Name of Person Filing Document: Your Address: Your City, State, Zip Code: Your Telephone Number: Attorney Bar Number (if applicable): SUPERIOR COURT OF ARIZONA PINAL COUNTY In the Matter of the Estate of ) ) ) ) PB 2 APPLICATION FOR CERTIFICATE OF REGISTRAR [ ] an Adult or [ ] a Minor, deceased The undersigned applicant states: The appointment of the Personal Representative of this Estate has terminated and, so far as is known by Applicant, no action concerning this Estate is pending in any court. Applicant requests a Certificate of Registrar pursuant to A.R.S. ' 14-3937. Dated this day of , 20 . Name STATE OF ARIZONA COUNTY OF PINAL ) )ss. I, , being duly sworn, states as follows: That I am the former Personal Representative for the above Estate and that the statements in the Application are accurate and complete to the best of my knowledge and belief. Signature SUBSCRIBED AND SWORN TO before me this day of By Deputy Clerk/Notary Public 20_____. My Commission Expires: � Superior Court of Arizona Pinal County May 23, 2002 ALL RIGHTS RESERVED Page 1 of 1 PB8 Application for Certificate Use only most current version Name of Person Filing Document: Your Address: American LegalNet, Inc. www.FormsWorkflow.com