DEMAND FOR SURETIES G.L. c. 190B, § 3-605 Estate of: First Name Middle Name Docket No. Commonwealth of Massachusetts The Trial Court Probate and Family Court Division Last Name Date of Death: 1. Information about the Applicant: Name: First Name M.I. Last Name (Address) (Apt, Unit, No. etc.) (City/Town) (State) (Zip) Primary Phone #: 2. I have the following financial or property interest or claim in this estate as a: Devisee Heir Creditor Other: 3. The value of my interest or claim is in excess of $5,000.00. 4. The Applicant gave notice of this Demand to the Personal Representative on by mailing to the following address: (Address) (Apt, Unit, No. etc.) (City/Town) (date) (Identify relationship to the Decedent G.L. c. 190B, § 2-103) (state interest) (State) (Zip) 5. I demand that the Personal Representative give sureties on the official bond. 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 Applicant Date: Signature of Co-Applicant (if applicable) Information on Attorney for Applicant Signature of Attorney (Print name) (Address) (Apt, Unit, No. etc.) (City/Town) (State) (Zip) Primary Phone #: B.B.O. # Email: MPC 360 (3/19/12) DMDSUR American LegalNet, Inc. www.FormsWorkFlow.com page 1 of 1