GEORGIA PROBATE COU RT STAND ARD FORM Petition for Year’s Support INSTRUCTIONS I. Specific Instructions 1. 2. The amount set apart shall be an amount sufficient to maintain the standard of living that the surviving spouse and each minor child had prior to the death of the testator or intestate, for a period of 12 months, taking into consideration the following: (1) the support available to the individual for whom the property or money is to be set apart, from sources other than year’s support, including but not limited to any separate estate and earning capacity of that individual; and (2) such other relevant criteria as the court deems equitable and proper, including the solvency of the estate. 3. This petition must be filed within 24 months after decedent’s death. 4. II. This form is to be used for filing a petition for year’s support pursuant to O.C.G.A. §53-3-1 et seq. The Petitioner or his/her/their attorney must prepare and file with the Court, no later than the date of the Final Order, a Georgia Department of Revenue Form PT-61 for each parcel of real property located in the State of Georgia shown on Exhibit “A.” General Instructions General instructions applicable to all Georgia probate court standard forms are available in each probate court. Effective 7/07 GPCSF 10 Petitioner American LegalNet, Inc. www.FormsWorkflow.com GEORGIA PROBATE COU RT STAND ARD FORM IN THE PROBATE COURT OF COUNTY STATE OF GEORGIA IN RE: ESTATE OF ) ) , ) ) ) DECEASED ESTATE NO. PETITION FOR YEAR’S SUPPORT TO THE HONORABLE JUDGE OF THE PROBATE COURT: The Petition of , First Middle Last Name whose mailing address is , shows that: 1. The petitioner is: A. The surviving spouse. B. A guardian or other individual acting on behalf of the surviving spouse or minor child(ren) (state specific relationship): . 2. The decedent, , whose domicile was (State full street address of decedent, including County of domicile) departed this life on , 20 . 3. (Initial one:) A. B. C. D. There is not a Will. There is a Will, which has been offered for probate. There is a Will, which will be offered for probate. There is a Will, which will not be offered for probate but is attached to this Petition or is on file with this Court. 4. The decedent's estate consists of real and/or personal property of the probable value of dollars. Effective 7/07 -1- GPCSF 10 Petitioner American LegalNet, Inc. www.FormsWorkflow.com 5. Petitioner shows that the following named minor child of said decedent , to wit: , Name of Minor Child D.O.B. Name, Address of Parent or Guardian Name of Minor Child D.O.B. Name, Address of Parent or Guardian Name of Minor Child D.O.B. Name, Address of Parent or Guardian Name of Minor Child D.O.B. Name, Address of Parent or Guardian Name of Minor Child D.O.B. Name, Address of Parent or Guardian , , , , (and (Full Name of Surviving Spouse, if applicable) (is) (are) entitled, before the payment of debts of the decedent, to an allowance called Year’s Support, which petitioner hereby claims for the individual(s) named above. 6. A schedule of the property or a statement of the amount of money or both which the petitioner proposes to have set aside to the individuals listed in paragraph 5. above as year's support is attached hereto as "Exhibit A" and made a part hereof. 7. (Select "A" or "B", and strike inapplicable words:) A. (There is no executor or administrator of this estate) (The petitioner is the executor or administrator of this estate) and therefore petitioner has set forth below by affidavit marked "Exhibit B" and made a part hereof a list of all interested persons, who must be mailed a copy of the notice not less than 21 days prior to the deadline shown in the notice by which objections, if any, must be filed. B. (is) (are) the acting executor(s) or administrator(s) of this estate and must receive 21 days’ notice by mail as described above. Note: “Exhibit B” is not required. Effective 7/07 -2- GPCSF 10 Petitioner American LegalNet, Inc. www.FormsWorkflow.com 8. In addition to all taxes and tax liens on real property accrued for years prior to the year of the decedent’s death, petitioner elects to have property taxes on any real property set apart as year’s support divested as follows: 1. 2. 3. Real property taxes accrued in the year of decedent’s death; Real property taxes accrued in the year in which this petition is filed; or Real property taxes accrued in the year following the filing of this petition if this petition is filed in the year of the decedent’s death. 9. Additional Data: Where full particulars are lacking, state here the reasons for any such omission. WHEREFORE, petitioner prays: 1. 2. 3. 