was the decedent’s conservator at the time of the decedent’s death.

Estate of 

First, middle, and last name

1. 

Name

2. I am:

 

 

 

 the duly appointed personal representative of the decedent (copy of letters of authority attached).

 a person entitled to delivery of assets under MCL 700.3983 (copy of affidavit attached).

 a person entitled to assignment of property under MCL 700.3982 (copy of order of assignment attached).

3. I received the following property from the conservator: (describe property received)

Date

 

                     

 

Signature

Name (type or print)

Attorney name (type or print)                                                            Bar no.

Address

City, state, zip                                                                        Telephone no.

Do not write below this line - For court use onlyPC 621 (12/17) RECEIPT OF PROPERTY FROM CONSERVATORMCL 700.3715(b), MCL 700.5426(4)Approved, SCAO JIS CODE: RPCSTATE OF MICHIGANPROBATE COURTCOUNTY OFRECEIPT OF PROPERTYFROM CONSERVATORFILE NO.

PC 621, Receipt of Property From Conservator

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About This Form:

• Sourced from www.courts.michigan.gov/Estates-Trusts (2023-03)
• Page(s): 1
• Fields(s): 15
• Average fields per page: 15
• Reading Level: Grade 11
• LIST Grouping(s): ES-00-00-00-00, ES-02-00-00-00.

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