NEW MEXICO SMALL ESTATE AFFIDAVIT
Collection of Personal Property
N.M.S.A 45-3-1201

In Regard to the Estate of:

I, 	,
upon duly sworn, state on my oath that:

1.	My post office address is:  	

2.	My residence address is:  	

3.	I am a successor to the decedent identified below as the Uniform Probate Code, Chapter 45, New Mexico Statutes Annotated. All successors, including myself, of the decedent are as follows:

Name/Relationship	Address	Share

4.	The decedent’s full name is  	

5.	The date of the decedent’s death was 	, and I have attached a copy of the death certificate hereto.

6.	That the value of the entire estate, wherever located, less liens and encumbrances, does not exceed fifty thousand dollars ($50,000.00).

7.	That at least thirty (30) days has elapsed since the death of the decedent.
8.	That no application or petition for the appointment of a personal representative is pending or has been granted in any jurisdiction.

9.	That I, as the claiming successor am entitled to payment or delivery of the property.

THE FORGOING STATEMENT IS MADE UNDER PENALTIEL OF PERJURY.

Signature of Affiant

STATE OF NEW MEXICO COUNTY OF  	

This instrument was acknowledged before me on 	                       (date) 

by                                                                                 (name of person(s)).

Notary Public

Printed Name
My Commission Expires: