IN THE CIRCUIT COURT FOR FLORIDA IN RE: ESTATE OF COUNTY, PROBATE DIVISION File No. Division Deceased. ORDER DETERMINING AMOUNT OF ELECTIVE SHARE (Contribution Not Required) On the petition of , for an order determining the amount of elective share, the court finding that all interested persons have been served proper notice of the petition and hearing, or have waived notice thereof; that the material allegations of the petition are true; that surviving spouse of the decedent who died on County, Florida; and that on , , is the , domiciled in , being within the time prescribed by law, the surviving spouse filed an election to take the elective share in accordance with the laws of the State of Florida; it is ADJUDGED: 1. The amount of the elective share to which the surviving spouse is entitled is $ . 2. The assets listed on Schedule E of the Petition to Determine Amount of Elective Share shall be applied to satisfy the surviving spouse's elective share or shall be distributed to the surviving spouse. 3. The following are directed to transfer assets to the personal representative in the time and manner shown on Schedule E: a. Beneficiaries of this estate and beneficiaries of decedent's revocable trust, if any who received a distribution of principal after the decedent's death; b. The trustee(s) of decedent's revocable trust. Bar Form No. P-4.0565 - 1 of 2 © Florida Lawyers Support Services, Inc. January 1, 2017 American LegalNet, Inc. www.FormsWorkFlow.com 4. The personal representative shall distribute to the surviving spouse the assets shown on Schedule E from the decedent's estate including any assets received from beneficiaries who received distributions after decedent's death and from the trustee(s) of decedent's revocable trust. 5. The personal representative shall file a receipt signed by the surviving spouse acknowledging the distribution. ADJUDGED FURTHER that no contribution toward elective share is required to be sought from any other person. ORDERED on , . Circuit Judge Bar Form No. P-4.0565 - 2 of 2 © Florida Lawyers Support Services, Inc. January 1, 2017 American LegalNet, Inc. www.FormsWorkFlow.com