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 (Intestate ­ Spouse and/or Descendants) Petitioner, 1. The decedent, , , domiciled in , alleges: , County, Florida, died intestate on and was survived by: a. b. c. 2. [Strike each statement that is not applicable.] A spouse who has not waived his or her homestead rights. A spouse who has waived his or her homestead rights. One or more lineal descendants. 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-4.0410 - 1 of 3 © Florida Lawyers Support Services, Inc. January 1, 2017 American LegalNet, Inc. www.FormsWorkFlow.com 3. 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 other lineal descendants having an interest in the decedent's estate, if any, and their respective relationships to the decedent are: NAME RELATIONSHIP YEAR OF BIRTH (Minor child) 4. 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: 5. 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 4; 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. Bar Form No. P-4.0410 - 2 of 3 © Florida Lawyers Support Services, Inc. January 1, 2017 American LegalNet, Inc. www.FormsWorkFlow.com 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 Email Addresses Florida Bar No. (address) Telephone: 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-4.0410 - 3 of 3 © Florida Lawyers Support Services, Inc. January 1, 2017 American LegalNet, Inc. www.FormsWorkFlow.com