IN THE CIRCUIT COURT OF JACKSON COUNTY, MISSOURI - PROBATE DIVISION AT IN THE ESTATE OF ESTATE NUMBER , Deceased. REQUEST OF INTERESTED PERSON FOR NOTICE BY MAIL (Sec. 473.030, RSMO) TO: and; executor, administrator, personal representative, TO: The Clerk of the Probate Division of said county: The undersigned is interested in said estate as a (distributee) (creditor). The full name of the undersigned is post office address is attorney is whose post office address is .The undersigned requests that written notice by ordinary mail on the following matters, to-wit: be given to the following named persons at the respective addresses opposite their names: All of the above pursuant to Section 473.030, RSMo. The undersigned swears that the matters set forth are true and correct to the best knowledge and belief of the undersigned, subject to the penalties of making a false affidavit or declaration. Dated: . By MO BAR No Attorney Service of the within notice is acknowledged on Executor, Administrator, Personal Representative Form 10369