CONFIDENTIAL INFORMATION/ RESET

Petition/Affidavit in Lieu of Probate of Will/

Administration
PC-212CI REV. 8/19
CONNECTICUT PROBATE COURTS
CONFIDENTIAL
RECEIVED:

Instructions: 1) A person who files a PC-212 to petition the court to settle a decedent's estate using the small estates
procedure under C.G.S. section 45a-273 must file this form to provide the court with the decedent’s social
security number. Since the social security number is confidential, this form must be filed separately from
the PC-212 and will not be included in the public records of the court.
2) For more information, see Probate Court Rules of Procedure, section 17.2.
3) Type or print in ink.
Probate Court Name District Number

In the Matter of
Hereinafter referred to as the decedent

The social security number of the decedent is required in connection with this proceeding.

Social Security Number _______________________________

Confidential Information/Affidavit In Lieu of Probate of Will/Administration PC-212CI