Get Fs 5336 2021-2025

My relationship to the decedent is. FS Form 5336 Department of the Treasury Bureau of the Fiscal Service PART C TYPE OF DISPOSITION Payment to yourself as voluntary representative on behalf of all persons entitled to share in the decedent s estate except for unmatured marketable securities. RESET For official use only Customer Name Case No. FS Form 5336 revised March 2018 OMB No. 1530-0055 Disposition of Treasury Securities Belonging to a Decedent s Estate Being Settled Without Administration IMPORTANT Follow instructions in filling out this form. You should be aware that the making of any false fictitious or fraudulent claim or statement to the United States is a crime that is punishable by fine and/or imprisonment. Print in ink or type all information* A person applying to act as voluntary representative of a decedent s estate that is not being administered uses this form 1 to apply to act as voluntary representative and 2 to request disposition of United States Treasury Securities and/or related payments belonging to the estate. See the instructions for the definition of a voluntary representative. If the decedent s securities and/or related payments are worth over 100 000 redemption and/or par value as of the date of death Treasury regulations require that the estate be administered through the court in this event this form may not be used* Also don t use this form to distribute bonds or to make payment to a trust. PART A ESTATE INFORMATION Provide the information below and submit certified copies of the death certificates for all deceased registrants. Name of Deceased Owner - If more than one person named on the securities the person who died last Decedent s Social Security Number Jurisdiction of Legal Residence By signing this form I certify that a legal representative has not been and will not be appointed through the court and that the estate will not be settled in accordance with the law of the decedent s domicile such as Summary Administration Small Estates Act Texas Muniment of Title Louisiana Judgment of Possession etc*. If the above statement does not apply do not complete this form* Instead send the securities and all evidence and/or documentation concerning the estate to the appropriate address in WHERE TO SEND near the end of this form* PART B PERSON QUALIFIED TO ACT AS VOLUNTARY REPRESENTATIVE Title 31 Code of Federal Regulations CFR provides that to be qualified to act as voluntary representative a person must be competent and eighteen years of age or older and be eligible according to the Order of Precedence for Voluntary Representative shown below. Carefully read the instructions before completing this Part. Only a blood relative or surviving spouse of the decedent can complete and submit this form* See Instructions at the end of the form for more information* Mark the box that represents your eligibility to act as voluntary representative. Order of Precedence for Voluntary Representative I am the surviving spouse I am a child of the decedent and there is no competent surviving spouse I am a descendant of a deceased child of the decedent and there are none of the above who are competent I am a parent of the decedent and there are none of the above who are competent I am a brother or sister of the decedent and there are none of the above who are competent competent I am next of kin of the decedent as determined by the law of the jurisdiction in which the decedent was domiciled at the date of death and there are none of the above who are competent.