PETITION TO RENDER INVENTORY ACCOUNT Docket No. Commonwealth of Massachusetts The Trial Court Probate and Family Court Estate of: First Name Middle Name Last Name Division Date of Death: The Petitioner(s) (hereafter "Petitioner") makes the following statements: 1. Information about the Petitioner: Name: First Name M.I. 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 #: Interest of the Petitioner: 2. The Personal Representative was appointed on (date) . 3. The Personal Representative named below: First Name (Address) M.I. (Apt, Unit, No. etc.) (City/Town) Last Name (State) (Zip) has neglected to prepare an inventory of assets of this estate and file it with this court or mail it to all interested persons, and at least three months have passed since the appointment of the Personal Representative; has neglected to render an account of the administration of this estate to the interested person, at least one year has passed since the appointment of the original Personal Representative, and the time for presenting claims has expired; has neglected to petition the court for allowance of his or her account of his/her administration of this estate, at least one year has passed since the appointment of the original Personal Representative, and the time for presenting claims has expired; Wherefore the Petitioner requests that the court compel the Personal Representative to: render to the court and to the Petitioner an inventory of said estate; render to the court and to the Petitioner an account of his or her administration; petition the court for allowance of the account of his or her administration. MPC 856 (3/1/17) page 1 of 2 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 Co-Petitioner (if applicable) Information on Attorney for Petitioner Signature of Attorney (Print name) (Address) (Apt, Unit, No. etc.) (City/Town) (State) (Zip) Primary Phone #: B.B.O. # Email: MPC 856 (3/1/17) page 2 of 2