IN THE CIRCUIT COURT FOR FLORIDA IN RE: ESTATE OF COUNTY, PROBATE DIVISION File No. Division Deceased. PETITION TO DETERMINE HOMESTEAD STATUS OF REAL PROPERTY (Testate) Petitioner, 1. died testate on County, Florida, and was survived by: a. b. c. d. 2. The decedent, , , domiciled in [Strike each statement that is not applicable.] , alleges: , A spouse who has not waived his or her homestead rights. A spouse who has waived his or her homestead rights. One or more minor children. One or more devisees who are neither a spouse nor a minor child of the decedent. At the time of decedent's death, the decedent owned and resided on the following described contiguous parcel of real property (the "Property"): Bar Form No. P-4.0420 - 1 of 4 © Florida Lawyers Support Services, Inc. January 1, 2017 American LegalNet, Inc. www.FormsWorkFlow.com 3. Decedent's last will [and codicils, if any] admitted to probate and record by Order of this Court devised the Property as follows: 4. Petitioner believes the Property was validly devised because: 5. The Property constituted the homestead of the decedent within the meaning of Section 4 of Article X of the Constitution of the State of Florida, and petitioner believes that upon decedent's death, title to the Property descended to and the constitutional exemption from claims of decedent's creditors inured to: 6. The name of the decedent's surviving spouse, if any, the names and years of birth of the decedent's minor children, if any, and the names of the decedent's other surviving descendants and devisees having an interest in the decedent's estate, if any, and their respective relationships to decedent are: NAME RELATIONSHIP YEAR OF BIRTH (Minor child) Bar Form No. P-4.0420 - 2 of 4 © Florida Lawyers Support Services, Inc. January 1, 2017 American LegalNet, Inc. www.FormsWorkFlow.com 7. The only persons, other than petitioner, having an interest in this proceeding, including unpaid creditors, and their respective addresses are: Petitioner requests that an order be entered determining that the Property constituted the exempt homestead of the decedent, title to which, upon decedent's death, descended and the constitutional exemption from claims inured as set forth in paragraph 5; directing the personal representative to surrender possession of the Property; and directing that the personal representative shall have no further responsibility with respect to the Property. 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 ______________________, _________. Petitioner Attorney for Petitioner [Print or T ype Names Under All Signature Lines] Email Addresses: Florida Bar No. (address) Telephone Bar Form No. P-4.0420 - 3 of 4 © Florida Lawyers Support Services, Inc. January 1, 2017 American LegalNet, Inc. www.FormsWorkFlow.com I CERTIFY that a copy hereof has been furnished to: by , on , . Attorney [Print or Type Names Under All Signature Lines] Bar Form No. P-4.0420 - 4 of 4 © Florida Lawyers Support Services, Inc. January 1, 2017 American LegalNet, Inc. www.FormsWorkFlow.com