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DATE FILEDFOR
COURT USE ONLY
AFFIDAVIT OF NOTICE TO CREDITORSRIGL 33-11-5.1
PC-10.14 (Rev. 07/17)
State of Rhode Island and Providence PlantationsProbate Court
Page 1 of 1
STATE OF RHODE ISLANDCounty of
Estate of
Alias
PROBATE COURT OF THECity or Town of
No.
The undersigned, upon oath, pursuant to RIGL 33-11-5.1, hereby certifies:Notice has been given to all known or easily ascertainable creditors.
Name of Fiduciary
Signature ofFiduciary
Date
Notary:Name of Notary
State County
On day of , 20 the petitioner, known to me or proved through satisfactory evidence, signed the document in my presence and swore or affirmed the statement(s) in the documents is/are truthful and accurate.
Signature ofNotary Public
Date
Commission ID# Commission Expirate Date Notary Seal
FIDUCIARY SIGN HERE
NOTARY SIGN HERE