Acceptance of Fiduciary Appointment PC-171 REV. 4/16 CONNECTICUT PROBATE COURTS RECORDED: RECEIVED: Instructions: 1) A person, individually or on behalf of a corporation, may use this form to notify the court that, if appointed, the person is willing to serve as a fiduciary in the matter referenced below. If this is the initial appointment of a trustee in a testamentary trust, use PC-284, Acceptance of Trust/ Testamentary Trustee. 2) If an individual fiduciary is not a Connecticut resident, a PC-482, Appointment of Agent of Service by Non-resident Fiduciary must be filed in court. 3) Type or print the form in ink. Use Second Sheet, PC-180, or an additional sheet if more space is needed. District Number Probate Court Name Estate of /In the Matter of Type Trust (If initial trustee in a testamentary trust, use PC-284.) Other (specify)_____________________________________________________________________________ Decedent's Estate Conservatorship Guardianship of Minor By signing below, I represent that: If appointed, I will accept the position of I am a Connecticut resident. I am not a Connecticut resident. Attach form PC-482, Appointment of Judge of Probate as Agent for Service by Non-resident Fiduciary. in the above matter. Signature Type or Print Name Date Address Signature Type or Print Name Date Address Telephone Number Telephone Number American LegalNet, Inc. www.FormsWorkFlow.com Acceptance of Fiduciary Appointment PC-171