Tennessee Probate Form

Small Estate Petition For Limited Letters Of Authority (Anderson)

Everything you need to know about Tennessee Form Small Estate Petition For Limited Letters Of Authority (Anderson), including helpful tips, fast facts & deadlines, how to fill it out, where to submit it and other related TN probate forms.

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About Small Estate Petition For Limited Letters Of Authority (Anderson)

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 Petition For Limited Letters Of Authority (Anderson) is a commonly used form within Tennessee. 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 Petition For Limited Letters Of Authority (Anderson)

Sometimes it’s tough to find a quick summary— here’s the important details you should know about Small Estate Petition For Limited Letters Of Authority (Anderson):

  • This form pertains to the State of Tennessee

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 Tennessee’s Form Small Estate Petition For Limited Letters Of Authority (Anderson) up to date, certain details can change from time-to-time with little or no communication.

How to file Form Small Estate Petition For Limited Letters Of Authority (Anderson)

Step 1 - Download the correct Tennessee 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 Tennessee 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 Petition For Limited Letters Of Authority (Anderson), take a break, and then review. Probate and estate settlement processes in TN 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 Petition For Limited Letters Of Authority (Anderson) 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 Petition For Limited Letters Of Authority (Anderson) 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?

👉 Find and Contact your Local Probate Court

👉 What is a Domicile Jurisdiction?

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When Small Estate Petition For Limited Letters Of Authority (Anderson) is due

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 Tennessee.

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

  1. The sooner you begin, the faster Tennessee 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 Tennessee. 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 Tennessee 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 Tennessee 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 Tennessee probate clerk or court for exact answers regarding Form Small Estate Petition For Limited Letters Of Authority (Anderson), and when in doubt— consult a qualified trust & estates lawyer for that area.

How to Download, Open, and Edit this form Online

Small Estate Petition For Limited Letters Of Authority (Anderson) is one of the many probate court forms available for download through Atticus.

It may also be available through some Tennessee 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 Tennessee.

While Atticus automatically provides the latest forms, be sure to choose the correct version of Form Small Estate Petition For Limited Letters Of Authority (Anderson) 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 Tennessee probate court office.

Small Estate Petition For Limited Letters Of Authority (Anderson) 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 Tennessee-provided government platform. Once you’ve opened the form, you should be able to directly edit the form before saving or printing.

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Did you know?

  • Form Small Estate Petition For Limited Letters Of Authority (Anderson) is a probate form in Tennessee.

  • Tennessee has multiple types of probate and the necessary forms depend on the unique aspects of each estate, such as type and value of assets, whether there was a valid will, who is serving as the personal representative or executor, and even whether or not they also live in Tennessee.

  • During probate, all personal representatives and executives in are required to submit a detailed inventory of assets that must separate non-probate assets from probate assets.

  • Probate in Tennessee, especially without guidance, can take years to finish and cost upwards of $14,000.

Frequently Asked Questions about Small Estate Petition For Limited Letters Of Authority (Anderson)

Probate is the government’s way of making sure that when a person dies, the right stuff goes to the right people (including the taxes the government wants).

All of that stuff is collectively known as someone’s “estate”, and it’s the job of the executor or personal representative to fill out all the forms and complete all the required steps to formally dissolve the estate. 

To get instant clarity on the entire probate process and get an idea of the steps, timeline, and best practices, read the Atticus Beginner’s Guide to Probate

The best place? Create an account in Atticus to start getting estate-specific advice. 

You may need a lawyer, you may not, and paying for one when you didn’t need it really hurts. Atticus makes sure you make  the best decisions (plus you can write it off as an executor expense).

We’ve also created a list of other probate services. Be sure to check it out!

An executor is named in someone’s will, and if the deceased didn’t have a will, then the spouse or other close family relative usually steps up to fulfill the role. If no one wants to do it, then a judge will appoint someone. 

The executor is responsible for the complete management of the probate process, including major responsibilities such as:

  • Creating an inventory of all probate assets.

  • Filling out all necessary forms

  • Paying off all estate debts and taxes

  • Submitting reports to the court and beneficiaries as requested

And much more. This process often stretches longer than a year. 

For an idea of what separates executors who succeed from those who make this way harder than it should be, visit our article, Executors of an Estate:
What they do & secrets to succeeding
.

The Exact Text on Form Small Estate Petition For Limited Letters Of Authority (Anderson)

Here’s the text, verbatim, that is found on Tennessee Form Small Estate Petition For Limited Letters Of Authority (Anderson). You can use this to get an idea of the context of the form and what type of information is needed.

