Small Estate

There are all sorts of forms executors, beneficiaries, and probate court clerks have to fill out and correspond with during probate and estate settlement, including affidavits, letters, petitions, summons, orders, and notices.

Small Estate is a commonly used form within Oregon. Here’s an overview of what the form is and means, including a breakdown of the situations when (or why) you may need to use it:

Atticus Fast Facts About Small Estate

Sometimes it’s tough to find a quick summary— here’s the important details you should know about Small Estate:

• This form pertains to the State of Oregon

• The official Oregon source for this form is here.

Government forms are not typically updated often, though when they are, it often happens rather quietly. While Atticus works hard to keep this information about Oregon’s Form Small Estate up to date, certain details can change from time-to-time with little or no communication.

Step 1 - Download the correct Oregon form based on the name and ID if applicable

Double check that you have both the correct form name and the correct form ID. Some Oregon probate forms can look remarkably similar, so it’s best to double, even triple-check that you’re using the right one! Keep in mind that not all States have a standardized Form ID system for their probate forms.

Step 2 - Complete the Document

Fill out all relevant fields in Form Small Estate, take a break, and then review. Probate and estate settlement processes in OR are long enough to begin with, and making a silly error can push your timeline even farther back. No thank you!

Note: If you don’t currently know all of the answers and are accessing Form Small Estate online, be sure to avoid closing the browser tab and potentially losing all your progress (or use a platform like Atticus to help avoid making mistakes).

Step 3 - Have Form witnessed or notarized (if required)

Some States and situations require particular forms to be notarized. If you have been instructed to get the document notarized or see it in writing on the document, then make sure to hire a local notary. There are max notary fees in the United States that are defined and set by local law. Take a look at our full guide to notary fees to make sure you aren’t overpaying or getting ripped off.

Step 4 - Submit Small Estate to the relevant office

This is most often the local probate court where the decedent (person who passed away) is domiciled (permanently resides) or the institution involved with this particular form (e.g. a bank). Some offices allow you to submit forms online, other’s don’t, and we while we generally recommend going in-person to expedite the process, sometimes that simply isn’t an option.

It’s also a generally good idea to establish a positive working relationship with any probate clerk (unfortunately there’s enough people & process out there making things more difficult and unnecessarily confusing for them), so a best practice is to simply ask the probate clerk proactively exactly how and where they’d prefer you to submit all forms.

Need help getting in touch with a local probate court or identifying a domicile probate jurisdiction?

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Different probate forms or processes can require different deadlines or response times for completing the appropriate form.

While some steps in the process are bound to specific deadlines (like petitioning for probate, having to submit an inventory of assets, or filing applicable notices to creditors and beneficiaries), many probate forms or processes are not tied to a specific deadline since the scope of work can vary based on situational factors or requirements involved.

Either way, there are a bunch of practical reasons why personal representatives should work to complete each step as thoroughly and quickly as possible when completing probate in Oregon.

5 reasons you should submit this form as quickly as possible:

1. The sooner you begin, the faster Oregon can allow heirs and beneficiaries to get their share of assets subject to probate. Acting promptly can also decrease the costs & overall mental fatigue through an otherwise burdensome process.
   
   Helpful Context: What’s the Difference Between Probate and Non-Probate Assets?

2. In general, creditors of an estate usually have around 3-6 months from the time you file notice to creditors to file any claims for debt against the deceased’s assets. If they don’t, then that debt is forfeited (and more importantly, the executor won’t be held personally responsible). So doing this sooner means you have a better idea of who is owed what and ensures you won’t get a surprise collector months later.

3. Not filing a will within 30 days (on average) could mean that the probate process proceeds according to intestate laws (laws that govern what happens to someone's stuff without a will) or is subject to unnecessary supervision by the probate court. And if you aren't directly related to the deceased (a.k.a. next of kin), this could also mean you lose your inheritance.

4. It’s important to file any necessary state tax returns on behalf of the deceased or estate by the following tax season in Oregon. If you don’t, you could owe penalties and interest. This also includes any necessary federal tax returns such as Forms 1040, 1041, or even a Form 706 estate tax return.

5. If a house in the State of Oregon is left empty (or abandoned) for a while, insurance can get dicey. For example, if the house burns down and no one has been there for a year, an insurance company may get out of paying your claim.

