IN THE CIRCUIT COURT FOR FLORIDA IN RE: ESTATE OF COUNTY, PROBATE DIVISION File No. Division Deceased. ORDER DETERMINING HOMESTEAD STATUS OF REAL PROPERTY (Intestate ­ Spouse, No Lineal Descendant ­ 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 intestate and was domiciled in County, Florida; 2. 3. 4. The decedent was survived by a spouse; The decedent was not survived by a descendant; 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-4.0454 - 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 title to the Property descended, as of the decedent's date of death, and the constitutional exemption from claims of the decedent's creditors inured to the decedent's surviving spouse, . ADJUDGED FURTHER that the personal representative is authorized and directed to surrender all of the Property which may be in the possession or control of the personal representative, to the surviving spouse, and the personal representative shall have no further responsibility with respect to it. ORDERED on , . , whose post office address is Circuit Judge Bar Form No. P-4.0454 - 2 of 2 © Florida Lawyers Support Services, Inc. January 1, 2017 American LegalNet, Inc. www.FormsWorkFlow.com