IN THE CIRCUIT COURT FOR FLORIDA IN RE: ESTATE OF COUNTY, PROBATE DIVISION File No. Deceased. Division Adversary Proceeding No. Petitioner, vs. Respondent. ORDER DETERMINING ELECTIVE SHARE (Contribution 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 died on in County, Florida; and that on is the surviving spouse of the decedent who , , , domiciled , 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. 2. 3. The amount of the elective share to which the surviving spouse is entitled is $ ; The assets listed on Schedule E of the Petition to Determine Amount of Elective Share shall be applied to the surviving spouse's elective share; and The following are directed to transfer assets to the personal representative in the time and manner shown on Schedules E and F of the petition: a. b. Beneficiaries of this estate and beneficiaries of decedent's revocable trust, if any, who received a distribution of principal after the decedent's death; The trustee(s) of decedent's revocable trust. ADJUDGED FURTHER that contribution in the manner and amount set forth is ordered from the direct recipients listed on Schedule F and such assets shall be delivered to the personal representative. Bar Form No. P-4.0575 - 1 of 2 © Florida Lawyers Support Services, Inc. Revised January 1, 2017 American LegalNet, Inc. www.FormsWorkFlow.com ADJUDGED FURTHER that the personal representative shall distribute to the surviving spouse the assets shown on Schedules E and F of the petition from decedent's estate, including any assets received from beneficiaries who received distributions after decedent's death, from the trustee(s) of decedent's revocable trust and from the direct recipients. The personal representative shall file a receipt signed by the surviving spouse acknowledging the distribution. ORDERED on , . Circuit Judge Bar Form No. P-4.0575 - 2 of 2 © Florida Lawyers Support Services, Inc. Revised January 1, 2017 American LegalNet, Inc. www.FormsWorkFlow.com