- 2 -

FORM P11 (RULE 25-3(2))

This is the {1st/2nd} affidavit of {Name} in this case and was made on {day/month/year}

No. u

{Location} Registry

In the Supreme Court of British Columbia

In the Matter of the Estate of
{LEGAL NAME OF DECEASED}, Deceased

AFFIDAVIT OF ASSETS AND LIABILITIES
FOR NON-DOMICILED ESTATE GRANT

{Rule 22-3 of the Supreme Court Civil Rules applies to all forms.}

I, {NAME}, of {address}, {Occupation}, SWEARuAFFIRM THAT:

1.  I am an applicant for {Set out whichever one of the following 6 choices is correct}

ua grant of probate

ua grant of administration with will annexed

ua grant of administration without will annexed

uan ancillary grant of probate

uan ancillary grant of administration with will annexed

uan ancillary grant of administration without will annexed

in relation to the estate of {LEGAL NAME OF THE DECEASED} (the “deceased”).

2.  The deceased was not ordinarily resident in British Columbia at the time of death.

3.  All property of the deceased situated outside British Columbia, if any, has been, is being or will be administered by a foreign personal representative or otherwise under the law of a foreign jurisdiction.

4.  I have made a diligent search and inquiry to find the property and liabilities of the deceased within British Columbia.

5.  Attached to this affidavit as Exhibit A is a Statement of Assets, Liabilities and Distribution that discloses:

(a)  all of the property of the deceased within British Columbia, irrespective of its nature or value, that passes to the applicant in the applicant’s capacity as the deceased’s personal representative in accordance with section 138 of the Wills, Estates and Succession Act;

(b)  the value of that property; and

(c)  the liabilities that charge or encumber that property.

6.  If I determine that there is any property or liability within British Columbia that has not been disclosed in Exhibit A or that information contained in this affidavit is incorrect or incomplete, I will promptly after learning of the same file a supplemental affidavit of assets and liabilities for non-domiciled estate grant in Form P15 to disclose the correct and complete information.

7.  In addition to the probate fees payable in relation to any property disclosed in Exhibit A, I promise to pay the Minister of Finance the probate fees payable with respect to the value of any property that passes to me as the deceased’s personal representative, and that is not disclosed in Exhibit A, on a determination being made as to the value of that asset.

SWORNuAFFIRMED BEFORE ME at {City/Town}, Province of uBritish Columbia, this u day of u, 20u
A Commissioner for taking Affidavits in British Columbia
{print name or affix stamp of commissioner} / )
)
)
)
)
)
)
) /
{NAME}

- 2 -

This is Exhibit A referred to in the affidavit of {NAME} sworn u affirmed before me on {mmm/dd/yyyy}.

______
A commissioner for taking affidavits for British Columbia

Statement of Assets, Liabilities and Distribution

Part I / Real Property (Including mortgages and vendors’ and purchasers’ interests in agreements for sale) within British Columbia / Value at death /
u / $u
TOTAL / $u
Part II / Personal Property (all assets except real property) within British Columbia / Value at death /
u / u
TOTAL / $u
GROSS VALUE OF ESTATE / $u
Part III / Liabilities / Paid or Unpaid / Amount /
uNIL
[or]:
uNIL, save and except liabilities
shown in Part I and Part II above / $00.00
TOTAL / $00.00