Excess Funds Claim-Probate Intake (TPA)

Probate Intake Questionnaire – Excess Funds Cases (TPA)

Please complete all sections as fully as possible. Attach additional pages if needed.
TPA Business Name
Have surplus funds been confirmed by the trustee or tax commissioner?*

YesNo
Is the trustee or commissioner requiring probate to collect surplus funds?*

YesNoNot sure
Full Legal Name of Decedent*

First NameLast Name
Decedent Date of Birth*

MonthDayYear
Date
Decedent Date of Death*

MonthDayYear
Date
County of Residence at Time of Death*
If other, please name county.
Last Known Address*
Was the Decedent a Georgia resident when they passed away?*

YesNo
Do you have a copy of the Death Certificate:*

YesNo
Upload copy of death certificate. Original will be required if accepted.

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Did the Decedent leave a will?*

YesNoUnsure
Do you have the original signed will?*

YesNo
Date of Will (if known)

MonthDayYear
Date
If no, of what State and county were they a resident?
Names of persons listed as beneficiaries in the will
Upload copy of will. Original will be required if accepted.

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Full Names of ALL Heirs *
Relationship to Decedent (for each heir)*
Address (for each heir)*
Phone/Email (for each heir)*
Do all heirs consent to appointment of an agreed upon Administrator/Executor?*

YesNo
Please review use this Heir Determination form if you are unsure who all of the legal heirs are.
Additional heirs listed on separate page
Name of person seeking appointment (Administrator/Executor)*
Relationship to Decedent*
Address of Administrator/Executor Candidate*
Phone of Administrator/Executor Candidate*
Email of Administrator/Executor Candidate*
Has this person ever served as an Executor/Administrator before?*

YesNo
Are all heirs/beneficiaries in agreement with this person serving?*

YesNo
Approximate Value of Surplus Funds*
Are there any other known estate assets (real property, vehicles, bank accounts, etc.)?*

YesNo
Describe other estate assets
Are there any known debts or creditors of the Decedent?*

YesNo
List known creditors
Have any probate proceedings already been filed in Georgia or another state?*

YesNo
Is there any disagreement among heirs or beneficiaries?*

YesNo
Are you aware of any challenges or contests to the will or heirship?*

YesNo
Have you already applied for or received an EIN for the estate?*

YesNo
Required Documents Checklist:- Original Will (if applicable)- Original Death Certificate- Photo ID for Administrator/Executor Candidate- Waivers/Consents signed by all heirs- Proof of Surplus Funds (Trustee/Clerk notice, Court filing, etc.)*

Original Will (if applicable)Original Death CertificatePhoto ID for Administrator/Executor CandidateProof of Surplus Funds (Trustee/Clerk notice, Court filing, etc.)
Signature*
Date*

MonthDayYear
Date
If No, please detail below.
If yes, please detail below.
If yes, please provide state, county and case number.
If yes, provide details.
If yes, provide EIN.
Should be Empty:

Probate Intake Questionnaire – Excess Funds Cases (TPA)