LETT DISTRICT COURT CLARK COUNTY, NEVADA In the Matter of the Estate of: ) ) Case No. P__________ ) ) ) LETTERS OF SPECIAL ADMINISTRATION ) ) Deceased. On the _____ day of ____________________, 20_____, the Court entered an Order appointing __________________________________________ as Special Administrator of the Decedent's Estate. The Order includes: A directive for no bond; A directive for the establishment of blocked accounts; A directive for the posting of bond in the sum of $_______________; or A directive for both the establishment of blocked accounts for sums in excess of $_______________ and the posting of bond in the sum of $_______________. The Special Administrator, having duly qualified, may act and has the authority and duties of Special Administrator. In testimony of which, I have this date signed these Letters and affixed the seal of the Court. CLERK OF COURT By: ____________________________________ Deputy Clerk Date OATH I, _________________________, whose mailing address is _____________________________________ _______________________________, solemnly affirm that I will faithfully perform according to law the duties of Special Administrator and that all matters stated in any petition or paper filed with the Court by me are true of my own knowledge or, if any matters are stated on information and belief, I believe them to be true. ___________________________________________ ADMINISTRATOR SUBSCRIBED AND AFFIRMED before me this _______ day of ____________________, 20____. CLERK OF COURT By: (OR) _________________________________ Deputy Clerk _________________________________ NOTARY PUBLIC American LegalNet, Inc. www.FormsWorkFlow.com County of _______________ State of _________