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]