Notice of Probate of Will, of Appointment of Executor, and Notice to Creditor Form

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Iowa Code 633.304A

In the District Court of Iowa in and for
County
In the Estate of
, Deceased.
Probate No.
To the Department of Health and Human Services, Who May Be Interested in the Estate of the above deceased person, who died on or about
You are hereby notified that on
the last will and testament for the above deceased person, bearing date of
was admitted to probate in the above-named court and that
was appointed executor of the estate. The birth date of the deceased is
and the deceased's social security number is

You are further notified that:

(If more than one spouse, provide the further information in the comment box)

Notice is hereby given that if the Department of Health and Human Services has a claim against the estate for the deceased person or persons named in this notice, the claim shall be filed with the clerk of the above-named district court, as provided by law, duly authenticated, for allowance, within six months of the date of sending this notice or the claim is thereafter forever barred. If the Department does not have a claim, the Department shall return a notice to the Executor within six months of the date of this notice that the Department does not have a claim. No further notice from the Executor by mail or otherwise is required, so none will be provided.

Attorney for Executor:
Mailing Address:
City: State: Zip:
Phone:
Email Address:

Further Comments:
0/500