Page 1 of 2 pages. THE SMALL ESTATES ACT FORM 180P, REV.2014.08.14 S. LEE AKERS, CLERK & MASTER E LEVENTH JUDICIAL DISTRICT OF TENNESSEE This document is for general informational purposes only, is not a substitute for qualified legal advice, and should in no way be relied upon or construed as legal advice. If you want specific information on legal issues or wish to address specific factual situations, you should seek advice from your lawyer. THE SMALL ESTATES ACT T.C.A. §§ 30-4- 101—105. This chapter is cumulative to existing law in the administration of decedent’s estates and is intended to provide an optional and alternative method for the administration of small estates. 30-4-105. SMALL ESTATE One with PERSONALTY value of $50,000 or less. 30-4-102(5). Can be TESTATE or INTESTATE. PERSONALTY PERSONALTY, or interest therein, owned by Decedent. Includes insurance on Decedent's life payable to the estate. Does not include personalty held jointly with right of survivorship or insurance on Decedent's life payable to beneficiaries other than the estate. 30-4-102(4). AFFIANT PERSON executing the AFFIDAVIT. 1 30-4-102(3). COURT Probate court in the Tennessee county where Decedent had legal residence on date of death. 30-4-102(2). PERSON Includes individual, partnership, firm, business trust, corporation or other legal entity. 30-4-102(3). TIME 45 days after Decedent’s death if no estate has been commenced. 30-4-103(1)(A). Upon motion of any of Decedent's competent, adult legatees/devisees/heirs/next-of-kin, 2 or on its own motion for good cause, C OURT may reduce the 45-day period. 30-4-103(1)(C). 3 WHO MAY FILE 4 Any competent, adult beneficiary/heir/personal representative/next-of-kin 2 /creditor. 30-4-103(1)(A). 5 Any competent adult not a beneficiary/heir/personal representative/next-of-kin 2 may be appointed if all competent, adult beneficiary/heir/personal representative/next-of-kin consent in writing to appointment of such P ERSON. The consent of any executor who has renounced appointment is not required for COURT to appoint AFFIANT. 30-4-103(D). AFFIDAVIT Must contain these facts: Whether Decedent left a Will, if so, original shall be deposited with the Clerk for safekeeping and the $5 fee paid as required by 32-1-112. 30-4-103(3). A copy of the original will be filed to support the AFFIDAVIT. 6 30-4-103(1)(A)(i). List of unpaid debts, to include name/address of each creditor and amount due. 30-4-103(1)(A)(ii). Itemized Property description with the value of all Decedent's PROPERTY. 30-4-103(1)(A)(iii). Names/addresses of all PERSONS known to have any of Decedent's PROPERTY. 30-4-103(1)(A)(iii). Schedule of all insurance on Decedent's life payable to Decedent's estate; 30-4-103(1)(A)(iii). Name/age/address/relationship of each person entitled to receive any of Decedent's PROPERTY. 30-4-103(1)(A)(iv). Disclosure that AFFIANT evidences by signature that, subject to penalty for perjury, the AFFIDAVIT is not false/misleading and that AFFIANT is mindful of all duties imposed upon AFFIANT. 30-4-103(1)(B). BOND REQUIRED Affiant bond with 2 or more sufficient sureties or 1 corporate surety. Bond must equal the value of Decedent's estate to be administered. Bond is not required if the provisions of 30-1-201 apply. 30-4-103(5). (Our Court’s position is that the provisions of 30-1-201 cannot apply as no letters are issued. Therefore, we require a bond.) 7 A SMALL ESTATE MAY BE ADMINISTERED IN THE FOLLOWING MANNER: ADMINISTRATION BY PROBATE CLERK Clerk not liable for good faith services to AFFIANT in completing the affidavit based upon information furnished by AFFIANT. 30-4-103(1)(B). Clerk charges fee for processing a small estate pursuant to 8-21-401 and 32-1-112. 30-4-103(3). Clerk files and assigns a number to the original AFFIDAVIT and indexes it as other estates are indexed. Clerk delivers to AFFIANT as many certified copies of the A FFIDAVIT as are requested. An Affidavit may be amended if the aggregate amount does not exceed the statutory limitation. 30-4-103(2). If required, Clerk sends the NONRESIDENT APPOINTMENT OF AGENT FOR SERVICE OF PROCESS that appoints the Tennessee Secretary of State as A FFIANT’s agent for service of process. 35-50-107. ADMINISTRATION BY AFFIANT 8 TAKE POSSESSION OF D ECEDENT’S PROPERTY AFFIANT must furnish a certified copy of the AFFIDAVIT to all PERSONS indebted to Decedent or holding Decedent’s property, (including registrar/transfer agent of any stock, bonds, notes or other evidence of ownership, indebtedness, property or right belonging to Decedent). Upon receipt of the A FFIDAVIT, and upon AFFIANT’s demand, those persons must pay/transfer/deliver to A FFIANT all such indebtedness owing by and other property in possession of or subject to registration and/or transfer by those persons. 30-4-104(a). After receiving a certified copy of the AFFIDAVIT, if PERSON holding any of Decedent's property refuses to pay/transfer/ deliver the property to or at Affiant’s direction, such P ROPERTY may be recovered or compelled in an action brought in any court of competent jurisdiction for such purpose upon proof of the facts required to be stated in the A FFIDAVIT. Costs of such proceeding will be adjudged against P ERSON wrongfully refusing to pay, transfer or deliver the PROPERTY. 