DECREE AND ORDER FOR FORMAL REMOVAL OF PERSONAL REPRESENTATIVE G.L. c. §3-611 Estate of: First Name Middle Name Docket No. Commonwealth of Massachusetts The Trial Court Probate and Family Court Division Last Name Also Known As: Date of Death: After hearing or on the uncontested Petition for Formal Removal of Personal Representative filed on (date) THE COURT FINDS: 1. The Petitioner is an interested person and has filed a complete and verified petition. 2. Any required notices have been given or waived by all the interested persons. 3. The Personal Representative(s) Name: First Name M.I. Last Name was/were appointed on is necessary because: (date) and removal of the above-named Personal Representative(s) The person who sought the appointment of the current Personal Representative(s) intentionally misrepresented material facts. The Personal Representative(s): intentionally misrepresented material facts. disregarded an Order of the Court. is incapable of discharging the duties of office. mismanaged the estate. failed to perform a duty pertaining to the office. other: The Petitioner is a Personal Representative appointed in the decedent's domicile and requests the removal of Personal Representative(s) who was appointed in this Commonwealth to administer local assets. THE COURT DECREES AND ORDERS: 1. The aforementioned Personal Representative(s) is/are removed from office. MPC 766 (3/19/12) JSA American LegalNet, Inc. www.FormsWorkFlow.com page 1 of 2 Docket No. Estate of: First Name Middle Name Last Name 2. The disposition of the assets of the estate remaining in the name of or under the control of the aforementioned Personal Representative(s) shall be as follows: 3. The Court further orders that: Date Justice of the Probate and Family Court MPC 766 (3/19/12) JSA American LegalNet, Inc. www.FormsWorkFlow.com page 2 of 2