Administration and Probate Act 1935
Form IIIa
SHORT FORM AFFIDAVIT
In the Supreme Court of Tasmania
Ecclesiastical Jurisdiction
In the(1)
of(2)
late of(3)
in the State of(4) (5) deceased.
I/We(6)(7)
in the State of
make oath and say as follows:
1That the said deceased died on theday of20at
inaged
2That the Inventory annexed hereto signed by me/us(7) and marked "A” contains true statements of all and singular the real and personal estate in Tasmania of or to which the above named deceased was at the time of his/her death possessed or entitled, and that after due inquiry I/we(7) believe that the values set forth in the Inventory are fair and reasonable at the date of swearing this affidavit and that the liabilities therein stated are justly due thereon.
3That in the event of the discovery of any additional assets or amounts I/we(7) will advise the Registrar.
Sworn by the deponent/s)
at in)
thisday of)…………………………………
20) Signature of person sworn
Before me, …………………………………………..
(Signature)
Justice of the Peace/
NOTES
(1)Here insert "will" or "intestacy" as the case requires.
(2)Here insert the full name of the deceased
(3)Here insert the place of residence of the deceased
(4)Here insert the name of the State where the deceased resided
(5)Here insert the occupation of the deceased
(6)Here insert "I" or "We" and the full names, addresses, and occupations of the administrator(s)
(7)Strike out whichever is inapplicable
A”
This is the Inventory marked "A" referred to in the annexed Affidavit of .………………………………………[insert names of administrator/s] sworn before me on the ………………day of …………….. 20
……………………….
Justice of the Peace/
In the Estate of …………………………………………………………. ,deceased.
Inventory
Assets / Value ($)Total / $
Liabilities / Value ($)
Total / $
……………………………………… Signed by Administrator/s