30-4- 104(e). Every PERSON making payment, transfer or delivery of Decedent's PROPERTY to AFFIANT are released and discharged from all further liability to the estate and its creditors to the same extent as if such payment, transfer or delivery were made to the duly appointed, qualified and acting personal representative of Decedent, and P ERSON making such payment, transfer or delivery shall not be required to see to the application thereof or to inquire into the truth or completeness of any statement in the AFFIDAVIT. 30-4-104(b). TAXES AFFIANT must file returns and pay tax on PROPERTY in Decedent's estate, pursuant to title 67, chap. 8, parts 3-5. 30-4- 104(d). DISTRIBUTION OF DECEDENT’S Decedent's PROPERTY must be distributed as provided by a will, or if none, to Decedent's heirs by law. AFFIANT and the recipient of PROPERTY from the AFFIANT are liable, (to the extent of the value of the PROPERTY so received), to unpaid Page 2 of 2 pages. THE SMALL ESTATES ACT FORM 180P, REV.2014.08.14 ESTATE creditors and to every other person with a prior claim against Decedent's estate or prior right to any of Decedent's P ROPERTY, and are also accountable to any personal representative of Decedent thereafter appointed. 30-4-104(c). BOND DISCHARGE AFFIANT/sureties may obtain discharge from liability under the bond in 1 of 2 ways: 30-4- 103(5). A. COURT may discharge bond after A FFIANT files: (i)The tax receipt issued pursuant to § 67-8-420, OR the certificate issued pursuant to 67-8- 409(f) AND 2.2 An affidavit that each of Decedent’s debts are paid. 30-4-103(5)(A). B. AFFIANT and sureties on AFFIANT ‘s bond may wait until the first anniversary of the filing og the affidavit when the court shall automatically discharge them from liability. TENNCARE RELEASE A TennCare release is not required for Small Estates. 9 1 Non-resident AFFIANTS are required to file the NONRESIDENT APPOINTMENT OF AGENT FOR SERVICE OF PROCESS that appoints the Tennessee Secretary of State as Affiant’s agent for service of process. 35-50-107. 2 Not all “next-of-kin” are heirs. See, Akers Chart for Heirs in Tennessee, Form 171P. 3 Since creditors are not listed as a possible movant to reduce time, the time should not be reduced for creditors unless an exceptional situation exists such as someone leaving the state with the property. 30-4- 103(1)(C) 4 While LETTERS can be issued in Tennessee to administer the estate of a non-resident decedent when such non resident decedent has property in Tennessee, this does not apply to Small Estates. The Act defines court as the court then exercising probate jurisdiction in the county in which Decedent had legal residence on the date of death. 30-4- 102(2). [Outside of a probate matter, an heir may be able to use 30-2- 103(b) as it applies to anyone who may owe Decedent money. This statute requires a passage of 6 months and amount must be $10K or less. 45-2- 708 is the statute that also authorizes a bank to make disbursement after 30 days.] 5 For heirs, we still apply the preference order of 30-1- 106; to breach this order there must be good reason, preferably in writing, e.g., a written waiver to serve by spouse: spouseðchildrenðparentsðsiblingsðsiblings’ issueðgrandparentsðgrandparents’ issueðcreditor) 6 The copy of the original Will will be Red stamped to show it has not been probated. 7 We require a bond on all small estates. Bond must be equal the value of the estate to be administered. 30-4- 103(4). The bond must use the word affiant and not use words like Personal Representative, Executor, or Administrator. We require a corporate surety, except that the Court will allow some attorneys to be surety up to $3,500. On rare occasions we could have two or more individual sureties, provided they are “sufficient” but that is almost impossible to measure. If everything looks secure and there are no debts, I will excuse bond for an estate around $1000 if T.C.A. § 30-1- 201 otherwise would not require a bond. Note also that the rational behind normally setting a bond is that while § 30-1-201 otherwise would not require a bond excused in a will, the document purporting to be a will has not been probated and therefore is not a will. 8 A Small Estate is not court “administered.” There are no letters of administration or letters testamentary issued. There can be no estate administration until such letters are issued. T.C.A. § 30-1- 101. If the legislature had intended for electives (Exempt Property, Year’s Support, Homestead, and Elective Share), to be included in a Small Estate, they would have made specific provision for such. 9 T.C.A. 71-5- 116(c)(2) states, “Before any probate estate may be closed pursuant to title 30,...the personal representative of the estate shall file...a release from...TennCare....” Thus, the TennCare release requirement, by not specifically excluding Small Estates, would seem to include them. The TennCare request for release, however, is required within 60 days of the issuance of either L ETTERS OF ADMINISTRATION or L ETTERS TESTAMENTARY. T.C.A. 71-5- 116(d)(1)(B). Such letters are not issued in a Small Estate. Therefore there is no triggering requirement for notice to TennCare pursuant to T.C.A. 71-5-116. Technically, a Probate estate is a testate estate, as probate is merely the proving of a will. If a will