RECORDED: PROBATE BOND PC-480 REV. 7/13 STATE OF CONNECTICUT COURT OF PROBATE [Type or print in ink.] DISTRICT NO. DATE COURT OF PROBATE, ESTATE OF/IN THE MATTER OF PRINCIPAL [Name and address] POSITION OF TRUST AMOUNT OF BOND $ SURETY [Name and address] AGENT OR AGENCY [Name and address] As appears in the records of this court, the above principal has been appointed to the POSITION OF TRUST indicated above and appeared in court and accepted said trust. KNOW ALL BY THESE PRESENTS, that we, as principal and surety, jointly and severally, promise to pay to the State of Connecticut the penal sum of the amount of bond written above and we, the said obligors, do bind ourselves and each of us, our heirs, executors, administrators, successors and assigns and each of them to pay the aforesaid sum. The CONDITION OF THIS OBLIGATION is that said principal and any co-fiduciary of whom probate bond is required shall faithfully perform the duties of the POSITION OF TRUST indicated above and administer and account for all monies and other property coming into his or her hands, as fiduciary, according to law. We have read and understand the section of this bond below entitled "IMPORTANT NOTICES, CONDITIONS AND REQUIREMENTS and, without excluding any other conditions and requirements that may be applicable, accept those stated in that section. NOW, THEREFORE, if the CONDITION OF THIS OBLIGATION, as aforesaid, is satisfied, according to law, then this obligation shall be void, otherwise to remain in full force and effect. SIGNED AND SEALED ON THE DATE WRITTEN ABOVE. PRINCIPAL................................ ........ ........... ........L. S. Type or print name: SURETY...................................... ....... ........... ........L.S. Type or print name: PRINCIPAL................................ ........ ........... .......L.S. Type or print name: SURETY...................................... ....... ........... .......L.S. Type or print name: The person signing above as surety must furnish proof of authority to act on behalf of the corporate surety. IMPORTANT NOTICES, CONDITIONS AND REQUIREMENTS Notice Applicable to all Principals and Sureties Surety for a fiduciary serving with one or more co-fiduciaries: By becoming a surety on the probate bond of a co-fiduciary, you accept the obligation to pay the damages resulting from a breach of any condition of a co-fiduciary's bond, upon determination of the amount of damages in accordance with law. Agreements between fiduciary and surety: A surety must disclose to the Probate Court and immediately furnish the court a copy of any agreement between the surety and fiduciary relating to the suretyship or its continuation. Principal and surety ­ obligation and penalty of bond extend to real estate and assets under an Order and Agreement/Restriction on Control of Assets. While the amount of this bond may be less than would otherwise have been required, either because an asset of the estate is real estate or because an asset of the estate is subject to an Order and Agreement/Restriction on Control of Assets, the obligation and penalty of this bond nevertheless extend to all duties of the fiduciary, including duties with respect to the real estate or an asset subject to the Order and Agreement/Restriction on Control of Assets. ACCEPTED BY THE COURT Date: ............... ......... .......... ....... ........... ....... ......... .......... ....... ...... Judge/Ass't Clerk As used in this document, the word fiduciary includes the plural, where the context so requires. PROBATE BOND American LegalNet, Inc. www.FormsWorkFlow.com PC-480