JDF 916 SC R 6 /1 9 APPLICATION FOR INFORMAL APPOINTMENT OF PERSONAL REPRESENTATIVE Page 1 of 4 District Court Denver Probate Court County, Colorado Court Address: I n the Matter of the Estate of : Deceased COURT USE ONLY Attorney or Party Without Attorney (Name and Address): Phone Number: E - mail: FAX Number: Atty. Reg. #: Case Number: Division Courtroom A PPLICATION FOR INFORMAL APPOINTMENT OF PERSONAL REPRESENTATIVE ****** Use this f orm if the d ecedent did not leave a w ill ******* The a pplicant, an interested person pursuant to 247 15 - 10 - 201(27), C.R.S., makes the following statements: 1. Information about the a pplicant: Name: Relationship to Decedent : Street Address : City: State: Zip Code: Mailing Address, if different: City: State: Zip Code: Primary Phone: Alternate Phone: Email Address: 2. The d ecedent , , died on (date) at the age of years. The d ecedent was domiciled or resided in the City of County of , the State of . 3. Venue for this proceeding is proper in this county because the d ecedent: h ad his or her domicile or residence in this county on the date of death. did not have his or her domicile or residence in Colorado , but had property located in this county on the date of death. 4. This a pplication is filed within the time period permitted by law. Three years or less have passed since the d , or circumstances described in 247 15 - 12 - 108, C.R.S. authorize tard y probate or appointment. 5. The a pplicant : has not received a Demand for Notice of Filings or Orders and is unaware of any Demand for Notice of Filings or Orders concerning the Decedent. has received or is aware of a Demand for Notice of Filings or Orde rs concerning the Decedent. See attached Demand for Notice of Filings or Orders or explanation. 6. No court has appointed a p ersonal r epresentative and no such appointment proceeding is pending in this state or elsewhere. A c ourt has appointed a p ersonal r epresentative or an appointment proceeding is pending in the State of . (Attach a statement explaining the circumstances and indicating the name and address American LegalNet, Inc. www.FormsWorkFlow.com JDF 916 SC R 6 /1 9 APPLICATION FOR INFORMAL APPOINTMENT OF PERSONAL REPRESENTATIVE Page 2 of 4 of the p ersonal r epresentative. Attach a certified copy of the appointing document if the ap pointment has been finalized.) 7. Except as may be disclosed in an attached explanation and after the exercise of reasonable diligence, the a pplicant is unaware of any unrevoked will relating to property in Colorado. 8. a) Did a spouse or partner in a civil union survive the d ecedent? Yes No b) Did the d ecedent have a surviving parent? Yes No c) Did the d ecedent have surviving children or other descendants? Yes No d) Does the d are not descendants of the d ecedent? Yes No e) Are all of the d surviving spouse or partner in a civil u nion Yes No f) Are any of the d Yes No 9. The names and addresses of the d partner in a civil union, children , and other heirs are as follows: If a guardian or conservator has been appointed for one of the persons listed below, also provide the name and address of the guardian or conservator. (s) , guardian or conservator. If a spouse , partner in a civil union, or child has predeceased the d ecedent, include the date of death. A sample of this section is included in the Instructions - JDF 90 7 . Name Address or D ate of D eath Age, only if Minor Relationship (e.g. spouse, partner in a civil union, child, brother, guardian for spouse, etc.) 10. Applicant is 21 years of age or older and nominates himself or herself to be appointed as p ersonal r epresentative. O r Applicant is 21 years of age or older and nominates himself/herself to be appointed as co - personal representative along with the following as a co - personal representative. Name: The Nomin ee is 21 years of age or older. Street Address: City: State: Zip Code: Mailing Address, if different: City: State: Zip Code: American LegalNet, Inc. www.FormsWorkFlow.com JDF 916 SC R 6 /1 9 APPLICATION FOR INFORMAL APPOINTMENT OF PERSONAL REPRESENTATIVE Page 3 of 4 Primary Phone: Alternate Phone: Email Address: O r Applicant nominates the fo llowing person be appointed as p ersonal r eprese ntative. Name: The Nominee is 21 years of age or older. Street Address : City: State: Zip Code: Mailing Address, if different: City: State: Zip Code: Primary Phone: Alternate Phone: Email Address: 11. The n ominee has priority for appointment because of: statutory priority . ( 24715 - 12 - 203, C.R.S .) reasons stated in the attached explanation. Persons with prior or equal rights to appointment are as follows: All person(s) (other than those identified in Paragraph 10 above) with prior or equal right to appointment have renounced their right to appointment (JDF 912SC ). All required renouncements accompany this application. 1 2. Bond i s not required by the will and no interested person demanded that bond be filed. (Skip #1 3 below.) Bond is required by will or is being demanded by an interested person. (Complete #1 3 below.) B o nd in the amount of $ has been demanded. 13 . Applicant , if required by 247 15 - 12 - 604, C.R.S. Estimate d v alue of r eal e state $ Estimate d v alue of p ersonal p roperty $ A nnual i ncome e xpected from all s ources $ TOTAL $ 1 4 . The p ersonal r epresentative may receive compensation. The hourly rates to be charged, any amounts to be charged pursuant to a published fee schedule, including the rates and basis for charging fees for any extraordinary services, and any other bases upon which a fee charged to the estate will be calculated, a re as stated below or in an attachment to this a pplication. * The basis of compensation has not yet been determined. * American LegalNet, Inc. www.FormsWorkFlow.com JDF 916 SC R 6 /1 9 APPLICATION FOR INFORMAL APPOINTMENT OF PERSONAL REPRESENTATIVE Page 4 of 4 * There is a continuing obligation to disclose any material changes to the basis for charging fees. (247 15 - 10 - 602 C.R.S.) 1 5 . The p ersonal r epresentative may compensate his, her , or its counsel. The hourly rates to be charged, any amounts to be charged pursuant to a published fee schedule, including the rates and basis for cha rging fees for any extraordinary services, and any other bases upon which a fee charged to the estate will be calculated, are as stated below or in an attachment to this a pplication. * The basis of compensation has not yet been determined. * * There is a continuing obligation to disclose any material changes to the basis for charging fees. (247 15 - 10 - 602 C.R.S.) 16. The a pplicant requests that the r egistrar informally appoint the n ominee as p ersonal r epresentative in unsupervised administration to serve: without bond with bond in the amount of $ and that Letters of Administration be issued . By checking this box, I am acknowledging I am filling in the blanks and not changin g anything else on the form. By checking this box, I am acknowledging that I have made a change to the original content of this form. VERIFICATION I declare under penalty of perjury under the law of Colorado that the foregoing is true and correct. Executed on the day of Executed on the day of (date) (date) , , , , (month) (year) (month) (year) at at (city or other location, and state OR country) (city or other location, and state OR country) (printed name) (printed name) (Signature of Applicant ) (Signature of Co - Applicant , if any) Attorney Signature, (if any) Date Note : Please remember to add any AKA names in the caption, if applicable. American LegalNet, Inc. www.FormsWorkFlow.com