Division Commonwealth of Massachusetts The Trial Court Probate and Family Court Department Docket No. AFFIDAVIT In the Es ta te of I / We he re by ce rtify tha t the e xe cutor who is na me d in the will, the te mpora ry e xe cutor whose appointment is sought, the person(s) who has / have requested to be appointed or who has / have been proposed as an administrator, administrator with the will annexed, special or temporary a dminis tra tor of the e s ta te of the de ce de nt, or a ny pe rs on who ha s be e n propos e d to re pla ce a n executor or administrator who has resigned or been removed [ ] is [ ] is not under indictment for or [ ] has [ ] has not be e n convicte d of the murde r in e ithe r the firs t or s e cond de gre e , or of ma ns la ughte r, or a s a n a cce s s ory be fore the fa ct of s uch crime committe d a ga ins t the de ce de nt. I / We he re by ce rtify tha t a ny pe rs on who is e ntitle d to a s ha re in the e s ta te e ithe r unde r the will its e lf or by ope ra tion of la w, by de s ce nt or dis tribution or through a s ha re of the de ce de nt's property as a joint tenant or tenant by the entirety [ ] has [ ] has not been charged or convicted of murde r in the firs t or s e cond de gre e , or of ma ns la ughte r (not including ve hicula r homicide or negligent manslaughter) arising from the death of the decedent. Please indicate the name(s) of the person(s) in the preceding paragraph who have been cha rge d or convicte d of a ny of the crime s liste d in conne ction with the de a th of the de ce de nt. Signed under the penalties of perjury this day of ,20 Signature(s): Petitioner - Attorney CJ- P 50 (3/04) pcpfc - c.g.f. American LegalNet, Inc. www.FormsWorkflow.com