IN THE CIRCUIT COURT OF COUNTY, MISSOURI Case Number: Probate Division In the Estate of , Deceased. (Date File Stamp) Application of Unmarried Minor Child(ren) for Refusal of Letters (No Surviving Spouse or Nonapplicant Children) The applicant states that applicant is the natural parent conservator of the estate court appointed guardian custodian of , unmarried minor child(ren) of the decedent who ded oni , residing at , survived by the above named minor child(ren), no surviving spouse and no other unmarried minor children. Decedent prlefopet rty, in this State, the value of which, less liens and encumbrances, is not greater in amount than tishallowat ed by law as exempt property and maintenance of said unmarried minor child(ren) for one year after the deah of decedentt , which said estate consists solely of the property described and of the value as follows: Description of Property Value See Appendix A. Total $ Wherefore, applicant prays that the court order that no letters be granted on said estate unless on the application of creditors or other interested partieshe exis, t tence of other or further property is shown. The applicant swears that the matters set forth above te arrue and correct to the best knowledge and belief of the applicant, subject to the penalties of making a false affidavit or declaration. Date: Signature of Attorney for Applicant Signature of Applicant (Name/Bar Number/Address/Telephone) (Name/Address/Telephone) OSCA (8-02) PR25 1 of 2 473.090.1 (1) RSMo>>>> 2 Appendix A Decedent: Case Number: Description of Property Value Real Property Personal Property TOTAL: $ OSCA (8-02) PR25 2 of 2 473.090.1 (1) RSMo