For value received,
I, ___________________________________, of
___________________________________________________, assign to
___________________________________, of ______________________________, as
assignee, all my right, title, and interest in the estate of
___________________________________, deceased, whose last place of residence was
_______________, and who died on _____________, 200(x).
I warrant that the value of property due me is at least _______________ Dollars
($_____________), and I agree to execute on demand any and all documents
necessary or convenient to transfer to assignee all of the interest in either
the real or personal property of descendant to which I am entitled by virtue of
the death.
This assignment is made subject to and on condition that assignee pay all estate and inheritance taxes which would have been payable by assignor with respect to the estate.
Dated ________________, 200(x).
__________________________ __________________________
STATE OF _____________________
COUNTY OF ____________________
BEFORE ME, the undersigned authority, on this _____ day of ______________, 200(x)______, personally appeared _______________ to me well known to be the person described in and who signed the Foregoing, and acknowledged to me that he executed the same freely and voluntarily for the uses and purposes therein expressed.
WITNESS my hand and official seal the date aforesaid.
______________________________
NOTARY PUBLIC
My Commission Expires:________
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