355 South Court Street. Bronson, Florida Phone: (352) Clerk 0!

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1 355 South Court Street Bronson, Florida Phone: (352) Clerk 0! DISPOSITION OF PERSONAL PROPERTY WITHOUT ADMINISTRATION F.S FLORIDA PROBATE RULE DECEASED MUST BE A LEVY COUNTY RESIDENT FILING FEE: $ THE PETITION MUST BE COMPLETED IN ITS ENTIRETY PLEASE PROVIDE (2) SELF ADDRESSED STAMPED ENVELOPES THE DEATH CERTIFICATE CAN BE RECORDED FOR AN ADDITIONAL $10.00

2 Instructions For Disposition of Personal Property Without Administration To Qualify: The qualified expenses must be equal to or more than the non-exempt assets. For example, the funeral bill must be equal to or more than the bank account balance. IF THE ACCOUNT OR ASSET IS MORE THAN THE FUNERAL BILL, IT PROBABLY WILL NOT QUALIFY. IF THE DECEDENTOWNEDREALPROPERTY, THENTHEESTATEALSOCANNOTQUALIFYFOR THIS TYPE OF PROCEEDING. The decedent (the person who died) must have died less than two years from the date of filing. All claims are barred after two years from the date of death, , Fla. Stat., which means that no claim could be filed in an estate and there can be no qualifying claims to offset the assets. 3. The expenses must be out-of-pocket expenses. This means that pre-paid funeral plans do not qualify and medical bills that are paid by insurance also do not qualify. 4. The expenses must be paid by the person seeking to acquire the assets, unless the person who paid the expenses assigns the right to reimbursement to the person filing the petition.. 5. If the funeral bill or other qualifying expense is unpaid, the asset will need to be distributed to the funeral home or medical provider. 6. Cars and household furnishings can only be claimed as exempt property by a surviving spouse or children of the decedent, though they can be distributed as a reimbursement if the estate otherwise qualifies including these assets. 7. There may be a $1,000 personal property homestead exemption that also can be applied to qualify the estate for this proceeding. This can only be utilized by heirs. If the estate qualifies, then file: 1. A certified copy of the death certificate that has the cause of death removed. 2. A copy of the funeral bill listed in paragraph llb, if any, including documentation that shows (a) payment of the bill (if paid) and (b) who paid the bill, if paid. If the bill is not paid, then payment will be made to the funeral home. If the bill was paid by life insurance, then also provide documentation showing the beneficiary of that policy, since that beneficiary would be the person entitled to the reimbursement. 3. A copy of the medical bills listed in Paragraph 11 c, if any, including documentation that shows (a) payment of the bill (if paid) and (b) who paid the bill. If the medical bills were paid by health insurance, the insurance payments cannot be used to qualify the estate for this proceeding. 4. Copy of bank statement, title, stock certificate or other documentation describing the property and showing its value. t I I I Page 1 of 3

3 5. The original will, if there is one. Copies will not suffice. 6. The completed Petition for Disposition of Personal Property Without Administration. Do not leave any blanks. If the particular blank does not apply, so state and provide an explanation. If there is none, please also so state. Be sure your phone number appears on the petition so that you can be reached by phone if necessary. 1. Top blank line, put the name of the county where you are filing the case. 2. Leave the case number blank, it will be filled in when you file the case 3. On the blank line underneath the words "In Re: The Estate of' put the decedent's full legal name 4. The next line separates the caption from the petition, leave it blank 5. In paragraph 1 put your name, address and social security number. 6. In paragraph 2, put your relationship to the decedent 7. In paragraph 3, put the decedent's full legal name and any aliases the decedent used. 8. In paragraph 4, put the name of the city and state where the decedent was when the decedent died and date of death of the decedent. 9. In paragraph 5, state the county of the place that was the decedent's permanent residence at the time of the decedent's death. 10. In paragraph 6, give the last known address of the decedent. 1 L In paragraph 7, give the decedent's age at the time of death. 12. In paragraph 8, state the decedent's social security number. 13. In paragraph 9, mark one box or the other. If there was a will, it must be deposited. Copies of the will cannot be accepted, the original will must be filed. 14. In paragraph 10, list each beneficiary of the estate. If you are a beneficiary, you must also be included in this list. A full and correct address must be listed for each beneficiary. 15. In paragraph 11 a, list each asset or item that you wish the court to distribute. This can be bank accounts, stock, cars, checks or any other item that you want to have distributed. For bank accounts, include the account number, the name of the bank, the type of account, and the amount in the account along with a copy of the bank statement. For cars, include the year, make, model, and VIN and value and a copy of the title. For stock, include the CUSIP number, the number of shares, the name of the company that issued the shares and the value per share and a copy of the certificate or statement from the company holding the shares. For checks, include the name of the company issuing the check, the check number, the date of the check and the amount of the check, along with a copy of the check. For other assets, include all identifying information about the asset, the value or estimated value ofthe asset and copies of the document about the asset. 16. In paragraph 11 b, list the funeral expense. Funeral expenses are limited to $6,000 and must be paid by the person asking for distribution. This is the amount you would claim as a creditor ofthe estate, if a full estate were to be opened. Pre-paid funeral expenses will not qualify. Page 2 of 3

