COMPLETE FOR PROBATE BONDS UNDER $500,000 (GUARDIAN OF MINOR $10,000) Social Security #-: Applicant (For partnership, give full names ofpartners and trade names) Please Print Applicant's net worth: Age Residence Address (Street and Number) (City) (State) (Zip) (City) (State) (Zip) Business Address (Street and Number) Amount of Bond Type of Bond Effective Date Complete name and address of Obligee How long so engaged? Occupation or business Previous Surety Yes Name of deceased (Ward) No Ifyes, give name and reason for change. Date of death Date of appointment Is applicant indebted to the estate or trust? Yes Name and address of attorney (If none, do not write the bond; submit it to our underwriters) No (If yes, explain on an attached sheet) Will the attorney remain involved throughout the duration of this estate? Yes Assets of estate or trust (describe) N o Applicant's relationship to Name, age, and health status of minor(s) deceased incompetent Applicant's net worth: ward(s) Are guardianship funds to be used for support of ward? Approximately how much per month? Yes No $ What is the source of the guardianship funds? (If an insurance settlement, do not execute the bond; instead refer it to an underwriter.) (Please send copy of court order authorizing monthly expenditures.) Who are the heirs of this estate? Has anyone objected to the applicant's appointment as fiduciary? Yes No Will any going business (excluding farms) of the estate be No (If yes, send copy of continued by fiduciary? Yes court order.) Is this bond required on the demand of an interested person? Yes No Who? Name and address of court: What is the applicant's experience in handling fiduciary responsibilities? ATTORNEY'S RECOMMENDATION Your recommendation will be helpful and may be the difference between getting a refusal or having the bond written. Tell us what you know and think of the applicant. I have personally known the Principal for years and offer the following recommendations and information for your consideration in accepting this bond: Our law firm is not very familiar with this applicant. Our law firm knows this applicant and is aware of no adverse or negative information about him/her. Our law firm is well acquainted with this applicant and offers our highest recommendation. Comments: 2000 © American LegalNet, Inc. PROBATE OR FIDUCIARY BOND Amount of bond Up to $2,000 2,000 - $20 and for each additional K to $50,000 50,000 - $260 and for each additional K to $200,000 200,000 - $860 and for each additional K to $500,000 500,000 - $1,61 0 and for each additional K to $ 1,000,000 1,000,000- $2,1 10 and for each additional K Per $1000 Per Annurn $10.00 5.00 4.00 2.50 1.00 .50 On Administrator, Personal Representative & Executor bonds of $25,000 or less, the premiums developed by the above rates are for the term of the bond. No renewal premiums will be charged for such bonds. Term minimum - $ 1 00 All others - Annual minimum premium $100 Premiums on bonds for guardians and conservators of minors must be charged in advance until the minor reaches the age of majority. See prepayment discount schedule below. PROBATE BOND PREPAYMENT DISCOUNT SCHEDULE Discount does not apply on first year premium which is payable in full, but applies to second and subsequent premiums only. Discount 15% 20% 25% 30% Advance payment of 1-5 renewal premiums Advance payment of 6-7 renewal premiums Advance payment of 8-9 renewal premiums Advance payment of 10 or more renewal premiums Premiums are subject to change. 2000 © American LegalNet, Inc.