IN THE CIRCUIT COURT FOR FLORIDA IN RE: ESTATE OF COUNTY, PROBATE DIVISION File No. Division Deceased. CAVEAT BY CREDITOR (Nonresident ­ Pro Se) 1. The interest of the caveator is that of a creditor of , deceased, whose last known residence address is , the last four digits of whose social security number, if known, are , 2. , whose year of birth, if known, is . , and who died on or about Caveator's name, mailing address and residence address are: 3. Caveator, a non-resident of the state of Florida who is not represented by an attorney , who County, Florida, whose mailing admitted to practice in Florida, hereby designates (is)(is not) a member of The Florida Bar, a resident of address is and whose residence address is___________________________________________________ as caveator's agent for the service of notice and consents that service of notice on the agent shall bind the caveator. Caveator requests that the clerk notify the caveator's agent in writing of the date of issuance of letters of administration and of the names and addresses of the personal representative and the personal representative's attorney, and that caveator be given such additional notice as the Florida Probate Rules require. Under penalties of perjury, I declare that I have read the foregoing, and the facts alleged are true, to the best of my knowledge and belief. Signed on this ________ day of __________________________, ________. Caveator Bar Form No. P-1.0300 - 1 of 2 © Florida Lawyers Support Services, Inc. Revised January 1, 2017 American LegalNet, Inc. www.FormsWorkFlow.com ACCEPTANCE I CERTIFY that I am a resident of Agent. County, Florida, and my mailing and residence addresses are indicated above. I hereby accept the foregoing designation as Resident Signed on this ________ day of __________________________, _________. Resident Agent [Print or Type Names Under All Signature Lines] Bar Form No. P-1.0300 - 2 of 2 © Florida Lawyers Support Services, Inc. Revised January 1, 2017 American LegalNet, Inc. www.FormsWorkFlow.com