ElectronicNoticeForm - Electronic Notice of Probate

Fields with asterisks (*) are required and the form cannot be submitted if these fields are not completed.

INFORMATION ABOUT THE DECEASED PERSON

Legal First Name

Legal Middle Name

Legal Last Name

Suffix (Jr, Sr, III, etc)

AKA (Also Known As)

Date of Birth

Date of Death

Social Security Number

Marital Status

INFORMATION ABOUT THE SPOUSE (FORMER SPOUSE) OF THE DECEASED PERSON
(Complete even if marital status is "Divorced" or "Widowed")

Legal First Name

Legal Middle Name

Legal Last Name

Suffix (Jr, Sr, III, etc)

Address1

Address2

City

State

Zip Code

Phone Number

INFORMATION ABOUT THE PROBATE COURT CASE

County Where the Case was Filed

Probate Case Number

Type of Probate Case

Date Petition Filed or Letters Granted

INFORMATION ABOUT THE PERSON COMPLETING THIS FORM AND OTHER REPRESENTATIVES

Relationship to Deceased

Legal First Name

Legal Middle Name

Legal Last Name

Suffix (Jr, Sr, III, etc)

Address1

Address2

City

State

Zip Code

Phone Number

Add New Person Information

By submitting this notice, I certify that the information provided is true and correct to the best of my knowledge.

After checking the required certification statement above, use the button below to submit the form. The following page will allow you to download and save or print a copy for your records.
Please Note: Alabama Medicaid is not able to provide a copy of the serialized certificate.

Cancel

Fields marked red are required or invalid. Please complete or correct the information.

INFORMATION ABOUT THE DECEASED PERSON

INFORMATION ABOUT THE SPOUSE (FORMER SPOUSE) OF THE DECEASED PERSON (Complete even if marital status is "Divorced" or "Widowed")

INFORMATION ABOUT THE PROBATE COURT CASE

INFORMATION ABOUT THE PERSON COMPLETING THIS FORM AND OTHER REPRESENTATIVES

INFORMATION ABOUT THE SPOUSE (FORMER SPOUSE) OF THE DECEASED PERSON
(Complete even if marital status is "Divorced" or "Widowed")