
1. I am the personal representative of this estate. Upon filing this sworn statement with the court, this estate will be closed without
a hearing. More than five months have passed since the date of my original appointment as personal representative.
2. If required by law or court rule, I have published notice to creditors, and the time for presentment of claims has expired.
3. I have fully administered this estate by paying, settling, or disposing of the claims that were presented, the estate and administration
expenses, and all other taxes. I have distributed the assets of the estate to the persons entitled to the assets.*
4. The interested persons, addresses, and their representatives are identical to those appearing on the initial application/petition,
except as follows:
5. a. No Michigan estate or inheritance tax is due.
b. Michigan estate tax or inheritance tax has been paid in full. (Evidence of full payment from Michigan Department of Treasury is attached.)
6. I sent a copy of this sworn statement to all distributees and to all claimants whose claims are neither paid nor barred and to all
demandants. I furnished a full account in writing to the distributees whose interests are affected by the administration.
7. I reopened the estate and have completed the administration.
Sworn to before me on County, Michigan.
My commission expires: Signature:
Notary public, State of Michigan, County of
NOTICE TO INTERESTED PERSON(S): You may object to this sworn statement by filing written objections with the probate court
mentioned above along with a $20.00 filing fee. If an objection is not filed within 28 days after this sworn statement is filed with the
court, the probate register may issue a certificate stating that it appears that you have fully administered this estate. The certificate
does not preclude any action against you or the surety on a bond you may have obtained. If an action or proceeding involving you
is not pending in this court one year after this sworn statement is filed, your appointment ends.
*Note: Specify any exceptions. If any claims remain undischarged, state whether the estate was distributed subject to possible
liability with the agreement of the distributees, or state in detail other arrangements that were made to accommodate outstanding
liabilities.
STATE OF MICHIGAN
PROBATE COURT
COUNTY OF
Estate of
Approved, SCAO JIS CODE: SST
FILE NO.
PC 591 (9/09) SWORN STATEMENT TO CLOSE UNSUPERVISED ADMINISTRATION
Do not write below this line - For court use only
SWORN STATEMENT TO CLOSE
UNSUPERVISED ADMINISTRATION
SUPPLEMENTAL
MCL 700.3954, MCL 700.3958,
MCR 5.311(A), (C)
Attorney signature
Attorney name (type or print)
Bar no.
City, state, zip
Address
Telephone no.
City, state, zip
Address
Personal representative name (type or print)
Telephone no.
Personal representative signature
Date
Date