is attached to a Small Estate Affidavit, the will is not probated. Therefore the Small estate with a will, even technically speaking, is not a “Probate Estate”. The words “Probate estate” are used in the TennCare statute, however, as a generic term for estates requiring Letters, as that is historically what “Probate” has become. Small Estates do not have a Personal Representative. “ A FFIANTS” of small estates are not personal representatives. The personal representative of an estate is one who has been issued L ETTERS OF ADMINISTRATION or LETTERS TESTAMENTARY. T.C.A. §§ 30-1- 101, 30-1-102, and 30-1-111. That has not been done in a Small Estate. The Small Estates Act, itself, recognizes that the AFFIANT is not a personal representative: (1) Regarding AFFIANT’s duty to take possession of estate property, those persons delivering property to A FFIANT are released and discharged from further liability “...to the same extent as if such... delivery were made to the duly appointed, qualified and acting personal representative of the decedent....” (Emphasis supplied.) T.C.A. § 30-4- 104(b); and (2) Regarding A FFIANT’s duty to distribute estate property, Decedent's property must be distributed as provided by a will or by law. A FFIANT and the recipient of such property are liable, (to the extent of the value of the property so received), to unpaid creditors and to every other person with a prior claim against Decedent's estate or prior right to any of Decedent's property, and “...shall be accountable to any personal representative of the decedent thereafter appointed.” (Emphasis supplied.) T.C.A. § 30-4-104(c). It would seem that T.C.A. 71-5- 116(d)(1)(B) would have to be changed to include the Small Estate Affidavit along with letters. Also, if probate clerks were required to administer small estates to aid TennCare potential recovery, then we need to increase the fee for Small Estates. 1 IN THE SEVENTH JUDICAL DISTRICT FOR THE STATE OF TENNESSEE ANDERSON COUNTY - CHANCERY DIVISION - PROBATE SECTION THE ESTATE OF: _ _________________________________ DOCKET NUMBER: ________________ PETITION FO R SMALL ESTATE LIMITED LETTERS OF AUTHORITY LETTERS OF ADMINISTRATION/LETTERS TESTAMENTARY Your Personal Representative(s)/Administrator(s), ____________________________________, would respectfully show the court as follows: The decedent ______________________________, age _____, died on the ____ day of ____________________, 20_____ at ______________________________________ (address) The permanent address of the decedent at the time of death was: _______________________, ____________________, TN __________ in ___________________ County, as evidenced by a copy of the death certificate which is being filed with this Petition. __ The Decedent left no Will __ The Decedent left a Will dated____________________, which does not require administration by the Court, but is being recorded pursuant to T.C.A. § 30-4-103. (ATTACH ORIGINAL WILL .) The names of the attesting witnesses to the decedent’s Will are: _________________________________________________ _________________________________________________ The Petitioner(s) is/are not aware of any instrument revoking the document and the Petitioner(s) believes the instrument is the decedent’s Last Will and Testament. 2 q Bond must be posted in the amount of $__________________. qBond is excused: qAffiant is the sole heir or beneficiary of the decedent’s estate. qEach person who is an heir or beneficiary of the decedent is an adult and has consented to waive the affiant’s bond as evidenced by each’s signed, acknowledged agreement to ‘waive’ bond which is filed along with this affidavit. qAffiant is a bank excused from bond by T.C.A. § 45-2-1005. __ The Decedent died owning an interest in business and/or personal property. List all personal property which includes cash, bank accounts, lock boxes, notes receivable, automobiles, stocks, bonds, life insurance or household furnishings, etc. Do not list jointly owned property or life insurance that is payable directly to a beneficiary other than the estate. This list should, however, Include all life insurance policies payable to the Decedent’s estate. The aggregate of the Decedent’s estate must not exceed the aggregate statutory amount of $50,000.00. The Decedent’s personal property owned at death is as follows: Items Value Location and Possession _________________________________________ ____________ __________________________________________ _________________________________________ ____________ __________________________________________ _________________________________________ ____________ __________________________________________ _________________________________________ ____________ __________________________________________ _________________________________________ ____________ __________________________________________ _________________________________________ ____________ __________________________________________ An estimate of the fair market value of the estate, unless bond is waived by statute, is $___________ Total Value 3 Creditor Amount Address _________________________________________ _____________ __________________________________________ _________________________________________ _____________ __________________________________________ _________________________________________ _____________ __________________________________________ _________________________________________ _____________ __________________________________________ _________________________________________ _____________ __________________________________________ _________________________________________ _____________ __________________________________________ _________________________________________ _____________ __________________________________________ _________________________________________ _____________ __________________________________________ _________________________________________ _____________ __________________________________________ The following are the names and addresses of all heirs and devisees of the deceased which the affiant(s) is (are) obligated to notify at their last known address. (Attach additional heirs and devisees on a separate sheet if necessary.) All of these persons must be notified by the affiant of the filing of this affidavit, by mailing a copy, to their last known address, postage prepaid. Name Address Age Relationship ______________________________ ______________________________ ______________________________ ________ ______________________ ______________________________ ______________________________ ______________________________ ________ ______________________ ______________________________ ______________________________ ______________________________ ________ ______________________ ______________________________ ______________________________ ______________________________ ________ ______________________ ______________________________ ______________________________ ______________________________ ________ ______________________ ______________________________ ______________________________ ______________________________ ________ ______________________ __ The Decedent left the following unpaid debts at death (attach additional sheet(s) if necessary): 4 Your Personal Representative(s)/Administrator(s) is/are willing to collect and preserve all assets of the estate, including the removal of any personal property from a property leased by the Decedent and cancellation of insurance policies that are no longer applicable due to the Decedent’s death. Your Personal Representative(s)/Administrator(s) acknowledge(s) that the decedent DID NOT have an interest in any real property on the date of death. Your Personal Representative(s)/Administrator(s) acknowledge(s) liability to TennCare, if applicable, to the extent of the value of the personal property. (See attached letter from TennCare.) Your Personal Representative(s)/Administrator(s) further acknowledge(s) that the affiant and the sureties, if any, will automatically be discharged on the first anniversary of the filing of the affidavit. Your Personal Representative(s)/Administrator(s) further evidence(s) by signature hereto that, subject to penalty of perjury, the information contained herein is not false or misleading and the affiant is not prohibited from filing affidavit because of having been sentenced to imprisonment in a penitentiary as set forth in T.C.A. § 40-20-115 or otherwise. The Personal Representative(s)/Administrator(s) is/are aware of and mindful of all duties imposed upon him in T.C.A. § 30-4-101 et seq. This______ day of _________________________, 20_______. ____________________________________ ___________ Name and Age of Personal Representative(s)/Administrator(s) _______________________________________ Relationship to Decedent: _______________ Signature of Personal Representative(s)/Administrator(s) ___________________________________________________________________________________ Address ___________________________________ Telephone Number Sworn to and subscribed before me on _______________________. My Commission Expires: __________________________________. Notary Public 5 I, ______________________ Clerk for the ________________ Court of ANDERSON County, Tennessee, certify that this is a court of record; that this is a true, full and correct copy of the Affidavit for Small Estate Limited Letter of Authority filed in this Court; that this Affidavit is still in full force and effect as of this date; and that the original of this Affidavit is on file in the office of the CLERK AND MASTER for ANDERSON County, Tennessee. _________________________________ ____________________________________ Date Clerk or Deputy Probate Clerk Legal Authority: TCA § 30-4-101 et seq. 9/11/2023 Note: Tennessee Code Annotated § 30-4-104 states that every person indebted to the decedent’s estate, having possession of any personal property belonging to the estate, or acting as registrar or transfer agent of any shares of stock, bonds, notes, or other evidence of ownership, indebtedness, or right belonging to the decedent’s estate must be furnished with a copy of the affidavit by the affiant, duly certified by the clerk of the court. Upon receipt of the copy of the affidavit and demand of the affiant, each person furnished with a copy of the affidavit shall pay, transfer, and deliver to the affiant: 1) all indebtedness owing by the recipient and other property in possession of or subject to registration or transfer by the recipient.

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