Docket No. PETITION TO MODIFY BOND Commonwealth of Massachusetts The Trial Court Probate and Family Court Division Estate of: Conservatorship of: Trust: Petitioner(s) (hereafter "Petitioner"), an interested person, makes the following statements: 1. Information about the Petitioner: Name: First Name M.I. (Address) Last Name (Apt, Unit, No. etc.) (Apt, Unit, No. etc.) Street Address: Mailing Address, if different: (Address) Primary Phone #: (City/Town) (State) (Zip) Interest of the Petitioner in the estate (e.g., Personal Representative named in will, surviving spouse, heir, devisee, Trustee, surety on the bond, etc.): 2. The assets of the personal estate subject to bonding requirements have a value of approximately $ 3. The Petitioner Name: OR the following: First Name M.I. Last Name . was/were appointed on (date) as 4. A bond without sureties with personal corporate sureties in the amount of $ is now in effect. 5. Petitioner states that the current bond is not appropriate for the following reasons: MPC 295 (1/16/13) MDBND American LegalNet, Inc. www.FormsWorkFlow.com page 1 of 2 Petitioner requests that the Court: Modify the amount of the bond to $ Release or discharge the current surety or sureties. Permit the substitution of another bond as follows: without sureties with personal corporate sureties in the amount of $ . with sufficient surety. Determine the amount of the bond and if sureties are required. 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 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: MPC 295 (1/16/13) MDBND American LegalNet, Inc. www.FormsWorkFlow.com page 2 of 2