STATE OF SOUTH CAROLINA ) IN THE PROBATE COURT ) COUNTY OF GREENVILLE ) AMENDING DEVISEES AND HEIRS ) IN THE MATTER OF: ) ) CASE NUMBER: ____________________ (Decedent) )	)	IN THE PROBATE COURT
Due to: incorrect listing of heirs/devisees filing of disclaimer by ________________________________________________________________________________________ other ____________________________________________________________________________________________________ The following information is hereby amended/supplemented:	)

4(a).	Names and addresses of beneficiaries (devisees) named in the Will.

Full Legal Name (including all known names)	Year of Birth	Full Address	Relationship to Decedent

See attached for additional devisees (check if applicable)

4(b).	Names and addresses of intestate heirs who are not devisees (persons who inherit if Decedent left no Will).

Full Legal Name (including all known names)	Year of Birth	Full Address	Relationship to Decedent

See attached for additional heirs (check if applicable)

The undersigned, being sworn, states that the facts set forth in the foregoing statement are true to the best of the undersigned’s knowledge, information and belief.

SWORN to before me this	day	Signature of Petitioner:
of ________________________,	20	Print Full Name:
Address:
Notary Public for South Carolina	Telephone (work)
My Commission Expires:	(Home):
(Cell):
Email:
Relationship to Decedent/Estate: