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Form 34 (cont.)

Form 34
Probate District:
Probate Court File No.:

IN THE COURT OF PROBATE FOR NOVA SCOTIA

IN THE ESTATE OF **, Deceased

Affidavit - Insolvent Estate

(S. 51(1))

I, **[name of personal representative], of **[place], in the County of **[county], Province of **[province], applicant,

make oath and say:

1.  I am the personal representative of this estate and request an Order declaring the estate insolvent and setting a date for the settlement and distribution of the estate.

2.  A grant of **[type of grant] was issued to the personal representative on **[date of grant].

3.  The estate has been advertised in the Royal Gazette pursuant to subsection 63(1) of the Act and Section 47 of the Probate Court Practice, Procedure and Forms Regulations and a true copy of the first insertion of the advertisement, published on page**[page #] of volume**[issue #] issue**on **[month and day], 20**, is attached as Exhibit "A".

4.  Attached as Exhibit "B" is a list of debts of the deceased, which sets out debts that have been paid by the personal representative, and those which remain unpaid.

5.  Attached as Exhibit "C" are true copies of all invoices received from the creditors listed in Exhibit "B".

6.  The estimated costs associated with the settlement and distribution of this estate are $**, made up of **[give particulars].

7.  To the best of my information and belief, the total amount of the debts listed in Exhibit"B" exceeds the value of the property of this estate.

SWORN TO before me at **, in the County of **, Province of Nova Scotia, this ** day of **, 20**.
______
A Barrister of the Supreme Court of
Nova Scotia
Commissioner of Oaths in and for the Province of Nova Scotia
Notary Public in and for the Province of Nova Scotia / )
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**[Signature of personal representative]

[The text and signature areas of this form may be adapted as required where there is more than one personal representative.]

(11037572_1.DOC)