DECREE AND ORDER OF SUPERVISED ADMINISTRATION 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 a hearing on the Petition for Supervised Administration filed on (date) . THE COURT FINDS: 1. The Petitioner is an interested person in the estate and has filed a complete and verified Petition for Supervised Administration. 2. The Personal Representative was appointed on (date) in a formal Procceeding. 3. Any required notices have been given or waived by all interested persons. 4. The Court finds that supervision is necessary under the circumstances. 5. The Court further finds: THE COURT ORDERS: 1. The Personal Representative shall serve in supervised administration. Unless further restricted below, the Supervised Personal Representative may exercise all of the powers of Personal Representative except the power to make any distribution of the estate without prior Order of the Court. The Court further orders the following restrictions: THESE FURTHER RESTRICTIONS SHALL BE ENDORSED ON THE PERSONAL REPRESENTATIVE'S LETTERS OF AUTHORITY 2. The Court further orders: Date Justice of the Probate and Family Court MPC 756 (3/19/12) JSA American LegalNet, Inc. www.FormsWorkFlow.com page 1 of 1