AFFIDAVIT IN SUPPORT OF RELEASE OF DEMAND FOR SURETIES Estate of: First Name Middle Name Docket No. Commonwealth of Massachusetts The Trial Court Probate and Family Court Division Last Name Date of Death: I, First Name M.I. Last Name Personal Representative(s) of the above-referenced estate appointed on (date) state the following: 1. On (date) , I was served with a Demand for Sureties by Name: First Name M.I. Last Name 2. A copy of the Demand is attached hereto. 3. Beneficiary/Claimant asserts he/she has an apparent interest in the estate in excess of $5,000.00 4. On (date) I paid the beneficiary/claimant the sum of $ in satisfaction of his/her interest in the estate, as evidenced by (please attach documents): 5. I request that new Letters issue reflecting that there are no limitations on my authority to act as Personal Representative. SIGNED UNDER THE PENALTIES OF PERJURY I certify under the penalties of perjury that the foregoing statements are true to the best of my knowledge and belief. Date: Signature of Personal Representative Date: Signature of Co-Personal Representative (if applicable) Information on Attorney for Personal Representative Signature of Attorney (Print name) (Address) (Apt, Unit, No. etc.) (City/Town) (State) (Zip) Primary Phone #: B.B.O. # Email: American LegalNet, Inc. www.FormsWorkFlow.com MPC 490 (3/19/12) AFRDS