SUPERIOR COURT OF WASHINGTON FOR KING COUNTY Estate of NO. GEORGE WASHINGTON, NOTICE OF REJECTION OF CREDITOR'S CLAIM & DECLARATION OF MAILING (RCW 11.40.100) Deceased. To: Claimant: Claimant's Name And: Your Attorney: Claimant's Attorney's Name As Personal Representative of Decedent's estate, I reject the Creditor's Claim that you have presented in the amount of $999.99 If you wish to contest the rejection, you must bring suit against me, as Personal Representative, in the proper Court within 30 days of notification of rejection, or the claim will be forever barred. If you receive this Notice by mail, the date of notification is the date of its postmark. Dated: July 4, 2003 Signed: ______________________________ Your Name, Personal Representative Notice of Rejection of Creditor's Claim & Declaration of Mailing RCW 11.40.100 Page 1 of 2 [Your Name, Address, & Phone] DECLARATION OF MAILING In accordance with RCW 9A.72.085, I declare under penalty of perjury under the laws of the State of Washington that on the date written below, I mailed by Certified Mail Return Receipt Requested of the US Postal Service, postage prepaid, a true and correct copy of this Notice of Rejection of Creditor's Claim & Declaration of Mailing to the Claimant named, and at address stated, in the Creditor's Claim, or, if the claim was made by Claimant's Agent, then to Claimant's Agent and at the Agent's address stated in the Creditor's Claim. SIGNED Date: On July 4, 2003 Place: At Seattle, WA Signature: ______________________________ Your Name, Personal Representative Notice of Rejection of Creditor's Claim & Declaration of Mailing RCW 11.40.100 Page 2 of 2 [Your Name, Address, & Phone]