CIRCUIT COURT OF CLAY COUNTY, MISSOURI PROBATE DIVISION Estate No. CV2____________________ Matter of__________________________________________, Deceased NOTICE OF FILING OF PETITION FOR COMPLETE SETTLEMENT AND PROPOSED ORDER OF DISTRIBUTION To All Persons Interested In The Above Referenced Estate: You are hereby notified that the undersigned independent personal representative will file a petition for an order of complete settlement of the estate together with a final settlement and proposed order of distribution in the Probate Division of the Circuit Court of Clay County, Missouri, on ____________________________ or as may be continued by the Court. If no objections to the settlement or proposed order of distribution are filed within 20 days after the date of the filing thereof, the Court will consider said settlement and proposed distribution and, upon their approval, the Court will determine the persons entitled to decedent’s descendible interest in the estate and the extent and character of their interest therein. Upon proof of compliance with the Court’s order of distribution by the independent personal representative, the Court will discharge the independent personal representative and his sureties, if any, from further claim or demand by any interest person. Date:________________ _________________________________________ Personal Representative _________________________________________ Address _________________________________________ _________________________________________ Telephone No. ACKNOWLEDGMENT OF SERVICE OF NOTICE Receipt of the above notice is hereby acknowledged. Date:_____________ ________________________________________ Heir ----- Devisee Form 604-I Revised 3/17/2003 Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com CIRCUIT COURT OF CLAY COUNTY, MISSOURI PROBATE DIVISION PROOF OF MAILING OF NOTICE OF FILING PETITION FOR COMPLETE SETTLEMENT AND PROPOSED ORDER OF DISTRIBUTION The undersigned independent personal representative states that a copy of the notice as the same appears on the reverse side hereof was mailed by the undersigned on __________________ by ordinary mail to the following interested persons: NAME ADDRESS 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. _________________________________ Personal Representative Form 604-I Revised 3/17/2003 Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com