Petition/Declaration of Insolvent Estate PC-204 R 10/19 ...

1 Petition/Declaration RESET. of Insolvent Estate PC-204 REV. 7/18 CONNECTICUT PROBATE COURTS. RECEIVED: Instructions: 1) A fiduciary of a decedent's Estate may use this form to seek a declaration that the Estate is Insolvent . 2) To be declared Insolvent , the expenses of, and claims against, the Estate must exceed the value of the probate assets. If assets of the Estate do not exceed the expenses of the funeral, Estate administration, last sickness, and taxes and claims due the State of Connecticut and the United States, the fiduciary may request that the court allow the fiduciary to settle the Insolvent Estate with the short form procedure under section 45a-383.

2 This procedure eliminates the additional notice and procedures otherwise required under sections 45a-378 to 45a-380. 3) The petition must be filed with the Probate Court having jurisdiction over the decedent's Estate . Unless previously filed, the inventory, PC-440, and return of claims, PC-237, for the Estate must be submitted with the petition . 4) For more information, see sections 45a-376 to 45a-384. 5) Type or print the form in ink. Use an additional sheet, or PC-180, Second Sheet, if more space is needed. Probate Court Name District Number Estate of Hereinafter referred to as the decedent.

3 Fiduciary(Name, address, and telephone number of each fiduciary). THE FIDUCIARY REPRESENTS THAT: The above Estate was opened as a solvent Estate , but is now Insolvent . The above Estate is Insolvent . The names and addresses listed below are all the known creditors of the Estate . Petition/Declaration of Insolvent Estate PC-204 Page 1 of 2. Petition/Declaration of Insolvent Estate PC-204 REV. 7/18 CONNECTICUT PROBATE COURTS. The assets of the Estate , excluding the assets that may be legally set out to the surviving spouse and the allowance for support of the spouse and that of the family of the decedent, will not be enough to pay the funeral expenses, the expenses of settling the Estate , the expenses of the last sickness, and the lawful taxes and claims due the State of Connecticut and the United States, which are listed below.

4 Section 45a-383. The estimated totals of the following expenses are: Funeral Expenses $. Administration Expenses $. Expenses of Last Sickness $. Taxes and Claims due to the State of Connecticut $. Taxes and Claims due to the United States $. WHEREFORE THE FIDUCIARY REQUESTS THAT: The Estate be declared Insolvent , and the court: order the fiduciary to receive and decide upon claims of the creditors of the Estate , in accordance with section 45a-378. OR. allow the fiduciary to settle the Estate , without claims procedures otherwise required, in accordance with section 45a-383. The representations made in this petition are made under the penalty of false statement.

5 Signature of Fiduciary Type or Print Name Date Signature of Fiduciary Type or Print Name Date Petition/Declaration of Insolvent Estate PC-204 Page 2 of 2.