4 17. In paragraph 11c, list the medical expenses for the last 60 days of the last illness. This amount is the balance after insurance has paid its portion. This is intended to be the amount that you would claim as a creditor in the estate if a full estate were to be opened. 18. In paragraph 11d, list any other debts of the decedent, if any. 19. In paragraph 12, for each asset, show who that asset should be distributed to. If an asset is to be split, that should be identified. 20. In paragraph 13, list any other assets or debts ofthe decedent, if any. 21. Sign the petition either before a notary and have it notarized, or take the unsigned petition to the Clerk of Court where you are going to file the petition and sign it before a deputy clerk. 22. Put your phone number in the place indicated, so that if there are any questions about the petition you can be contacted. 7. If the decedent is survived by a spouse, and the applicant is not the spouse, consent from the spouse must be obtained. 8. Additional consents may be needed from other family members, depending on the facts of the case. Page 3 of 3

5 IN THE CIRCUIT COURT, EIGHTH JUDICIAL CIRCUIT IN AND FOR LEVY COUNTY, FLORIDA PROBATE DIVISION INRE: TIIEESTATEOF: Case No.: Deceased. I PETITION FOR DISPOSITION OF PERSONAL PROPERTY WITHOUT ADMINISTRATION (Verified Statement) Petitioner alleges: 1. Petitioner's name, address and social security number are: 2. Petitioner's relationship to the Decedent is: The Decedent's name is The Decedent died in, on, The Decedent was a resident of County, Florida. 6. The Decedent's last lmown address was 7. Decedent's age was The Decedent's social security number is ( ) The Decedent left no will. ( ) The Decedent's will was deposited with the Clerk of Court on, So far as is lmown, the names of the beneficiaries of decedent's estate and of the decedent's surviving spouse, if any, their address and relationship to decedent, and the ages of any who are minors are: Name Address Relationship Birth Date (IF MINOR) 1

6 11. The estate of decedent consists only of personal property exempt from the claims of creditors under the Constitution of Florida, and non-exempt personal property the value of which does not exceed the sum of the amount of preferred funeral expenses and reasonable and necessary medical and hospital expenses of the last 60 days of the decedent's last illness, all being described as follows [please indicate exempt property in description]: A. PERSONAL PROPERTY: DESCRIPTION VALUE B. Preferred funeral expenses (statement or receipt attached): Services by: Amount: Paid: Due: C. Medical and hospital expenses for last 60 days oflast illness (statement or receipt attached): Services by Type of Service Amount Paid Due D. Other debts of decedent: Creditor Goods or Services (How Incurred) Amount 2

7 12. Requested distribution to: Name Property Amount or Value 13. I know of no other assets or debts of the decedent except: Under penalties of perjury, I declare that I have read the foregoing, and the facts alleged are true, to the best of my knowledge and belief. PEI'I'l'IONER Telephone No.: Sworn to and subscribed before me on, 200 'by ~a~s, who produced ~lar.::en::-tfi:7h~c"::"tafion. (Seal) CLERK OF THE CIRCUIT COURT By: DepufY Clerk COUNTY OF STATEOF OR- STATE OF FLORIDA NOTARY PUBLIC (Seal) NotarY Pubhc Print Name My Commission Expires:

8 IN THE CIRCUIT COURT OF THE EIGHTH JUDICIAL CIRCUIT IN AND FOR LEVY COUNTY, FLORIDA PROBATE DIVISION In re: The EST ATE OF Case Number Division Deceased ~/ CONSENT AND WAIVER OF NOTICE (Disposition of Personal Property Without Administration) The undersigned, whose name and address are whose social security or tax identification number is and who has an interest in the above estate as acknowledges receipt of a copy of the Petition for Disposition of Personal Property Without Administration, heretofore filed in this proceeding, hereby waives hearing and notice of hearing thereon, and consents to the entry of an order pursuant to the prayer of the petition without notice or hearing. Signed on [Print or Type Names Under All Signature Lines]

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