IN THE CIRCUIT COURT OF JACKSON COUNTY, MISSOURI - PROBATE DIVISION AT TO ALL PERSONS INTERESTED IN THE ESTATE OF ESTATE NUMBER , Deceased. NOTICE OF FILING OF STATEMENT OF ACCOUNT AND SCHEDULE OF PROPOSED DISTRIBUTION (Sec. 473.840) You are hereby notified that the undersigned independent personal representative will file the attached statement of account, containing a schedule of proposed distribution of the assets of the estate, in the Probate Division of the Circuit Court of Jackson County, Missouri, at on . If no objections to the statement of account or schedule of distribution are filed within twenty (20) days after the filing thereof, the undersigned independent personal representative will distribute inacco rdance with the schedule of proposed distribution contained in the statement of account. If no proceeding is commenced in the court within six months after the filing of the statement of account, each independent personal representative is thereby discharged from further claim of demand by any interested person. Copies of the original and any supplementary and corrected inventories and all settlements filed in the court are attached hereto. Personal Representative: Address: / zip Telephone: ( ) Personal Representative: Address: / zip Telephone: ( ) Attorney: MO BAR No Address: / zip Telephone: ( ) Fax Number: ( ) E-Mail Address: Form 10605 6/19/96 Page 1 of 2 >>>> 2 IN THE CIRCUIT COURT OF JACKSON COUNTY, MISSOURI - PROBATE DIVISION AT IN THE ESTATE OF ESTATE NUMBER , Deceased. PROOF OF MAILING OF COPY OF NOTICE OF FILING OF STATEMENT OF ACCOUNT AND SCHEDULE OF PROPOSED DISTRIBUTION (Sec. 473.840) The undersigned personal representative states that a copy of the notice as the same appears on the reverse side hereof, together with the documents referred to therein, was mailed to the undersigned on , by ordinary mail, according tolaw to the following interested persons: NAME ADDRESS The undersigned swears that the matters set forth in the foregoing pleading are true and correct according to the undersigneds best knowledge and belief, subject to penalty for making a false affidavit or declaration. Personal Representative Personal Representative Form 10605 6/19/96 Page 2 of 2