Docket No. GENERAL TRUST PETITION Commonwealth of Massachusetts The Trial Court Probate and Family Court Division case name The Petitioner(s) (hereafter "Petitioner"), an interested person(s), makes the following statements: 1. Petitioner is: Name: First Name M.I Last Name (Address) (Apt, Unit, No. etc.) (City/Town) (State) (Zip) Primary Phone #: Interest of the Petitioner in the matter (e.g. Trustee, Beneficiary, etc): 2. Identify the Trust and Settlor (e.g. ABC Trust, Trust under written instrument by Jane Smith, under the will of Jane Smith dated 1/1/12, etc.): Date of Trust: (date) Dates of Amendments, if any: A copy of the trust and any amendments are attached or are on file with the Court. Venue for this proceeding is proper in this Court because: 3. Current Trustee(s) is/are Name: the Petitioner First Name AND/OR as follows: M.I Last Name (Address) (Apt, Unit, No. etc.) (City/Town) (State) (Zip) Primary Phone #: 4. Persons interested in this trust and their representatives (Guardian, Conservator, etc.) are as follows: Name Address Interest Indicate if this person is: Minor Incompetent Minor Incompetent Minor Incompetent 5. The Petitioner states the following: MPC 201 (1/16/13) American LegalNet, Inc. www.FormsWorkFlow.com page 1 of 2 The Petitioner requests the Court do the following: SIGNED UNDER THE PENALTIES OF PERJURY I certify under the penalties of perjury that the foregoing statements are true to the best of my knowledge and belief. Date: Signature of Petitioner Date: Signature of Petitioner Information on Attorney for Petitioner, if any Signature of Attorney (Print name) (Address) (Apt, Unit, No. etc.) (City/Town) (State) (Zip) Primary Phone #: B.B.O. # Email: MPC 201 (1/16/13) American LegalNet, Inc. www.FormsWorkFlow.com page 2 of 2