BEFORE THE REGISTER OF WILLS FOR , MARYLAND Estate of: Estate No: Date of Appointment of Personal Representative: Date of Death: FINAL REPORT UNDER MODIFIED ADMINISTRATION (Must be filed within 10 months after the date of appointment) I, Personal Representative of the estate, report the following: 1. The estate continues to qualify for Modified Administration as set forth in the Election for Modified Administration on file with the Register of Wills. 2. Attached are the following Schedules and supporting attachments: Total Schedule A: Reportable Property ............................................... $ Total Schedule B: Payments and Disbursements .............................. $ Total Schedule C: Distribution of Net Reportable Property ............... $ 3. I acknowledge that: (a) (b) Final distributions shall be made within 12 months after the date of my appointment as personal representative. If Modified Administration is revoked, the estate shall proceed under Administrative Probate, and I will file a formal Inventory and Account, as required, until the estate is closed. I solemnly affirm under the penalties of perjury that the contents of the foregoing are true to the best of my knowledge, information, and belief and that any property valued by me which I have authority as personal representative to appraise has been valued completely and correctly in accordance with law. Attorney Signature Personal Representative Date Address Personal Representative Date Address Personal Representative Date Telephone Number RW 1143 - Page 1 of 4 (Form RW 1144 must be included when filing this form) PDF American LegalNet, Inc. www.FormsWorkflow.com FINAL REPORT UNDER MODIFIED ADMINISTRATION SUPPORTING SCHEDULE A Reportable Property Estate of: Item No. Estate No: Description Basis of Valuation TOTAL REPORTABLE PROPERTY OF THE DECEDENT (CARRY FORWARD TO SCHEDULE C) Value $ INSTRUCTIONS ALL REAL AND PERSONAL PROPERTY MUST BE INCLUDED AT DATE OF DEATH VALUE. THIS DOES NOT INCLUDE INCOME EARNED DURING ADMINISTRATION OR CAPITAL GAINS OR LOSSES REALIZED FROM THE SALE OF PROPERTY DURING ADMINISTRATION. ATTACHED APPRAISALS OR COPY OF REAL PROPERTY ASSESSMENTS AS REQUIRED: 1. Real and leasehold property: Fair market value must be established by a qualified appraiser. For decedents dying on or after January 1, 1998, in lieu of a formal appraisal, real and leasehold property may be valued at the full cash value for property tax assessment purposes as of the most recent date of finality. This does not apply to property tax assessment purposes on the basis of its use value. 2. The personal representative may value: Debts owed to the decedent, including bonds and notes; bank accounts, building, savings and loan association shares, money and corporate stocks listed on a national or regional exchange or over the counter securities. 3. All other interests in tangible or intangible property: Fair market value must be established by a qualified appraiser. ATTACH ADDITIONAL SCHEDULES AS NEEDED RW 1143 - Page 2 of 4 2003 PDF American LegalNet, Inc. www.FormsWorkflow.com FINAL REPORT UNDER MODIFIED ADMINISTRATION SUPPORTING SCHEDULE B Payments and Disbursements Estate of: Item No. Estate No: Description Amount paid TOTAL DISBURSEMENTS: (CARRY FORWARD TO SCHEDULE C) $ INSTRUCTIONS: 1. Itemize all liens against property of the estate including mortgage balances. 2. Itemize sums paid (or to be paid) within 12 months from the date of appointment for: debts of the decedent, taxes due by the decedent, funeral expenses of the decedent, family allowance, personal representative and attorney compensation, probate fee and other administration expenses of the estate. ATTACH ADDITIONAL SCHEDULES AS NEEDED RW 1143 - Page 3 of 4 2003 PDF American LegalNet, Inc. www.FormsWorkflow.com FINAL REPORT UNDER MODIFIED ADMINISTRATION SUPPORTING SCHEDULE C Distributions of Net Reportable Property Estate of: Estate No: 1. SUMMARY OF REPORTABLE PROPERTY TOTAL FROM SCHEDULE A ............................................................................. TOTAL FROM SCHEDULE B ............................................................................. TOTAL NET REPORTABLE PROPERTY (SCHEDULE A MINUS SCHEDULE B) ....... 2. SPECIFIC BEQUESTS (If applicable) Name of Legatee or Heir Distributable Share of Reportable Estate Inheritance Tax Thereon 3. DISTRIBUTION OF BALANCE OF ESTATE Name of Legatee or Heir Distributable Share of Reportable Estate Inheritance Tax Thereon $ $ Total Reportable Distribution Inheritance Tax ATTACH ADDITIONAL SCHEDULES AS NEEDED RW 1143 - Page 4 of 4 PDF American LegalNet, Inc. www.FormsWorkflow.com CERTIFICATE OF SERVICE OF FINAL REPORT UNDER MODIFIED ADMINISTRATION , , I delivered or mailed, postage I hereby certify that on this day of prepaid, a copy of the foregoing Final Report Under Modified Administration and attached Schedules to the following persons: Names Addresses Attorney Personal Representative Address Personal Representative City, State, Zip Code Personal Representative Telephone Number FOR REGISTER OF WILLS USE Distributions subject to collateral tax at Distributions subject to collateral tax at Distributions subject to direct tax at Distributions subject to direct tax at % % % % Tax thereon Tax thereon Tax thereon Tax thereon Exempt distributions to (Identity of the Recipient) Exempt distributions to (Identity of the Recipient) Exempt distributions to (Identity of the Recipient) Total Inheritance Tax due Total Inheritance Tax paid Gross estate Probate Fee and Costs Collected RW 1144 (When filing RW 1143, this form must be included) 2003 PDF American LegalNet, Inc. www.FormsWorkflow.com