If you’re not using Atticus to get specific forms, deadlines, and timelines for Oregon probate, then try and stay as organized as possible, pay close attention to the dates mentioned in any correspondence you have with the State’s government officials, call the local Oregon probate clerk or court for exact answers regarding Form Small Estate, and when in doubt— consult a qualified trust & estates lawyer for that area.

Small Estate is one of the many probate court forms available for download through Atticus.

It may also be available through some Oregon probate court sites, such as . In order to access the latest version, be updated with any revisions, and get full instructions on how to complete each form, check out the Atticus Probate & Estate Settlement software or consider hiring a qualified legal expert locally within Oregon.

While Atticus automatically provides the latest forms, be sure to choose the correct version of Form Small Estate f using any other site or resource in order to avoid having to re-complete the form process and/or make another trip to the Oregon probate court office.

Small Estate is a .pdf, so opening it should be as simple as clicking “View Form” from within the Atticus app or by clicking the appropriate link found on any Oregon-provided government platform. Once you’ve opened the form, you should be able to directly edit the form before saving or printing.

Here’s the text, verbatim, that is found on Oregon Form Small Estate. You can use this to get an idea of the context of the form and what type of information is needed.

Small Estate Affidavit – Instructions Page 1 of 7 (May 2021) INSTRUCTIONS FOR SMALL ESTATE AFFIDAVIT TALK TO A LAWYER IF YOU DO NOT UNDERSTAND YOUR DUTIES OR ANY PART OF THESE INSTRUCTIONS! If you make a mistake, you may have to personally pay the cost of the mistakes and loss to the estate. The Affidavit will be filed with the court and has legal consequences. These instructions are not a complete statement of the law. You are responsible for following all Oregon laws, even those not explained here. Contact the Oregon State Bar Lawyer Referral Service if you need help finding a lawyer or have questions about the Bar’s Modest Means Program. Oregon State Bar Lawyer Referral Service - www.oregonstatebar.org Phone: 503.684.3763 or toll-free in Oregon at 800.452.7636 BEFORE YOU START  Make sure there are no other probate cases filed on this estate. Go to www.courts.oregon.gov to search online case records or call your local court for help searching.  DO NOT SIGN THE AFFIDAVIT YET! Your signature must be notarized by a court clerk or notary public. You will need photo identification. Sign the Affidavit in the presence of the notary or clerk.  Parties o You are the Affiant (the person completing the Affidavit). Affiants have specific legal duties under ORS 114.505 to 114.560 . o The person who died is the Decedent  You will need the death certificate and the will (if any) o You need a certified copy of the death certificate. You can get the death certificate from the funeral home or the Office of Vital Statistics .  If Decedent died outside Oregon, the death record may not be called a “death certificate.” Anywhere these forms use ‘death certificate’ it means the official record of death. o If Decedent left a will, you need the original will and an affidavit of attesting witness or affidavit of genuine signature (often attached to the will). ORS 113.055(1) has more information. You may be able to provide other evidence that the signature is Decedent’s. Talk to a lawyer about filing a regular probate case if you don’t have the will and supporting documents.  If the will was submitted for probate in another state, you will need a certified copy. A non-certified photocopy is not enough. Contact the court where the will was submitted.  If you only have a copy of the will, you cannot use this form. Talk to a lawyer about filing a regular probate case, which may accept a copy of the will. Small Estate Affidavit – Instructions Page 2 of 7 (May 2021)  Decedent must have died at least 30 days before you file the Affidavit (60 days if you are a creditor)  The “estate” means all of Decedent’s assets that are subject to administration by a court in Oregon o “Subject to administration” means the asset is in Decedent’s name alone and generally requires the asset to be located in Oregon. Talk to a lawyer if the estate includes assets in another state. o The estate does not include assets that transfer automatically to others following death, for example: • Assets owned jointly with right of survivorship (like vehicles and bank or investment accounts) • Assets that transfer by beneficiary designation (like life insurance and retirement accounts), unless Decedent’s estate is designated as a beneficiary • Accounts that are designated payable on death or transfer on death  Court staff can answer questions about filing your forms, but cannot give you legal advice, including what to put on the form  Oregon laws are found in the Oregon Revised Statutes (ORS) here: https://www.oregonlegislature.gov/bills_laws/Pages/ORS.aspx . Where you see “ORS” and a number, the first 3 numbers are the chapter and the last 3 numbers are the section. For example, ORS 114.505 means chapter 114 and section 505. Small estates are governed by Oregon Revised Statutes (ORS) 114.505-114.535 1 . Other laws and rules apply to court filings generally and to probate (estate) law. QUALIFIED FILERS AND ELIGIBLE ESTATES FILER / AFFIANT You can file a Small Estate Affidavit if you are any of the following:  An heir. An heir is someone who would inherit from an estate if there is no will. Heirs are defined by ORS 112.015 – 112.115 .  