4. That this petition be accepted and filed. That notice issue and be published and served as described above. That any interested person who is a minor or an incapacitated adult have a guardian ad litem appointed for him or her, except for any minor child of decedent on whose behalf this petition has been filed by a guardian who is not the spouse of the decedent. That this Court grant such other and further relief as it deems proper under the circumstances. Signature of petitioner Printed Name Address Telephone Number Signature of Attorney: Typed/printed name of Attorney: Address: Telephone: Effective 7/07 State Bar # -3- GPCSF 10 Petitioner American LegalNet, Inc. www.FormsWorkflow.com VERIFICATION GEORGIA, COUNTY Personally appeared before me the undersigned petitioner(s) who on oath state(s) that the facts set forth in the foregoing petition are true. Sworn to and subscribed before me this day of , 20 . Petitioner NOTARY/CLERK OF PROBATE COURT My Commission Expires Effective 7/07 Printed Name -4- GPCSF 10 Petitioner American LegalNet, Inc. www.FormsWorkflow.com IN THE PROBATE COURT OF COUNTY STATE OF GEORGIA IN RE: ESTATE OF DECEASED ) ) , ) ) ) ESTATE NO. PETITION FOR YEAR’S SUPPORT EXHIBIT A SCHEDULE OF PROPERTY [NOTE: If the petitioner proposes to have set aside any interest in real property, then the complete legal description of the real property and the interest therein must appear in full on this schedule and on the proposed Certificate of Order of Year's Support (page 8).] The following is a schedule of the property or a statement of the amount of money or both which the petitioner proposes to have set aside as year's support: Petitioner Effective 7/07 -5- GPCSF 10 Petitioner American LegalNet, Inc. www.FormsWorkflow.com IN THE PROBATE COURT OF COUNTY STATE OF GEORGIA IN RE: ESTATE OF ) ) , ) ) ) DECEASED ESTATE NO. PETITION FOR YEAR’S SUPPORT EXHIBIT B LIST OF INTERESTED PERSONS (To be completed if (1) there is no appointed executor or administrator of the estate, or (2) if the petitioner has been appointed the executor or administrator of the decedent’s estate) Petitioner hereby certifies that petitioner has made reasonable inquiry to ascertain the names, last known addresses, and ages (if under 18) of all the interested persons with respect to the within matter. Petitioner understands that, for purposes of this affidavit, the term "interested person" refers to the above-named decedent’s children, spouse, other heirs, beneficiaries, creditors, and any others having a property right or claim against the estate which may be affected by the above Year’s Support proceeding. Petitioner hereby certifies that the following are all of the interested persons known to Petitioner with respect to this matter and that any incapacitated adults are identified as such: Name Last Known Address Sworn to and subscribed before me this day of Age (or over 18) Relationship to Decedent Petitioner , 20 . Notary Public, or Clerk, Probate Court Effective 7/07 -6- GPCSF 10 Petitioner American LegalNet, Inc. www.FormsWorkflow.com ACKNOWLEDGMENT OF SERVICE AND CONSENT TO AWARD OF YEAR’S SUPPORT COUNTY GEORGIA, IN RE: PETITION OF FOR YEAR’S SUPPORT ESTATE OF , DECEASED We, the undersigned, being over 18 years of age, laboring under no legal disability and being interested persons with respect to the within matter, hereby acknowledge service of the petition for year’s support and notice, waive copies of same, waive all further service and notice, and hereby consent to the award of year’s support as proposed in the petition. SIGNATURE(S) OF INTERESTED PARTIES Sworn to and subscribed before me this day of , 20 . NOTARY/CLERK OF PROBATE COURT Print Name My Commission Expires -----------------------------------------------------------------------------------------------------------------------------Sworn to and subscribed before me this day of , 20 . NOTARY/CLERK OF PROBATE COURT Print Name My Commission Expires ------------------------------------------------------------------------------------------------------------------------------Sworn to and subscribed before me this day of , 20 . NOTARY/CLERK OF PROBATE COURT Print Name My Commission Expires ------------------------------------------------------------------------------------------------------------------------------Sworn to and subscribed before me this day of , 20 . NOTARY/CLERK OF PROBATE COURT Print Name My Commission Expires -----------------------------------------------------------------------------------------------------------------------------Sworn to and subscribed before me this day of , 20 . NOTARY/CLERK OF PROBATE COURT Print Name My Commission Expires ------------------------------------------------------------------------------------------------------------------------------Effective 7/07 -7- GPCSF 10 Petitioner American LegalNet, Inc. www.FormsWorkflow.com Probate Court Return Mailing Address: GEORGIA, CERTIFICATE OF ORDER OF YEAR'S SUPPORT (Pursuant to Ga. Code Ann. §53-3-11) COUNTY DATE ORDER GRANTED: GRANTOR: (NAME OF DECEDENT) GRANTEE: (FULL NAME OF SURVIVING SPOUSE, AND EACH MINOR CHILD, AND DATE OF BIRTH OF EACH MINOR) ADDRESS OF GRANTEE: Legal Description of Real Property and Interest Therein: Also land in , Count(y)(ies). Original Certificate delivered or mailed to Clerk of Superior Court of County on Certificate prepared by: , 20 . I do hereby certify that the above information is based on the order of the Probate Court issued on the date set out above and that the above information is true and correct. SIGNATURE OF ATTORNEY State Bar #: Effective 7/07 By: PROBATE CLERK/DEPUTY CLERK -8- GPCSF 10 Petitioner American LegalNet, Inc. www.FormsWorkflow.com