New Hampshire Small Estate Affidavit Template
This document is prepared in accordance with the New Hampshire Revised Statutes Annotated (RSA) 553:32, which provides a streamlined process for the distribution of small estates. It allows for the direct transfer of assets without formal probate administration under specific conditions.
Instructions: Complete all sections with accurate information. If a section is not applicable, write “N/A”.
Section 1: Deceased Information
Full Name of Deceased: ________________________________________________________
Date of Death (MM/DD/YYYY): ___________________________________________________
Last Known Address: __________________________________________________________
County of Domicile at Time of Death: ____________________________________________
Section 2: Affiant Information
Full Name of Affiant: __________________________________________________________
Relationship to Deceased: ______________________________________________________
Address: _____________________________________________________________________
Phone Number: ________________________________________________________________
Email Address: ________________________________________________________________
Section 3: Qualifications
To qualify for the use of this affidavit, confirm the following statements are true:
- The value of the entire estate, wherever situated, less liens and encumbrances, does not exceed $10,000.
- Thirty days have elapsed since the death of the decedent.
- No application or petition for the appointment of a personal representative is pending or has been granted in any jurisdiction.
Section 4: Description of Assets
List all assets subject to this affidavit including personal property, bank accounts, and vehicles. Provide descriptions and values.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Section 5: Debts and Liabilities
List all known debts and liabilities of the deceased at the time of death:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Section 6: Distribution of Assets
Provide the names of the rightful heirs and describe the distribution of assets:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Section 7: Acknowledgment
I, (name of affiant) __________________________, affirm under the penalty of perjury that the statements contained herein are true and accurate to the best of my knowledge. I agree to indemnify and hold harmless any transferee or third party who relies upon this affidavit.
Date: __________________
Signature of Affiant: _________________________________________________________
State of New Hampshire
County of ____________________
Subscribed and sworn to (or affirmed) before me this __ day of ____________, 20__, by (name of affiant) ________________________________________, proved to me on the basis of satisfactory evidence to be the person who appeared before me.
Notary Public: _______________________________________________________________
My Commission Expires: ________________________________________________________