A devisee. A devisee is someone named in the will to receive part of the estate. A devisee may be a person, trustee, charity, or other organization.  A personal representative. A will may name a personal representative (also called ‘executor’) to handle the estate.  A creditor of the estate. A creditor is a person or organization who has a claim (debts, for example) against the estate. If you are filing as a creditor, you must mark the appropriate box on the form. If the decedent did not leave a will and has no heirs, you must get written authorization to file the Affidavit from the State Treasurer. You can only file the Affidavit if all the statements in Section 2 of the Affidavit are true. Talk to a lawyer if you are not sure you are qualified. ESTATE You can only file a Small Estate Affidavit if the total value of the estate is under $275,000 and:  No more than $75,000 of the fair market value of the estate is from personal property and  No more than $200,000 of the fair market value of the estate is from real property The dollar limits are based on the fair market value of the assets. Do not reduce any asset’s value 1 https://www.oregonlegislature.gov/bills_laws/ors/ors114.html Small Estate Affidavit – Instructions Page 3 of 7 (May 2021) by debts or liens. Do not include any asset that transfers automatically. See the next section for more information about assets. Talk to a lawyer if the estate values are higher than the limits above. FILL OUT THE FORM Be sure your entries and descriptions are clear and specific to avoid confusion. If your entries are not clear, you may have to file an amended Affidavit. YOU MAY HAVE TO PERSONALLY PAY THE COST OF MISTAKES IF YOU DO NOT DISTRIBUTE ASSETS CORRECTLY! Talk to a lawyer if you are not sure how to distribute the estate. ASSETS (Assets include both real and personal property)  Valuation Date means the date the asset’s value is established. o If Decedent died within a year of filing the Affidavit, use the value as of the date of death. If it has been more than a year, the valuation date must be no more than 45 days before filing the Affidavit. o Example: Decedent died two years before the Affidavit is filed. Asset A was worth $10,000 when Decedent died. Asset A is worth $12,000 three weeks before the filing date. Use the $12,000 value for Asset A.  Value to use o Use the fair market value as of the valuation date o Do not reduce any values by the amount owed on debts or liens (like mortgages or loans)  Real Property means land or interests in land. This may include a house, rental property, or easement. Mineral rights and timber that was not harvested by the date of death are considered real property. You must use a legal description of the property in addition to the street address. o The legal description can be found on the deed or by calling the county recorder’s office  Personal Property means any asset that is not real property, including intellectual property and money. The following details will help identify assets: • Vehicles - year, make, model, VIN, and license number • Bank and Investment Accounts - the name of the bank, type of account (checking, savings, IRA, 402(k), brokerage, etc.), and last 4 digits of the account number • Stocks and bonds - the name of company, number of shares or type of bond, and any identifying numbers (a CUSIP number is good) • Manufactured home - year, make and serial number • Promissory notes (such as for real property sold and secured by a trust deed) - the name of the borrower, the date of the note, and the original amount of the note • Life insurance (payable to the estate or without a designated beneficiary) - the name of the insurance company and the policy number Small Estate Affidavit – Instructions Page 4 of 7 (May 2021) DEVISEES If Decedent left a valid will, “devisees” are those named in the will to receive any part of the estate. The same person may be both a devisee and an heir. If so, they should be listed on the Affidavit in both sections. Divorce and marriage may affect the terms or validity of a will. Talk to a lawyer. Check to see if the will requires a devisee to survive Decedent by a certain amount of time or until an event occurs. Such conditions may be called survivorship provisions. Note any conditions on the Affidavit with the asset to be distributed. HEIRS An heir is anyone entitled to inherit part of an estate under Oregon law. You must figure out who the heirs are. Read ORS 112.015 – 112.115 for Oregon’s laws about heirs (“intestate succession”). Read the law carefully! Other Oregon laws may affect who is an heir. If you have questions, talk to a lawyer. Notes about heirs and devisees  Adopted children are treated as natural-born children under the law  If there are no heirs or devisees, the estate is inherited by (“escheats to”) the State Treasurer under ORS 112.055  Even if you cannot locate an heir or devisee, that person remains entitled to their portion of the estate. You must tell the court the names of any heirs you cannot locate. All heirs must be listed, even if Decedent did not know of them or have any contact with them. Any asset not covered by the will must be distributed to heirs as though the will did not exist. See the “Heirs” section above for how to handle assets not awarded to a devisee. If you have questions, talk to a lawyer. Notes about Wills  Many wills break the estate down into “tangible personal property” and “residue.” Often the same people will receive the same shares of those assets. If not, list those categories separately. o Residue means any asset not specifically identified in the will o If the will directs that the residue goes to “my children” and the decedent had a deceased child, read the will carefully. Depending on what the will says, the deceased child’s share could go to their children, or the siblings of the deceased child could receive a larger share of the residue. o If the will does not include directions about how to distribute residue, the residue must be distributed among the heirs according to ORS 112.015 – 112.115 .  You can enter the specific asset to be distributed to a recipient, or the portion of the estate each recipient will get Claims, Creditors, and Estate Expenses  Claims are liabilities of Decedent. Claims can include bills, debts, etc. Any person, business, or institution with a claim is a “creditor.” o You can use estimates for claims. If you don’t know the amount of a claim and can’t get a reasonable estimate, enter “unknown.” o See ORS 114.545 for information about paying undisputed claims like funeral expenses, utility bills, credit cards, mortgages, caregiver costs, etc. Small Estate Affidavit – Instructions Page 5 of 7 (May 2021)  You must file any required tax returns and pay any taxes owed from estate assets. This includes the decedent’s final personal income tax returns. This could also require fiduciary income tax returns if the decedent’s assets after death earned enough income before you distribute the estate. You may want to talk to a tax advisor. o Click here to go to the IRS for more information about federal taxes o Click here to go to the Oregon Department of Revenue website for information about state taxes  If the estate does not have enough money or assets to pay all claims and expenses, you must pay claims and expenses in the order of priority in ORS 115.125 . You could be personally liable if the estate does not have enough money and you pay the claims in the wrong order.  If Decedent received any government assistance such as Medicaid, the Oregon Health Plan, food stamps, or welfare benefits, a state agency may have a claim against the estate  Administrative expenses are usually expenses that arise after the decedent’s death. Examples include the filing fee for this Affidavit, lawyer fees, cost of preparing tax returns and buying death certificates, costs to maintain or prepare assets for sale, etc. Disputed Claims  If you believe a claim is not valid, you must deny it in writing. Enter it as a ‘disputed claim’. For example, a claim for services you believe were not rendered to Decedent, claims you believe were already paid, or claims for more than Decedent agreed to pay.  You cannot enter a claim as ‘disputed’ just because the estate does not have enough assets to pay it.  You must deny in writing claims that are not presented on time. See ORS 114.540(1)(a) for the time deadlines, usually within four months of the date of filing the Affidavit or amended Affidavit. How to Deny Claims  You must give notice of denial of claim within 60 days after the claim is presented to you. If you don’t, the claim is considered allowed. If you allow a claim that is invalid, you could be personally liable.  Mail or deliver notice that you are denying the claim to the person who filed the claim and their lawyer, if any. You can deny all or part of the claim. The notice must state the reason for denial and include other information required by ORS 114.540(2) . A creditor can ask the court for a “summary determination” of a claim. The court will hold a hearing unless you and the creditor reach an agreement about the claim. See ORS 114.540 . Before distributing the estate assets, you must wait until (1) 4 months have passed after the date the Affidavit, or the latest-filed amended Affidavit, was filed AND (2) all claims, expenses, and taxes have been paid Small Estate Affidavit – Instructions Page 6 of 7 (May 2021) Any creditor or beneficiary of the estate who has not been paid what they are entitled to receive from the estate can file a petition for summary review of administration. This must be done within two years of the filing date of the most recent