District Court Denver Probate Court __________________________________ County, Colorado Court Address: In the Matter of the Estate of: COURT USE ONLY Case Number: Deceased Division: Courtroom: CERTIFICATE OF ANCILLARY FILING – DECEDENT’S ESTATE The domiciliary foreign personal representative’s sworn statement stating that no administration, or application, or petition for administration, is pending in Colorado, has been filed with this Court. The following listed documents regarding ________________________________________, as the domiciliary foreign personal representative, have been filed with this Court: Certified, exemplified, or authenticated copies of the foreign court’s order appointing the domiciliary foreign personal representative. Certified, exemplified, or authenticated copies of the foreign court’s letters or other documents evidencing or affecting the domiciliary foreign personal representative’s authority to act. Other: ________________________________________________________________________ Date: ________________________________ ___________________________________________ (Deputy) Clerk or Registrar of Court [COURT SEAL] JDF 930 11/07 CERTIFICATE OF ANCILLARY FILING – DECEDENT’S ESTATE American LegalNet, Inc. www.FormsWorkflow.com