SUPERIOR COURT OF THE DISTRICT OF COLUMBIA PROBATE DIVISION _________ _________ _________ _________ _________ ADM GDN TRP CON SEB _________ _________ _________ _________ _________ In re: _______________________________________________ Minor/Ward/Deceased/Other PRO SE PETITION FOR ___________________________________ (Briefly and plainly state relief requested.) 1. __________________________________ (Name of petitioner) ___________________________________ (Interest of petitioner, i.e., are you an heir, a legatee, the minor, a relative?) Petitioner seeks the following relief: _____________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ Petitioner is entitled to this relief because (i.e., explain why you are entitled to what you asking for or asking the Court to do. Be specific. Attach additional typewritten pages if more space is needed.) ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________ Signature ___________________________________ Typed Name ___________________________________ Address (Actual address/not Post Office Box) ___________________________________ ___________________________________ Telephone number 2. ____________________________________ Signature of Attorney ____________________________________ Typed Name of Attorney ____________________________________ Address (Actual address/not Post Office Box) ____________________________________ ____________________________________ Telephone number _________________________________ Unified Bar number _________________________________ E-mail address (optional) July 2010 ­ 153.10.v1 American LegalNet, Inc. www.FormsWorkFlow.com VERIFICATION I, ____________________________, being first duly sworn, on oath, depose and say that I have read the foregoing pleading by me subscribed and that the facts therein stated are true to the best of my knowledge, information, and belief. _________________________________ Signature of petitioner Subscribed and sworn to before me this ____ day of _________________, 20______. _________________________________ Notary Public/Clerk CERTIFICATE OF SERVICE I hereby certify that on the ____ day of ____________________, 20____, a copy of the foregoing was served by first class mail, postage prepaid, to the following persons (list names and addresses of all parties): ____________________________________ Signature July 2010 ­ 153.10.v1 American LegalNet, Inc. www.FormsWorkFlow.com SUPERIOR COURT OF THE DISTRICT OF COLUMBIA PROBATE DIVISION _________ ADM _________ In re: ___________________________________________________ Minor/Ward/Deceased/Other _________ GDN _________ _________ TRP _________ _________ CON _________ _________ SEB _________ ORDER Upon consideration of the pro se petition for ___________________________________________ filed herein by ______________________________________, and any response thereto, it is hereby, by the Court, this ________day of _________________, 20_____, ORDERED 1. 2. That the motion be Granted Denied That ____________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ____________________________________ JUDGE cc: July 2010 ­ 153.10.v1 American LegalNet, Inc. www.FormsWorkFlow.com