Affidavit. See ORS 114.550 . A court will hold a hearing unless you and the person who filed the petition reach an agreement about the payment. FILE THE FORMS File in the appropriate circuit court the: • Small Estate Affidavit • Certified death certificate • Original will (if any) o with supporting affidavit or other supporting evidence confirming the signature of Decedent on the will The Affidavit has the information you need to find the proper court. Go to www.courts.oregon.gov to find the court’s address. NOTE: In some counties you may need to file in a different court like a municipal or justice court. You can check with your circuit court to see if they accept small estate filings and get information about where to file. You have to pay the filing fees when you file your papers. Go to www.courts.oregon.gov for the filing fee. • If you are low income, you may ask the court to defer (postpone) or waive your filing fee. You must complete an Application and Declaration for Deferral or Waiver of Fees and an Order Regarding Deferral or Waiver of Fees and file them with your papers. If the fee is deferred, you will have to pay the fee later. If the fee is waived, you do not have to pay it. Copies – Make copies of ALL documents for your records! After you file, ask the court for certified copies of the Affidavit. You may need these for banks and other institutions. Certified copies cost $5.00 plus 25 cents per page. Certified copies will include copies of all documents filed with the Affidavit except the death certificate. The filing fee and copy charges can be included in the Affidavit as estate expenses. You do not need certified copies to send with your required notices, regular photocopies are fine. REQUIRED NOTICES The Affidavit includes notice you are required to make. Read the “Required Notices” section carefully. You must mail or deliver a copy of the Affidavit (and the will, if any) to each recipient within 30 days of filing the Affidavit AMENDED AFFIDAVITS You must file an amended Affidavit if you discover:  a material error or omission in a prior Affidavit  additional assets not included in a prior Affidavit Small Estate Affidavit – Instructions Page 7 of 7 (May 2021) If the new estate values are higher than the limits for a small estate, your authority to administer the estate ends. You must promptly notify the court and any party entitled to a required notice.  A regular probate case must be started. You must turn over estate assets to the personal representative of the estate. Note that filing an amended Affidavit resets the time limits to file claims against the estate for all unpaid creditors, not just new ones Amended Affidavits must include all prior information in addition to new information. Review the instructions above and do not change any information from the original Affidavit unless the original entry was in error. Send copies of the amended Affidavit to any party entitled to a required notice, even if you sent the original Affidavit. See the “Required Notices” section of the original Affidavit. Small Estate Affidavit Page 1 of 10 (Sep 2021) IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE COUNTY OF __________________ In the Matter of: Case No: _________________ SMALL ESTATE AFFIDAVIT Decedent Amended (print legal name of the deceased) Filing Fee at ORS 21.145(4) NOTICE OF DUTY TO PAY DEBT OR TURN OVER PROPERTY To any person who receives a copy of this affidavit: Under ORS 114.535 1 , if you owe a debt to the decedent or have personal property of the decedent, you must pay the debt or turn over the property to the affiant. If you refuse, the affiant may ask the court to compel you to pay the debt or turn over the property and you could be responsible for the affiant’s attorney fees. I swear that the following statements are true to the best of my knowledge. I understand that this affidavit has legal consequences and that I can talk to a lawyer. The legal fees can be paid by Decedent’s estate if listed in this affidavit. I understand that I may have to personally pay for mistakes, omissions, or failure to perform a duty or obligation. THIS AFFIDAVIT IS BEING FILED BY A CREDITOR OF THE ESTATE BECAUSE DECEDENT DIED INTESTATE AND WITHOUT HEIRS . WRITTEN AUTHORIZATION FOR THIS FILING FROM THE STATE TREASURER IS ATTACHED. Thirty (30) or more days have passed since Decedent died No probate or small estate exists. No personal representative for the decedent’s estate has been appointed in Oregon, no petition is pending for appointment of a personal representative of the estate in Oregon, and no other small estate affidavit has been filed in Oregon. This Affidavit is filed in this court because: Decedent died in this county At death, Decedent lived in or owned property in this county Decedent’s estate currently owns property located in this county 1 https://www.oregonlegislature.gov/bills_laws/ors/ors114.html Small Estate Affidavit Page 2 of 10 (Sep 2021) AFFIANT’S INFORMATION (person completing this Affidavit) Name: Mailing Address: Phone: 1. I have authority to file this affidavit because (check all that apply): I am an heir of