STATE OF MICHIGAN PROBATE COURT COUNTY OF OAKLAND Estate of PETITION AND ORDER FOR DISCOVERY ESTATE NOT EXCEEDING $15,000.00* FILE NO. , decedent XXX-XXLast four digits of SSN PETITION I, Name and relationship , represent that: . Attached is a death certificate. Date 1. Decedent died on 2. Decedent was a resident of City/Township in this county. Decedent lived outside of Michigan and left an estate within this county to be administered. 3. Funeral and burial expenses are $ . The following persons have paid the following amounts toward the funeral and burial expenses (statements and receipts are attached) NAME AMOUNT NAME AMOUNT The amount of funeral and burial expenses remaining unpaid is $ . The total value of the decedent's property remaining after payment of funeral and burial expenses does/will not exceed $15,000 as adjusted for cost of living.*(See below) 4. The decedent's property and its gross value (if known) is as follows: (attach separate sheet if necessary) DESCRIPTION OF PROPERTY ESTIMATED VALUE Total SEE SECOND PAGE Do not write below this line ­ For court use only * This amount is adjusted for cost-of-living based on the year of death as follows: Date of Death Before January 1, 2001 2001 2002-2004 2005-2006 2007-2008 2009-2011 2012-2013 2014-2017 PEMH 1027 (2/17) PETITION Amount $15,000.00 $16,000.00 $17,000.00 $18,000.00 $19,000.00 $20,000.00 $21,000.00 $22,000.00 FILED 20 Deputy Register of Probate MCL 700.1210, MCL 700.3982 AND ORDER FOR DISCOVERY ESTATE NOT EXCEEDING $15,000.00 American LegalNet, Inc. www.FormsWorkFlow.com 5. The name, age, relationship, and address of each heir is as follows: NAME AGE RELATIONSHIP ADDRESS 6. I REQUEST that any financial institution be ordered to reveal to the petitioner whether the decedent had any accounts with them and if so, the account number(s) and the balance(s) in the account(s) both at the time of the decedent's death and at the present. I declare under the penalties of perjury that this petition has been examined by me and that its contents are true to the best of my information, knowledge, and belief. Attorney signature Name (type or print) Address City, state, zip Telephone no. Bar no. Date Petitioner Signature Address City, state, zip Telephone no. ORDER FOR DISCOVERY 7. IT IS ORDERED that: Upon presentation of a certified copy of this order, any financial institution shall reveal to the petitioner whether the decedent had any account(s) with them, and if so, the account number(s) and the balance(s) in the account(s) both at the time the decedent's death and at present, for purposes of causing an assignment of decedent's assets, if said assets total less than $15,000.00.* Date Judge Bar no. I certify that I have compared this copy with the original on file and that it is a correct copy of the original. Date Deputy register American LegalNet, Inc. www.FormsWorkFlow.com