For Clerk's Use Only PROBATE INFORMATION FORM Confidential Document Case No.__________________________ PETITIONER MUST COMPLETE THE FOLLOWING INFORMATION: Nominated Fiduciary or Petitioner's Name: Nominated Fiduciary's License Number : Mailing Address: Physical Address: _____________________________________________________ _____________________________________________________ _________________________________________________________________________ _________________________________________________________________________ Work Telephone # _____________________________ SS# _____________________________ WT ___________ Eye Color __________ Hair Color __________ Home Telephone # ______________________________ DOB _____________________________ Race ___________ HT ___________ Relationship to person alleged to be incapacitated, in need of protection or the Decedent: ______________________________________________________ INFORMATION FOR PERSON ALLEGED TO BE INCAPACITATED OR IN NEED OF PROTECTION. Name of Person Needing Protection: Mailing Address: Physical Address: ____________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ DOB ___________________ SS#_____________________ Home Telephone # ________________________ IF CONCERNING AN ESTATE MATTER: INFORMATION ABOUT THE DECEDENT (The Person Who Died) Decedent's Name: ____________________________________________ DOB ______________________ Revised: 10/06/2011 Page 1 of 1 American LegalNet, Inc. www.FormsWorkFlow.com