District Court Denver Probate Court ____________________________________ County, Colorado Court Address: IN THE MATTER OF THE ESTATE OF: Deceased Attorney or Party Without Attorney (Name and Address): COURT USE ONLY Case Number: Phone Number: E-mail: FAX Number: Atty. Reg. #: Division Courtroom APPLICATION FOR INFORMAL APPOINTMENT OF SPECIAL ADMINISTRATOR 1. Applicant, (Name) _______________________________________________, as ________________________________ _____________________________________(state nature of interest), is an interested person. (§15-10-201, C.R.S.) 2. The decedent died on the date of __________________________________, at the age of __________years, domiciled in the City of _______________________, County of _______________________, State of _________________________. 3. Venue for this proceeding is proper in this county because the decedent: was a domiciliary of this county on the date of death. was not a domiciliary of Colorado, but property of the decedent was located in this county on the date of death. 4. Applicant: has not received a demand for notice and is unaware of any demand for notice of any probate or appointment proceeding concerning the decedent that may have been filed in this state or elsewhere. has received, or is aware of, a demand for notice. (See attached demand or explanation.) 5. Except as may be disclosed on an attached explanation, applicant is unaware of any unrevoked will relating to property located in this state. The date of decedent’s last will is _____________________________________________. The dates of all codicils are _____________________________________________. The will and any codicils are referred to as “the will.” The will: was deposited with this Court before the decedent’s death. (§15-11-515, C.R.S.) has been delivered to this Court since the decedent’s death. (§15-11-516, C.R.S.) is filed with this application. has been probated in the State of ___________________________. Authenticated copies of the will and of the statement probating it are filed with this application. (§15-12-402, C.R.S.) is lost, destroyed, or otherwise unavailable. (See attached explanation.) (§15-12-402, C.R.S.) 6. Appointment of a special administrator is necessary: to protect the decedent’s estate prior to appointment of a personal representative. (§15-12-614, C.R.S.) because a prior appointment has been terminated. (§15-12-609, C.R.S.) 7. No more than 3 years have passed since the decedent’s death. (§15-12-108, C.R.S.) More than 3 years have passed since the decedent’s death. A statutory time limitation would apply to the commencement of these proceedings except for the circumstances described in an attachment to this application. 8. The general character and probable value of decedent’s estate is (§15-12-604, C.R.S.): Estimated value of real estate $ _______________________________________________. Estimated value of personal property $ __________________________________________. Estimated annual income expected from all sources $ ______________________________. CPC 15-A R7/04 APPLICATION FOR INFORMAL APPOINTMENT OF SPECIAL ADMINISTRATOR This form conforms in substance to CPC 15-A. Page 1 of 2 American LegalNet, Inc. www.USCourtForms.com 9. __________________________________________________________________________________________________ Name, address and telephone number of the nominee for Special Administrator __________________________________________________________________________________________________ is 21 years of age or older, and has priority for appointment because of: nomination by the will as personal representative. statutory priority. (§§15-12-203 and 615, C.R.S.) reasons stated in the attached explanation. 10. Those persons having prior or equal rights to appointment have renounced their rights to appointment or have been given notice of these proceedings. (§15-12-310, C.R.S.) Any required renouncements accompany this application. 11. Listed below are the names and addresses of decedent’s spouse, children, heirs and devisees, and the names and addresses of guardians or conservators of incapacitated or protected persons. See instructions below: NAME ADDRESS AGE AND DATE OF INTEREST AND (Include spouse, if any) (or date of death) BIRTH OF MINORS RELATIONSHIP (or nature of disability) (See instructions) APPLICANT REQUESTS the appointment of (Name) _________________________________________________________, as special administrator to serve with bond in the amount of $ __________________________and without notice and hearing. As the applicant and being sworn, I verify that the facts set forth in this application are true to the best of my knowledge, information, and belief. _______________________________________________ ________________________________________________ Signature of Attorney for Applicant (Type or Print name below) Signature of Applicant (Type or Print name, address and telephone # below) Date _______________________________________________ Date ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________ State of _________________________ County of ________________________ Subscribed and affirmed or sworn to before me this ______day of _______________, 20 ___, by ____________________. My commission expires: _____________________ __________________________________________________ Notary Public/Deputy Clerk INSTRUCTIONS FOR PARAGRAPH 11: Include any statements of legal disability or other incapacity required by Rule 10, C.R.P.P. List the names and dates of death of any deceased devisees. (See applicable antilapse statute, §§15-11-601 and 603, C.R.S.) Where a listed person is an heir, detail the relationship to the decedent which creates heirship. Examples: son, daughter of pre-deceased son. (§§15-11-101 - 114, C.R.S.) Attach additional sheets if necessary. CPC 15-A R7/04 APPLICATION FOR INFORMAL APPOINTMENT OF SPECIAL ADMINISTRATOR This form conforms in substance to CPC 15-A. Page 2 of 2 American LegalNet, Inc. www.USCourtForms.com