IN THE CIRCUIT COURT FOR FLORIDA IN RE: ESTATE OF File No. Division Deceased. COUNTY, PROBATE DIVISION ORDER DETERMINING HOMESTEAD STATUS OF REAL PROPERTY (Testate ­ Devised to Persons Other Than Heirs, No Spouse or Minor Child ­ Not Exempt From Claims) On the petition of for an order determining homestead status of real property (the "Property"), all interested persons having been served proper notice of the petition and hearing, or having waived notice thereof, the court finds that: 1. The decedent died testate and was domiciled in County, Florida; 2. 3. 4. The decedent was not survived by a spouse or minor child; Decedent's homestead was devised to persons who are not protected heirs of the decedent; At the time of death, the decedent owned and resided on the Property described in the petition; it is ADJUDGED that the following described Property: Bar Form No. P-4.0468 - 1 of 2 © Florida Lawyers Support Services, Inc. January 1, 2017 American LegalNet, Inc. www.FormsWorkFlow.com constituted the homestead of the decedent within the meaning of Section 4 of Article X of the Constitution of the State of Florida. ADJUDGED FURTHER that the Property was validly devised to: NAME ADDRESS RELATIONSHIP SHARE ADJUDGED FURTHER that the Property is not exempt from the claims of the decedent's creditors and is subject to administration in the decedent's estate. ORDERED on , . Circuit Judge Bar Form No. P-4.0468 - 2 of 2 © Florida Lawyers Support Services, Inc. January 1, 2017 American LegalNet, Inc. www.FormsWorkFlow.com