IN THE CIRCUIT COURT FOR FLORIDA IN RE: ESTATE OF COUNTY, PROBATE DIVISION File No. Deceased. Division PETITION FOR ADMINISTRATION (Intestate Nonresident -- Single Petitioner) Petitioner, 1. Petitioner has an interest in the above estate as . Petitioner's address is and the name and office address of petitioner's attorney are set forth at the end of this petition. 2. Decedent, , whose last known address was , and, if known, whose age was died on 3. are: NAME ADDRESS RELATIONSHIP YEAR OF BIRTH [if Minor] , and the last four digits of whose social security number are at County, _____________________. , . On , alleges: the date of death, decedent was domiciled in So far as is known, the names of the beneficiaries of this estate and of the decedent's surviving spouse, if any, their addresses and relationships to decedent, and the years of birth of any who are minors, 4. Venue of this proceeding is in this county because . Bar Form No. P-3.0160 - 1 of 2 © Florida Lawyers Support Services, Inc. January 1, 2017 American LegalNet, Inc. www.FormsWorkFlow.com 5. , whose address is , is qualified under the laws of the State of Florida to serve as personal representative of the decedent's estate and is entitled to preference in appointment as personal representative because . 6. Florida are The nature and approximate value of the assets in this estate subject to probate in the State of 7. 8. will (will not) be required to file a federal return. This estate (will)be required to file a federal estate taxestate tax return. Domiciliary or principal probate proceedings(are)(are not) knownbebe pending in anotherstate are not known to to pending in another state , , , whose . [delete if inapplicable] An authenticated copy of so much of the domiciliary proceedings as is required by Florida After the exercise of reasonable diligence, petitioner is unaware of any unrevoked wills or be or country. Letters have been issued by the address of which is to address is 9. 10. Probate Rule 5.470 accompanies this petition. codicils of decedent. Petitioner requests that appointed personal representative of the Florida estate of the decedent. 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 __________________________, ________. Attorney for Petitioner Email Addresses: Petitioner Florida Bar No. (address) Telephone: [Print or Type Names Under All Signature Lines] Bar Form No. P-3.0160 - 2 of 2 © Florida Lawyers Support Services, Inc. January 1, 201 American LegalNet, Inc. www.FormsWorkFlow.com