IN THE CIRCUIT COURT FOR THE NINTH JUDICIAL CIRCUIT, IN AND FOR ORANGE COUNTY, FLORIDA CASE NO. Division: In re: Estate of Deceased. ____________________________________/ PERSONAL REPRESENTATIVE’S PETITION TO DETERMINE HOMESTEAD STATUS Petitioner, as personal representative of this estate, alleges: 1. The decedent died on ______________________. 2. At the time of death, the decedent resided on property located in Florida that was owned by the decedent and is described as ______________________________________ together with improvements described as: ________________________________________(referred to in this petition as "the Property.") 3. (CHECK ONE BOX ONLY) The Property is located in a municipality and is less than one-half acre of contiguous land. The Property is located outside a municipality and is less than 160 acres of contiguous land. 4. The Property was the decedent’s homestead. 5. (CHECK ONE BOX ONLY) The decedent was not survived by a minor child. The decedent was survived by a minor child or children as described below. 6. (CHECK ONE BOX ONLY) The decedent was not survived by a spouse. The decedent was survived by a spouse, but the spouse has validly waived homestead rights in a marital agreement. A copy of agreement is attached as Exhibit A. The decedent was survived by a spouse. 7. The decedent was survived by the following persons who are heirs at law as provided American LegalNet, Inc. www.FormsWorkflow.com by F.S. 732.102–732.108: Name and Address Relationship Age/Minor’s Birth Date 8. (CHECK ONE BOX ONLY:) The decedent’s homestead was devised by Article ___ of the decedent’s will to ____ ____________________________. The decedent died intestate. 9. (CHECK ONE BOX ONLY:) Title to the decedent’s homestead passed pursuant to the provisions of the decedent’s will to _____________________________________. The decedent’s homestead was not subject to devise and descended pursuant to F.S. 732.401 as follows: Name Relationship Share or Interest 10. (CHECK ONE BOX ONLY:) Petitioner believes that the decedent’s homestead passed as alleged above to the surviving spouse or to a person who is, or to persons who are, heirs of the decedent and the decedent’s exemption under Article X, §4, of the Florida Constitution has inured to that/those person(s). The decedent’s homestead is exempt from the claims of the decedent’s creditors. Petitioner believes that the decedent’s homestead did not pass to the spouse or persons who are the heirs of the decedent and it is an asset in the hands of the personal representative for payment of creditors’ claims and other proper purposes of administration. 11. In addition to persons identified above, the following persons, including creditors, may be interested in this petition, and their addresses and their possible interests are: Name Address Interest (if known) 12. All interested persons have either joined in this petition, consented to the relief requested, been served proper notice of this proceeding, or waived notice. 13. (CHECK ONE BOX ONLY:) The personal representative believes that other assets of this estate are sufficient to satisfy the debts, taxes, claims, and expenses of administration in this estate. American LegalNet, Inc. www.FormsWorkflow.com The personal representative believes this estate has insufficient assets, other than the Property, to satisfy the debts, taxes, claims, and expenses of administration. WHEREFORE, the personal representative requests that an order be entered determining that: A. the Property was the homestead of the decedent; B. (CHECK ONE BOX ONLY:) the Property is subject to the claims of creditors of this estate; the Property is not subject to the claims of creditors of this estate; C. the Property passed to: Name and Address Relationship Share or Interest (CHECK ONE BOX ONLY:) pursuant to Article ____ of the decedent’s will. pursuant to F.S. 732.401. 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. ___________________________ Petitioner ________________________________ Attorney for Petitioner ________________________________ ________________________________ ________________________________ address ________________________________ phone Florida Bar number ________________ American LegalNet, Inc. www.FormsWorkflow.com