SUPERIOR COURT OF WASHINGTON
FOR KING COUNTY
Estate of
NO.
GEORGE WASHINGTON,
Deceased.
STATUS REPORT (With Will)
(ie, Report of Affairs of Estate) &
DECLARATION OF MAILING
(RCW 11.68.065)
In accordance with RCW 9A.72.085, I declare under penalty of perjury under the laws
of the State of Washington that the following is true and correct to the best of my
knowledge:
1. Personal Representative. I am the Personal Representative of Decedent's estate.
2. Decedent. Decedent died testate on January 1, 2003, was then a resident of King
County, Washington, and left property in this state subject to probate.
3. Will. Decedent's last Will was signed by Decedent on December 31, 1999 and
admitted to probate by this Court's order dated March 1, 2003.
4. Probate Assets. As Personal Representative, I have taken possession or control
over the following assets, which represent all of the assets of Decedent’s probate estate:
List of assets of probate estate --- from your Inventory
5. Property Collected or Paid Out. As Personal Representative, I have collected or
paid out the following property:
List of property collected or paid out --- ie, income & expense
Status Report (With Will)
RCW 11.68.065
Page 1 of 3
[Your Name, Address, & Phone]
6. Property Distributed. As Personal Representative, I have distributed the
following assets to Decedent’s beneficiaries:
List of property distributed & to whom
7. Creditor's Claims. As Personal Representative, I have been presented with the
following Creditor's Claims, which I have allowed or rejected as indicated:
List of Creditor's Claims presented & whether allowed or rejected & in what amount
8. Estate, Inheritance, & Fiduciary Income Taxes. As Personal Representative, I
have filed the following Estate, Inheritance, or Fiduciary Income Tax Returns:
List of tax returns filed & date when filed
9. Administration Almost Completed. I have completed the administration of
Decedent's estate except as regards the following:
Description of what remains to be done before the estate can close & what I am doing
about it
10. Estimated Closing Date. I believe I will be able to complete the foregoing
matters by December 31, 2004 and to file my Declaration of Completion of Probate
within 30 days thereafter. If I am unable to do so, I will promptly file an updated Status
Report with the Court.
SIGNED
Date:
On
Place: At
March 1, 2004
Seattle, WA
Signature: ______________________________
Your Name, Personal Representative
Status Report (With Will)
RCW 11.68.065
Page 2 of 3
[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 first-class mail of
the US Postal Service, postage prepaid, a true and correct copy of this
Status Report & Declaration of Mailing
(With Will)
to each of Decedent's heirs and beneficiaries who remains entitled to distribution from the
estate, whose names, addresses, and telephone numbers are shown immediately following
the signature block below.
SIGNED
Date:
On March 1, 2004
Place: At Seattle, WA
Signature: ________________________________
Your Name, Personal Representative
Name
Address
Telephone Number
Add List
Status Report (With Will)
RCW 11.68.065
Page 3 of 3
[Your Name, Address, & Phone]