Decedent and Decedent left no will I am a devisee (entitled to receive something) in Decedent’s will I am named as personal representative in Decedent's will I am a creditor of Decedent or the estate and was not paid the full amount owed within 60 days after Decedent's death and (check one): Decedent died without a will (intestate) and without heirs. I have attached authorization from the State Treasurer allowing me to file this affidavit. or Authorization from the State Treasurer is not required because Decedent died with a will (testate) or left heirs 2. I am qualified to serve as the affiant because all the following are true:  I am 18 years old or older  I have not been convicted of a felony in Oregon or another state  I am not incapacitated or financially incapable (I am able to make health care decisions and manage my business affairs)  I am not currently suspended or disbarred from the practice of law; I did not resign from the Oregon State Bar while misconduct charges were pending  I am not a licensed funeral service practitioner unless Decedent was a relative of mine or Decedent was a licensed funeral service practitioner in a business relationship with me DECEDENT’S INFORMATION 3. A certified copy of Decedent’s death certificate is filed with this affidavit (required) Name: As shown on the death certificate Residence Address: Mailing Address: Social Security # (last 4 digits): Date of Death: Age at Death: Address for Place of Death: Small Estate Affidavit Page 3 of 10 (Sep 2021) ASSETS 4. The valuation date for the decedent’s estate is: Decedent’s date of death (if Affidavit is filed one year or less after Decedent’s death) Within 45 days before filing this Affidavit (if Affidavit is filed more than one year after the date of death) 5. As far as I know, the following assets are in the decedent’s estate and subject to administration in Oregon. My authority as affiant applies only to the assets listed here. Real Property Maximum total value $200,000 (see Instructions) List street address. You MUST include or attach a legal description. Fair Market Value None ---------------------- Total value of all real property Additional page attached titled “Section 5 – Real Property” Personal Property Maximum total value $75,000 (see Instructions) (Clearly identify assets according to the Instructions) Fair Market Value None ---------------------- Total value of all personal property Additional page attached titled “Section 5 – Personal Property” 6. Decedent’s safe deposit box (check all that apply): No inventory required Decedent did not rent a safe deposit box, either alone or with others and did not own any contents in a box rented by someone else Decedent did rent a safe deposit box with others, and at least one of the others is still alive and Decedent did not own any contents in the box or Inventory required Decedent owned contents in a safe deposit box rented by someone else Decedent did rent a safe deposit box alone or with other people and none of the others is still alive and I have an inventory of the box from the bank or credit union that has the box (see ORS 114.537(1)) I have listed all assets in the box that have value, if any, on this Affidavit (assets have value if they can be sold) The safe deposit box assets have no value or have value as listed in Section 5 Small Estate Affidavit Page 4 of 10 (Sep 2021) I have no information about a safe deposit box. If I later discover that the decedent did rent a safe deposit box, either alone or with others who have all died, I will:  Get an inventory of the box from the bank or credit union that has the box (see ORS 114.537(2))  Add the value of the assets in the box, if any, to the total value of personal property listed in section 5 of this Affidavit (assets have value if they could be sold)  If Decedent’s total items of personal property are still $75,000 or less, the bank can give me the contents of the box. If any items in the box have value, I will file an amended Small Estate Affidavit (see ORS 114.515(6)).  If Decedent’s total assets are more than $75,000 after I add the value of the items in the box, then the bank will keep the contents in the box. I will file a notice with the court that the estate is no longer a small estate. I will deliver or mail a copy of that notice to the bank that has the box. DISTRIBUTION OF ASSETS 7. Decedent: did not leave a will (intestate) to the best of my knowledge did leave a will (testate) and the original will (not a copy) accompanies this Affidavit and the will has an affidavit of attesting witness or affidavit regarding a genuine signature (If this is not true, you may not be able to file a Small Estate Affidavit, see the Instructions or talk to a lawyer.) or Decedent’s will has been submitted for probate in another state. A certified copy of the will accompanies this Affidavit. 