Petition/Action on a Probate Bond CONNECTICUT PROBATE COURTS PC-9010 NEW 7/16 RECEIVED: Instructions: 1) A person having an interest in an estate may use this form to commence an action in the Probate Court against a surety of a probate bond to recover for losses incurred because a fiduciary failed to perform properly the fiduciary duties. An award for damages cannot exceed the amount of the probate bond. 2)If the petitioner is filing this action in the petitioner222s own right alone and not as a representative of theestate or on behalf of all persons having an interest in the estate, pProbate Court Name District Number Estate of Petitioner (ame and address.) Respondent/Fiduciary (ame, address and position of trust.) Respondent/SuretyThe petitioner represents that: 1.On , the above-named fiduciary, as principal, and the above-named surety, assurety, executed a probate bond in the amount of $payable to the State of Connecticut, which5.The petitunpaid creditor other (Provide description.) . Petition/Action on a Probate BondAmerican LegalNet, Inc. www.FormsWorkFlow.com Petition/Action on a Probate Bond CONNECTICUT PROBATE COURTS PC-9010 NEW 7/16 6.This petition is made by the petitioneras a representative of the estate; or on behalf of the petitioner and all other persons having an interest in the estate; or in petitioner222s own right and some, but not all, others having an interest in this action on the probate bond. a)List name (s) and address(es) of the person (s) on whose behalf this action is brought: b)Describe how the above-named persons are interested in the estate and how the action or neglect of thefiduciary has injured or affected their interest: WHEREFORE, the petitioner claims a judgment for the recovery of damages in the aggregate amount of ($ ) Dollars. The representations made in this petition are made under the penalty of false statement. Signature of Petitioner Type or Print Name Date Petition/Action on a Probate Bond PC-9010 Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com