DECREE AND ORDER ON PETITION FOR FORMAL ADJUDICATION Estate of: First Name Middle Name Docket No. Commonwealth of Massachusetts The Trial Court Probate and Family Court Division Last Name Also Known As: Date of Death: After a hearing or on the uncontested Petition for Formal Adjudication dated: THE COURT FINDS: 1. The Petitioner is an interested person and has filed a complete and verified Petition. 2. The Decedent died on (date) domiciled in Massachusetts OR . 3. The Petition was filed within the time period permitted by law. 4. Any required notices have been given to or waived by all interested persons and any guardian ad litem appointed has assented to the Petition or the report of the guardian ad litem has been considered by the court. 5. Venue is proper. 6. 7. A. The Decedent did not leave a will. The Decedent left a will. The original will is filed. The will is dated (date) date(s) . The dates of all codicils are . The will and any codicils are referred to as the will. Based on a preponderance of credible evidence presented, the court is satisfied that: The will is valid and unrevoked. There are no known prior wills that have not been expressly revoked by a later instrument. The will is the Decedent's last will. --OR-B. The original will has been lost, destroyed, or is otherwise unavailable. The copy of the will or the statement of its contents is dated (date) . The dates of all codicils are date(s) . The copy of the will, or the statement of its contents, and any codicils are referred to as the will. Based on a preponderance of the credible evidence presented, the court is satisfied that: a. The contents of the will are as stated in the copy or statement filed with the court. b. The will is valid and unrevoked. There are no known prior wills that have not been expressly revoked by a later instrument. The will is the Decedent's last will. American LegalNet, Inc. www.FormsWorkFlow.com MPC 755 (4/15/16) page 1 of 3 Docket No. Estate of: First Name Middle Name Last Name --OR-C) The will is not a valid will. 8. At the time of death, the Decedent's heirs at law were: identical to those persons stated in the dated: (date) original . amended MPC 162 Surviving Spouse, Children, Heirs at Law --OR-the following named persons (each and every heir at law must be named): NAME RELATIONSHIP TO DECEDENT 9. The following person is qualified to serve as Personal Representative pursuant to G. L. c. 190B, § 3-203: First Name M.I. Last Name First Name M.I. Last Name (Address) (City/Town) (State) (Apt, Unit, No. etc.) (Address) (City/Town) (State) (Apt, Unit, No. etc.) (Zip) (Zip) Primary Phone #: Primary Phone #: Any will to which the requested appointment relates is being or has been probated. THE COURT DECREES AND ORDERS (select only that requested on the Petition): TESTACY DETERMINATION 1. The Decedent died intestate. The will has not previously been admitted to formal probate and is hereby so admitted. The will is not admitted to formal probate. The Petition is dismissed with prejudice as to that instrument. DETERMINATION OF HEIRS 2. The Decedent's heirs at law as of date of death are as found above. APPOINTMENT OF PERSONAL REPRESENTATIVE 3. The aforementioned person is appointed or confirmed as Personal Representative. 4. The Personal Representative shall serve in a(n): Unsupervised Administration. Supervised Administration described as follows: American LegalNet, Inc. www.FormsWorkFlow.com MPC 755 (4/15/16) page 2 of 3 Docket No. Estate of: First Name Middle Name Last Name without a surety on the bond because: The will waives the requirement of a surety bond. All of the heirs or all of the devisees have filed a written waiver of sureties on the bond. The Personal Representative is a bank or trust company. The court finds that sureties are not in the best interest of the estate. with personal corporate sureties on the bond in the penal sum amount of $ A Demand for Sureties (MPC 360) has been filed. The Personal Representative's prior bond is re-examined and approved. 5. Letters of Authority shall issue; or previously issued Letters of Authority for the Personal Representative are confirmed. 6. The court further orders: Date Justice Magistrate American LegalNet, Inc. www.FormsWorkFlow.com MPC 755 (4/15/16) page 3 of 3