8. Heirs Name of heir Last known address Relationship to decedent There are no heirs (see ORS 112.015 – 112.115) Additional page attached titled “Section 8 - Heirs” Small Estate Affidavit Page 5 of 10 (Sep 2021) 9. Devisees Name of devisee Last-known address There are no living devisees or Decedent did not leave a will Additional page attached titled “Section 9 – Devisees” 10. Asset Distribution The following people are entitled to receive the following property from Decedent’s estate: Name of heir (no will), devisee (will) Assets to be received (Note any conditions or survivorship provisions here. See Instructions.) Additional page attached titled “Section 10 – Asset Distribution” 11. Missing heirs or devisees Decedent died testate (left a will) and I can locate all living devisees. None of the devisees are missing without a known address. Decedent died intestate (had no will) and I can locate all living heirs. None of the heirs are missing without a known address. I cannot locate the following heir or devisee and I do not know if this person has died. Person I cannot locate: Property that person is to receive: Additional page attached titled “Section 11 – Missing Heirs or Devisees” Small Estate Affidavit Page 6 of 10 (Sep 2021) CLAIMS AGAINST ESTATE 12. I have made reasonable efforts to determine creditors of Decedent and the estate. I will continue attempts to determine all creditors of Decedent until distribution is complete.  Creditors should mail claims against the estate to me at (address): (optional) Email address*: (optional) Fax number*: *Note: Only use email and fax if you will regularly check for communications. If you provide your email address or fax number, the court will assume you receive any communication sent to you that way. 13. Undisputed Claims There are no undisputed claims The following expenses or claims against the estate remain unpaid (including reimbursement owed to someone who paid claims or expenses). I do not dispute these expenses or claims. I will pay undisputed claims as provided in ORS 114.545. (See Instructions for examples) Name and Last Known Address of Creditor Description of Undisputed Expense or Claim Amount (known or estimated) Additional page attached titled “Section 13 – Undisputed Claims” 14. Disputed claims There are no disputed claims I dispute the following claims against the estate. I believe these claims may be invalid. (See Instructions for examples.) Name and Last Known Address of Creditor Description of Disputed Claim Amount (known or estimated) Additional page attached titled “Section 14 – Disputed Claims” Small Estate Affidavit Page 7 of 10 (Sep 2021) 15. Estate administration and funeral expenses I do not expect to have administrative or funeral expenses I expect to pay the following expenses related to the estate (see Instructions for examples) Name and Address of Creditor Description of Expense Amount (known or estimated) Additional page attached titled “Section 15 – Estate Expenses” INFORMATION FOR CREDITORS AND HEIRS AND DEVISEES Claims may be barred. Some claims against the estate may be barred unless certain things happen. (1) Claims against the estate not listed in this Affidavit, or in amounts larger than those listed in this Affidavit, may be barred unless: (i) A claim is presented to the affiant within 4 months of the filing of this Affidavit or an amended Affidavit at the address, email address, or fax number stated in this Affidavit for presenting claims, or (ii) A personal representative of the estate is appointed within the time allowed under ORS 114.555 (2) If this Affidavit lists one or more claims that the affiant disputes, those claims may be barred unless: (i) A petition for summary determination is filed within 4 months of the filing of this Affidavit or an amended Affidavit, or (ii) A personal representative of the estate is appointed within the time allowed under ORS 114.555 Remedies. If the affiant does not comply with Oregon law and a person is injured because of that, the only ways to take action against the affiant are: (1) The summary determination of claims process under ORS 114.540 (2) The summary review of administration process under ORS 114.550 (3) The appointment of a personal representative for the estate within the time allowed by ORS 114.555 (usually 4 months from the date the Affidavit was filed) ***Note that time limits apply under the statutes Financial institutions not liable. A financial institution (as defined in ORS 706.008) that opens one or more deposit accounts for an affiant is not liable to any other person for opening the account or accounts or permitting the affiant to withdraw funds from the account or accounts by any means. The financial institution is not required to ensure that the funds of the decedent that are paid out by the affiant are properly applied. See ORS114.545(5). Small Estate Affidavit Page 8 of 10 (Sep 2021) REQUIRED NOTICES (Photocopies are allowed, you don’t need certified copies)  Heirs and devisees Within 30 days after filing this Affidavit with the court, I will deliver or mail to each heir and each devisee, if any, at their last known address: o a copy of this Affidavit showing the date of filing and o a copy of the will, if the decedent died testate If there are no heirs or devisees, or if there is a missing heir or devisee, I will deliver or mail a copy of this Affidavit within 30 days after filing