JDF 92 3 SC R9/18 ORDER OF INTESTACY , DETERMINATION OF HEIRS AND Page 1 of 2 FORM AL APPOINTMENT OF PERSONAL REPRESENTATIVE District Court Denver Probate Court County, Colorado Court Address: In the Matter of the Estate of: Deceased COURT USE ONLY Case Number: Division: Courtroom: ORDER OF INTESTACY , DETERMINATION OF HEIR S AND FORMAL APPOINTMENT OF PERSONAL REPRESENTATIVE Upon consideration of the Petition for Adjudication of Intestacy and Formal Appointment of Personal Representative filed by ( p etitioner) on (date) , THE COURT FINDS , DETERMINES , AND ORDERS: 1. The p etitioner is an interested person and has filed a complete and verified petition. 2. The d ecedent died on (date) and 120 hours have elapsed since the d 3. The d ecedent was domiciled or resided in the City of County of , St ate of . 4. Venue is proper in this county . 5. The p etition was filed within the time period permitted by law. 6. Any required notices have been given or waived. 7. The d ecedent did not leave a w ill. The prior informal finding as to testacy is set aside. American LegalNet, Inc. www.FormsWorkFlow.com JDF 92 3 SC R9/18 ORDER OF INTESTACY , DETERMINATION OF HEIRS AND Page 2 of 2 FORM AL APPOINTMENT OF PERSONAL REPRESENTATIVE 8. The heirs of the d ecedent are: Name Relationship (e.g. spouse, partner in a civil union, child, brother, guardian for spouse, etc.) Share /Percentage of Estate 9. The following person is quali fied to serve and is appointed or confirmed as p ersonal r epresentative: Name: The Nominee is 21 years of age or older. Street Address : City: State: Zip Code: Mailing Address, if di fferent: City: State: Zip Code: Primary Phone: Alternate Phone: Email Address: The prior informal appointment of (name) is set aside and the Letters are revoked. 10. Th e p ersonal r epresentative will serve without bond. with bond in the amount of $ . in unsupervised administration. in supervised administration as described in an attachment to this o rder. 11. Letters of Administration will be issued or previously issu ed l etters are confirmed. Date: Judge Magistrate American LegalNet, Inc. www.FormsWorkFlow.com