________
Relationship to Deceased: ________________________________________________________
Legal Address: ___________________________________________________________________
Contact Number: _________________________
Email Address (if available): ______________________________________________________
Section 3: Estate Information
Total Estimated Value of Estate (assets only, not exceeding state-specified amount): $___________
List of Assets to be transferred under this Affidavit:
- Asset Description 1: _________________________________________________________
- Asset Description 2: _________________________________________________________
- Asset Description 3: _________________________________________________________
Section 4: Declarations
The undersigned affiant hereby declares that:
- All information provided in this affidavit is true and accurate to the best of my knowledge and belief.
- The deceased did not leave a will, to the best of my knowledge and belief.
- No application or petition for the appointment of a personal representative is pending or has been granted in any jurisdiction.
- The value of the entire estate, wherever located, less liens and encumbrances, does not exceed the threshold amount as prescribed by North Dakota law.
- I am legally entitled to collect the assets described herein.
- All debts of the deceased, including funeral and burial expenses, have been paid or otherwise provided for.
Section 5: Signature
Signature of Affiant: _______________________________ Date: ____________________
State of _______________
County of ______________
Subscribed and sworn to (or affirmed) before me this ___ day of _______________, 20__
_________________________________
Notary Public
My Commission Expires: ___________________