with the court to: Estate Administrator Oregon State Treasury 775 Summer Street NE, Suite 100 Salem OR 97301-1279  Creditors Within 30 days after filing this Affidavit with the court, I will deliver or mail a copy of this Affidavit showing the date of filing to the last known address of: o each undisputed creditor (listed in section 13 above) and o each disputed creditor (listed in section 14 above) I will deny any claims that are not presented on time under ORS 114.540(1)(a) I will deny any claims presented on time that are not valid To deny a claim, I will mail or deliver written notice to the person who filed the claim and their attorney, if any, stating the reason for denying the claim and the information required by ORS 114.540(2) I understand that if I allow a claim that is invalid, I may have to personally pay the cost of the claim  State Within 30 days after filing this Affidavit with the court, I will deliver or mail a copy of this Affidavit showing the date of filing and a copy of the death certificate to the Department of Human Services (DHS) and the Oregon Health Authority at: Department of Human Services Estate Administration Unit PO Box 14021 Salem OR 97309-5024  Department of Corrections Decedent was not imprisoned in an Oregon prison at any time during the 15 years before death (note: a county or city jail is not a prison) Or I do not know if Decedent was imprisoned in an Oregon prison during the 15 years before death Decedent was imprisoned in an Oregon prison during the 15 years before death And within 30 days after this Affidavit is filed with the court, I will send a copy of this Affidavit showing the date of filing and a copy of the death certificate to: Department of Corrections 2575 Center St NE Salem, OR 97301 Small Estate Affidavit Page 9 of 10 (Sep 2021) AFFIANT DUTIES You must read and check each section below. You may be personally liable for failing to meet your responsibilities. If the court appoints a personal representative for the estate within 4 months after this Affidavit is filed, I will give the personal representative all of Decedent’s assets and records I will not distribute any assets until all claims, expenses, and taxes have been paid and 4 months have passed since this Affidavit was filed I will distribute the estate according to the will that was filed with the Affidavit. If Decedent did not leave a will, I will distribute the estate according to the laws of intestacy in ORS 112.017 - 112.115. Amended Affidavits If I discover a material error or omission in this Affidavit, I will file an amended Small Estate Affidavit and serve it as required by ORS 114.515(6) If I discover assets Decedent owned that are not listed in this Affidavit, I will file an amended Small Estate Affidavit before taking control of those assets according to ORS 114.515(6) If any newly-discovered property makes Decedent’s total asset values exceed the maximum values for a small estate , I will promptly notify the court and all persons I notified before, as required in ORS 114.515(7). Property and Income I will take control of, and collect income from, the assets of the estate listed in this Affidavit (see ORS 114.535). I will only sell assets as provided in ORS 114.547. I understand that my authority over Decedent’s assets only applies to assets listed in this Affidavit. I will administer the estate as promptly and with as little loss of value as I reasonably can under the circumstances. I understand that I may have to pay for loss of value caused by: o my neglect or unreasonable delay in collecting the estate’s assets o paying out money or delivering property in a way I should not have o failing to pay taxes as required by law o failing to close the estate in a reasonable time o dealing with the estate in a way that benefits me personally over creditors, heirs, or devisees o any other negligent or intentional bad acts regarding estate assets, or failing to act in a way that causes loss to the estate I will not commingle estate property with my own property or the property of any other person (“commingle” means combine) I will keep records of my work on the estate at least until the later of: 2 years after the filing of this Affidavit or the conclusion of any summary review proceeding under ORS 114.550 I will pay estate claims and expenses according to ORS 114.545(1)(f) and ORS 114.545(1)(g) from estate assets. If the estate does not have enough assets to pay all claims and expenses, I will pay them in the order set out in ORS 115.125. Small Estate Affidavit Page 10 of 10 (Sep 2021) I have read this Affidavit. The statements in this Affidavit are true and correct to the best of my knowledge. I understand that I make this statement under penalty of perjury. This Affidavit is made under ORS 114.505-114.560. Date Signature of Affiant (DO NOT SIGN until you are with a notary or court clerk) Print Name Address City, State, Zip Phone State of ______________, County of _____ _______ Signed and sworn to (or affirmed) before me on (date) ______ ____ _ by (name) My commission expires: Signature of notarial officer Title (and rank, if military officer)