CIRCUIT COURT OF CLAY COUNTY, MISSOURI PROBATE DIVISION No. Matter of APPLICATION FOR ALLOWANCE OF COMPENSATION , as of the above captioned estate, requests the Court to make and enter its order allowing the sum of $_____________, as reasonable compensation for services rendered as of said estate as computed on the ** attached schedule which is hereby made a part of this application. (Complete the next line for decedent’s estates ONLY.) previous allowance has/have been allowed in the amount of $ . THE STATEMENTS AND REPRESENTATIONS IN THIS DOCUMENT ARE MADE UNDER OATH AND ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND BELIEF. I UNDERSTAND THEY ARE MADE SUBJECT TO THE PENALTIES OF MAKING A FALSE AFFIDAVIT OR DECLARATION. Dated Signature **Your attached schedule must show itemized time records and all other factors involved in computing a reasonable fee. Itemization is not necessary in deceased estates, if the statutory fee is requested and the computation schedule on the reverse side of this form is completed or, if the fee is consented to in writing by all residuary beneficiaries. ORDER ALLOWING COMPENSATION TO The application of the of the above named estate being duly filed and considered, it is ordered that is allowed $ , compensation for services rendered in this estate. Date JUDGE Form 213 Revised 9/7/2005 CLERK Page 1 of 2 American LegalNet, Inc. www.USCourtForms.com COMPENSATION SCHEDULE FOR STATUTORY FEE IN DECEASED ESTATES (Sec. 473.153 RSMo.) Personal Property Administered: (Include Real Estate sold by Personal Representative less any encumbrances.) Disbursements: (claims, administrative expenses, etc.) $ Distributions: (to beneficiaries—at values on date of distributions.) TOTAL $ $ Explain here any substantial changes from inventory values: STATUTORY COMPUTATION 5% on $5,000 $ 4% on next $20,000 $ 3% on next $75,000 $ 2 ¾% on next $300,000 $ 2 ½ % on next $600,000 $ 2% on all over $1,000,000.00 $ TOTAL FEES $ Less fees previously allowed $ BALANCE $ THE STATEMENTS AND REPRESENTATION IN THIS DOCUMENT ARE MADE UNDER OATH AND ARE TRUE AND CORRECT TO MY BEST KNOWLEDGE AND BELIEF. I UNDERSTAND THEY ARE MADE SUBJECT TO THE PENALTIES OF MAKING A FALSE AFFIDAVIT OR DECLARATION. Date Attorney Form 213 Revised 9/7/2005 Page 2 of 2 American LegalNet, Inc. www.USCourtForms.com