How to Fill Out the Pennsylvania Small Estate Affidavit (Form PA 167)

The LA County PA 167 form is the affidavit you file with the Los Angeles County Public Administrator to claim personal property held by that office after someone dies, without opening a probate case. It uses California’s small estate affidavit procedure under Probate Code Section 13100, which releases assets to a rightful successor when the qualifying estate value sits below a statutory cap. For deaths on or after April 1, 2025, that cap is $208,850.¹ You submit the signed affidavit, a certified death certificate, and Form DE-300 directly to the Public Administrator’s office; when the paperwork checks out, the property is released without a court order.

Can You Use the PA 167

Three conditions have to be true before you file.

At least 40 days must have passed since the date of death. The certified death certificate attached to your affidavit is the proof.²

No probate proceeding can be open in California for the decedent’s estate. The one exception: if a personal representative has already been appointed, you can still use the affidavit when that representative gives written consent for the property to be released to you. Attach a copy of the consent and the representative’s letters.²

The gross fair market value of the decedent’s California real and personal property, excluding the categories listed in Probate Code Section 13050, must fall at or below the limit tied to the date of death:³

Death on or after April 1, 2025: $208,850
Death from April 1, 2022 through March 31, 2025: $184,500
Death before April 1, 2022: $166,250¹

Value is measured as of the date of death, before subtracting debts or liens.

What Counts Toward the Value Limit

Several categories of property drop out of the calculation under Probate Code Section 13050, so an estate with substantial total assets can still qualify when most of the value sits in excluded categories.⁴ The main exclusions:

Joint tenancy property, which passes automatically to the surviving joint tenant.
Life estates and other interests that ended at death.
Community property and other assets passing to a surviving spouse under Probate Code Section 13500.
Property held in a revocable trust.
Multiple-party accounts with payable-on-death designations or surviving co-owners, to the extent the balance belongs to someone other than the decedent.
Cars, motorcycles, boats, and off-highway vehicles registered or titled in California.
Manufactured homes, mobilehomes, truck campers, and floating homes registered under the Health and Safety Code.
Any amounts owed to the decedent for Armed Forces service.
Up to $20,875 of compensation owed to the decedent for personal services, including unused vacation pay.¹

A valuable vehicle is a common source of confusion. It does not push the estate over the cap because it is excluded entirely from the calculation. Vehicles transfer separately through the DMV using Form REG 5.⁴

What the Affidavit Has to Say

Probate Code Section 13101 sets out the required contents. The PA 167 is built around them, but knowing what each line is doing helps you fill it out without getting the claim bounced back.² The affidavit must include:

The decedent’s full legal name as it appears on official records.
The date and place of death.
A declaration that at least 40 days have passed since the death, with the certified death certificate attached.
A statement that no probate proceeding is being conducted in California, or that the personal representative has consented in writing.
A declaration that the gross fair market value of the decedent’s California real and personal property, excluding Section 13050 property, does not exceed the applicable dollar threshold.
A specific description of the property you are claiming, with account numbers, dollar amounts, or physical descriptions of items held by the Public Administrator.
Your name as the successor, and a statement that you are the decedent’s successor as defined by law or are authorized to act on the successor’s behalf.
A statement that no other person has a superior right to the property.
A request that the property be paid, delivered, or transferred to you.
A declaration under penalty of perjury that everything in the affidavit is true and correct.

For any death on or after April 1, 2022, Judicial Council Form DE-300 also has to be attached. It is a single-page reference sheet listing the current dollar thresholds; you don’t fill it out, but it must travel with your affidavit.⁵

Documents to Gather

Collect everything before you sit down with the form:

A certified death certificate. Photocopies won’t do. In Los Angeles County, an authorized certified copy from the Registrar-Recorder costs $26.⁶
Form DE-300, downloaded from the California Courts website.⁵
Proof of your relationship to the decedent. If there is a will naming you, bring a copy. Without a will, gather birth, marriage, or adoption records that establish the family connection.
Asset information: account numbers, descriptions, or other identifying details for the property you are claiming.
If a probate case exists, the personal representative’s written consent and a copy of their letters.

Signing the Form

The statute allows the affidavit to be either notarized or signed as a declaration under penalty of perjury.² In practice, many institutions holding decedent property require notarization anyway.⁷ Call the Public Administrator before you sign to confirm which they accept. Redoing the form because of a missing notary seal is an avoidable delay.

