THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH http://www.courts.state.nh.us Court Name: Case Name: Case Number: (if known) Petition for Administration of Estate Of Person Presumed Dead (RSA 553:18 and 553:19) 1. 2. 3. 4. Petitioner Name Mailing Address Petitioner Name Mailing Address Attorney Name Mailing Address Person Presumed Dead Last known residence (street, city or town) Has person presumed dead lived in this county for at least one year? 5. This person: (select one) Is presumed to have been killed as a result of some catastrophic event, but his or her body could not be recovered. Left his or her home and has not been heard of or from directly or indirectly for 6 months. The petitioner believes he or she may be dead. 6. The legatees and heirs-at-law to the estate of the person presumed dead are as follows: Yes No Telephone Telephone Telephone 7. The value of the estate of the person presumed dead consists, as nearly as can be ascertained, of: Real Estate ......................................................................... Personal Estate .................................................................. Total amount of Estate ........................................................ $ $ $ 8. The petitioner requests that administration be granted to of and whose date of birth is NHJB-2497-P (01/02/2014) Page 1 of 3 American LegalNet, Inc. www.FormsWorkFlow.com Case Name: Case Number: PETITION FOR ADMINISTRATION OF ESTATE OF PERSON PRESUMED DEAD (RSA 553:18 AND 553:19) The petitioner has also filed with this petition a "Notice on Petition for Administration of Estate of Person Presumed Dead", and requests that the information contained in that form be published and that if no information is received indicating that is alive, and that circumstances lead to a reasonable belief that he or she is dead, that administration of his or her estate be granted. Date Petitioner Signature ORDER FOR PUBLICATION It is ordered that the annexed notice be published in a newspaper with statewide distribution and which is also published on the Internet. (The petitioner is responsible for arranging publication.) In addition, the annexed notice shall be published in the county in which the person had last lived for one year. Such notice shall be published at least once per week for four consecutive weeks. A copy of the "Notice on Petition for Administration of Estate of Person Presumed Dead" shall be given to the following relatives: Date Signature of Judge Printed Name of Judge ORDER FOR ADMINISTRATION Petition for Administration of Estate of Person Presumed Dead is granted; letters of appointment to be issued. Prior to the issuance of said letters, the fiduciary is ordered to file with the court, within 30 days of this order, a fiduciary bond in the amount of $ , without sureties with corporate sureties. Failure to file the bond within 30 days may result in dismissal of the case. Further order Date Signature of Judge Printed Name of Judge NHJB-2497-P (01/02/2014) Page 2 of 3 American LegalNet, Inc. www.FormsWorkFlow.com THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH http://www.courts.state.nh.us Court Name: Case Name: Case Number: (if known) Notice on Petition for Administration of Estate Of Person Presumed Dead (RSA 553:18 and 553:19) Information is wanted regarding than one year. This person left his or her home on or about been heard of, or from, since that date. who left his or her home in , where he or she had resided for more , and has not hair, about been was about years of age, with eyes, tall, and weighed about pounds. Occupation had A petition to administer this person's estate has been filed, and this notice is ordered by the Judge for County. This petition will be put before the court on at County Probate Division in . All persons interested in this matter may appear and be heard by the court. Any person having information about is requested to forward that information to the Judge in the above-named county, or to contact the court at the following telephone number: . BY ORDER OF THE COURT, Date Clerk of Court Return of Publication 1. 2. 3. Name of publication Name of person authorized to sign below Dates notice was published I certify that notices, of which the above is a true copy, were published once each week for four consecutive weeks as required by the order of notice above. Date Newspaper Representative American LegalNet, Inc. www.FormsWorkFlow.com NHJB-2497-P (01/02/2014) Page 3 of 3