PETITION FOR SALE OF REAL ESTATE G. L. c. 202, � 19 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. GENERAL INFORMATION The Petitioner(s) (hereafter "Petitioner") makes the following statements: 1. The Petitioner is the Personal Representative of the estate: Name: First Name Middle Name Last Name (Address) (Apt, Unit, No. etc.) (Address) (Apt, Unit, No. etc.) (City/Town) (City/Town) (State) (State) (Zip) (Zip) Mailing Address, if different: Primary Phone #: 2. The court examined and approved the Personal Representative's bond on: (date) . The bond was . without surety OR with personal OR corporate surety in the penal sum amount of $ FORM ALERT: The Inventory form (MPC 854) must be filed with this Petition. 3. Any lien for tax imposed by G. L. c. 65C has been released or discharged as evidenced by the following document filed with this Petition: a closing letter, a release, or a discharge from the Commissioner of Revenue. OR an affidavit of the Personal Representative signed under the penalties of perjury stating that the gross estate does not necessitate a Massachusetts estate tax filing. 4. The Division of Medical Assistance is not interested OR is interested: due to the filing of a written statement of claim against the estate pursuant to G. L. c. 118E, � 32(h)(1). due to the filing of a notice of claim that an action has been commenced pursuant to G. L. c. 190B, � 3-803(f). FORM ALERT: If interested, the Personal Representative must give notice by citation (if not assented to) of this Petition by certified mail to the Division of Medical Assistance, Estate Recovery Unit, P.O. Box 15205, Worcester, MA 01615-0205. II. REAL ESTATE 5. The Decedent was at the time of his or her death the owner of a (insert % or other description) (Address) (Apt, Unit, No. etc.) (City/Town) (State) (Zip) American LegalNet, Inc. www.FormsWorkFlow.com interest in certain real estate located at: county of: MPC 210 (3/1/17) page 1 of 2 bounded and described on an attachment (include docket number and case name on the attachment). Title Reference: the same being all part County Book: Page: or Certificate of Title No. of the real estate of the Decedent. FORM ALERT: A description of the real estate with the docket number and case name clearly legible must be attached to this Petition. 6. That it is for the advantage of all parties interested that the same be sold. 7. That an advantageous offer for the purchase of the real estate has been made to the Personal Representative in the sum of dollars ($ ). 8. If any heirs or devisees have conveyed or mortgaged his/her interest in the property to a third person, list the third person's name, address, and nature of his/her interest below. FORM ALERT: Do NOT include the names of heirs, devisees, or the Decedent's mortgage. NAME OF THIRD PARTY ADDRESS NATURE OF INTEREST III. RELIEF REQUESTED Wherefore the Petitioner requests that the court authorize the Personal Representative to sell the real estate: at a private sale in accordance with said offer or for a larger sum. at a public auction upon the following terms: AND that the Personal Representative may become the purchaser of the real estate. 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 Petitioner Information on Attorney for Petitioner, if any 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 210 (3/1/17) page 2 of 2