If notarization is required, sign in front of a California notary public with a valid government-issued photo ID. The notary verifies your identity, watches you sign, and attaches an acknowledgment certificate.

When More Than One Heir Is Involved

If several people are entitled to the same property, all of them have to sign a single affidavit.⁷ Getting everyone into one notary’s office is often impractical. One workaround: include a statement in the affidavit that it may be signed in counterparts, so each heir signs a separate copy, each signature is individually notarized, and the signed copies are submitted together. If the estate has several distinct assets, preparing a separate affidavit for each asset can also simplify who needs to sign what.

Where to Submit

Send the completed, signed affidavit, the certified death certificate, Form DE-300, and any other supporting documents to the Los Angeles County Public Administrator:

Phone: 213-974-0460, 8:00 a.m. to 5:00 p.m.
TTY: 213-628-4010
Email: PAInfo@ttc.lacounty.gov
Fax: 213-633-1944

Call or email first to confirm the current mailing address and whether hand delivery is accepted.⁸ If mailing, use certified mail with a return receipt and keep copies of everything you send.

What Happens After You Submit

The office reviews the affidavit to confirm each statutory requirement is met: the 40 days have run, the estate qualifies under the cap, the property description matches what they hold, and the signature is proper. If anything is incomplete, they will contact you for corrections.

Once the claim clears, the office releases the funds or property to you directly. The Public Administrator’s FAQ states that distribution after court-approved accounting takes one to two months; the timeline for affidavit-based claims without court involvement may differ.⁹ Processing speed depends on claim volume and whether follow-up is needed. If several weeks pass without word, call the Investigations Unit at 213-974-0460 for a status check.

What You Take On By Signing

Receiving property through this affidavit carries personal liability. Two categories matter.

You are personally liable for the decedent’s unsecured debts, up to the net value of the property you received. Net value is the fair market value at the time you presented the affidavit, minus any liens and minus any payments you’ve already made toward claims from people with superior rights.¹⁰ Creditors can pursue you the way they could have pursued the decedent, and you can raise any defense the decedent could have raised.

You are also personally liable to anyone with a stronger legal claim to the property, such as a closer relative under intestate succession or a beneficiary named in a will you didn’t know about. You owe that person the value of what you received plus any income the property generated. If you’ve already sold or disposed of the property, interest runs at 7 percent per year from the date of disposition.¹¹

Fraud changes the math. Anyone who fraudulently obtains property through this procedure owes the rightful heir three times the fair market value. Claims must be brought within three years of when the affidavit was presented, or three years after the fraud was discovered, whichever is later, and that limitations period does not pause.¹¹

Who Counts as a Successor

The affidavit requires you to declare you are the successor and that no one has a superior right. Whether that is true depends on the will.

With a will, the successor is whoever the will names as beneficiary of the property in question. Without a will, California’s intestate succession rules decide, running from surviving spouse and children, to parents, then siblings and their descendants, then grandparents and their descendants, and on through more distant relatives, including descendants of a predeceased spouse.¹² Community property goes entirely to a surviving spouse; the spouse’s share of separate property depends on whether the decedent also left children, parents, or siblings. Stepchildren do not inherit under intestate succession unless they were legally adopted.

Before signing, confirm no one higher on that list is alive and entitled to the same property. A false declaration that no one has a superior right exposes you to the treble-damages fraud penalty above.

1
California Courts. Probate Code Section 890 Adjusted Amounts
2
California Legislative Information. California Probate Code 13101
3
California Legislative Information. California Probate Code 13100 – Affidavit Procedure for Collection or Transfer of Personal Property
4
California Legislative Information. California Probate Code 13050
5
California Courts. DE-300 Maximum Values for Small Estate Set-Aside and Disposition of Estate Without Administration
6
Los Angeles County Registrar-Recorder/County Clerk. Online Request
7
Sacramento County Public Law Library. Affidavit for Collection of Personal Property (Small Estate Affidavit)
8
Treasurer and Tax Collector. Public Administrator General Information
9
Treasurer and Tax Collector. Public Administrator Frequently Asked Questions
10
California Legislative Information. California Probate Code PROB 13109
11
California Legislative Information. California Probate Code 13110
12
California Legislative Information. California Probate Code 6402