SUPERIOR COURT OF THE DISTRICT OF COLUMBIA PROBATE DIVISION Trust of _______________________ Settlor decedent Tr. No.______ Notice of Action Taken on Claim To:________________________ Claimant You are hereby notified that your claim in the amount of $___________________ for____________________against the above-entitled trust is: (check appropriate box)  Allowed in the stated amount.  Allowed in the amount of $_________ and disallowed as to the balance.  Disallowed.  The Trustee does not know whether the residuary probate estate is insufficient to pay the claim and therefore the claim is disallowed without prejudice. __________________ Trustee Date mailed or delivered__________________________ NOTICE If your claim has been disallowed in whole or in part, with or without prejudice, the claim will be barred to the extent of its disallowance unless you file a Petition For Payment From Trust not later than 60 days after the mailing of this notice or such shorter period as might be allowed by the applicable statute of limitations. American LegalNet, Inc. www.FormsWorkflow.com