<HTML> <HEAD> <HTML> <HEAD> <meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 29A-3-A - STATEMENT OF CLAIM29A-3-A </title> <META NAME="Keywords" Content="South Dakota Codified Laws SDCL 29A-3-A "> <META NAME="Description" Content="South Dakota Codified Laws 29A-3-A"> </HEAD> <BODY> <!-- File converted by Wp2Html Version 4.0 --> <!-- Email Andrew@brackenbeds.co.uk for more details --> <!-- WP Style Open: System_34 --><!-- WP Style End: System_34 --> <Div align="full"> <!-- WP Paired Style On: HG5 --><Div align="center"><!-- WP Style End: HG5 --> APPENDIX A. APPENDIX TO CHAPTER 29A-3 <!-- WP Paired Style Off: HG5 --></Div> <br> <!-- WP Style End: HG5 --> <!-- WP Style Open: P3-0 --></Div><Div align="full">&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: P3-0 --> The Supreme Court of South Dakota by order dated March 17, 1997, adopted the following rule:<br> <p> State of South Dakota ) In Circuit Court<br> County of ________ ) ss ______________ Judicial Circuit<br> ) <br> <p> Estate of )<br> ____________________ ) FILE NO.____________<br> Deceased )<br> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<br> <br> <!-- WP Paired Style On: CLPP --><Div align="center"><!-- WP Style End: CLPP --> <b> STATEMENT OF CLAIM</b> <!-- WP Paired Style Off: CLPP --><!-- WP Style End: CLPP --> </Div> <br> <p> <!-- WP Paired Style On: SMPF --><!-- WP Style End: SMPF --> This claim is made against the estate: <!-- WP Paired Style Off: SMPF --><!-- WP Style End: SMPF --> <br> <p> Description of Claim Due Date, If Not Yet Due Amount<br> 1._______________________ ____________________ $__________<br> 2._______________________ ____________________ $__________<br> 3._______________________ ____________________ $__________<br> 4._______________________ ____________________ $__________<br> 5._______________________ ____________________ $__________<br> TOTAL CLAIM $__________<br> <br> <!-- WP Paired Style On: SMPF --><!-- WP Style End: SMPF --> * This claim is unsecured. <!-- WP Paired Style Off: SMPF --><!-- WP Style End: SMPF --> <br> <p> <!-- WP Paired Style On: SMPF --><!-- WP Style End: SMPF --> * This claim is secured by __________. <!-- WP Paired Style Off: SMPF --><!-- WP Style End: SMPF --> <br> <p> <!-- WP Paired Style On: SMPF --><!-- WP Style End: SMPF --> * This claim is contingent or unliquidated because __________. <!-- WP Paired Style Off: SMPF --><!-- WP Style End: SMPF --> <br> <p> <!-- WP Paired Style On: SMPF --><!-- WP Style End: SMPF --> __________. <!-- WP Paired Style Off: SMPF --><!-- WP Style End: SMPF --> <br> <p> <!-- WP Paired Style On: SMPF --><!-- WP Style End: SMPF --> Dated _______. <!-- WP Paired Style Off: SMPF --><!-- WP Style End: SMPF --> <br> <p> <!-- WP Paired Style On: SL --><!-- WP Style End: SL --> __________ <!-- WP Paired Style Off: SL --><!-- WP Style End: SL --> <br> <p> <!-- WP Paired Style On: SL1 --><!-- WP Style End: SL1 --> Claimant's Signature <!-- WP Paired Style Off: SL1 --><!-- WP Style End: SL1 --> <br> <p> <!-- WP Paired Style On: SL --><!-- WP Style End: SL --> __________ <!-- WP Paired Style Off: SL --><!-- WP Style End: SL --> <br> <p> <!-- WP Paired Style On: SL1 --><!-- WP Style End: SL1 --> Claimant's Name <!-- WP Paired Style Off: SL1 --><!-- WP Style End: SL1 --> <br> <p> <!-- WP Paired Style On: SL --><!-- WP Style End: SL --> __________ <!-- WP Paired Style Off: SL --><!-- WP Style End: SL --> <br> <p> <!-- WP Paired Style On: SL1 --><!-- WP Style End: SL1 --> Claimant's Address <!-- WP Paired Style Off: SL1 --><!-- WP Style End: SL1 --> <br> <p> <!-- WP Paired Style On: SL --><!-- WP Style End: SL --> __________ <!-- WP Paired Style Off: SL --><!-- WP Style End: SL --> <br> <p> <!-- WP Paired Style On: SL1 --><!-- WP Style End: SL1 --> Claimant's Telephone Number <!-- WP Paired Style Off: SL1 --><!-- WP Style End: SL1 --> <br> (The following information shall appear on the back of the Statement of Claim form) <hr> How To Use This Form:<br> <!-- WP Style Open: P3-0 --></Div><Div align="full">&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: P3-0 --> The Statement of Claim is presented by:<br> 1. Filing the Statement of Claim with the clerk of courts and mailing a copy to the personal representative, or<br> 2. Mailing or delivering the Statement of Claim to the personal representative. (A proof of notice should be filed with the clerk if the Statement of Claim is mailed to the personal representative.)<br> <!-- WP Style Open: P3-0 --></Div><Div align="full">&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: P3-0 --> If the claim is not yet due, the date when it will become due must be stated. If the claim is secured, the security must be described. If the claim is contingent or unliquidated, the nature of the uncertainty must be stated. See SDCL 29A-3-804.<br> Comments:<br> <!-- WP Style Open: P3-0 --></Div><Div align="full">&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: P3-0 --> No presentation of claim is required in regard to matters claimed in court proceedings brought against the decedent which were pending in any court at the time of death. See SDCL 29A-3-804(b). A claim can be &quot;presented&quot; by commencing an action against the personal representative within the time for presenting a claim. See SDCL 29A-3-804(a)(2).<br> <!-- WP Style Open: P3-0 --></Div><Div align="full">&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: P3-0 --> The time limitations specified in SDCL 29A-3-803 do not apply to liability claims against the decedent or the personal representative to the extent that they are &quot;protected by liability insurance,&quot; or any proceeding to enforce any mortgage, pledge, or other lien upon property of the estate.<br> <p> <b> Source:</b> SL 1997, ch 348 (Supreme Court Rule 97-43).<p> </BODY> </HTML>