IN THE CIRCUIT COURT OF JEFFERSON COUNTY, MISSOURI IN THE ESTATE OF ESTATE NUMBER , Deceased. ORDER REFUSING LETTERS FOR SPOUSE (Sec. 473.090, RSMO) On this date the application of is presented to the court and the court finds that applicant is the surviving spouse of the above named decedent who died domiciled in and a resident of Jackson County, Missouri survived by unmarried minor children, and leaving an estate in this state the value of which, less liens and encumbrances, is not greater in amount than is allowed by law as exempt property and for maintenance of such spouse and unmarried minor children for one year after the death of the decedent, consisting of real and personal property as set forth in Appendix A attached hereto. To the end therefore, that the said surviving spouse, may be authorized and empowered to collect, sue for and retain the aforesaid property as provided by law, shall become vested with the right, title and interest of the decedent therein. It is, ORDERED, ADJUDGED AND DECREED that no letters shall be issued on said estate, unless, on the application of creditors or other parties interested the existence of other or further property is shown. Dated: . Judge Commissioner Page 1 of 2 American LegalNet, Inc. www.FormsWorkflow.com ESTATE NUMBER APPENDIX A REAL PROPERTY VALUE $ PERSONAL PROPERTY VALUE $ Page 2 of 2 American LegalNet, Inc. www.FormsWorkflow.com