THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH http://www.courts.state.nh.us Court Name: Case Name: Estate of Case Number: (if known) MOTION FOR SUMMARY ADMINISTRATION 1. Telephone Executor/Administrator Name Mailing Address Telephone Executor/Administrator Name Mailing Address 2. Attorney Name Telephone Mailing Address Bar ID# 3. The estate of the decedent has been open for at least 6 months. Yes No 4. To the best of my knowledge and belief, there are no outstanding debts, obligations or unpaid or unresolved claims attributable to the deceased’s estate. Yes No No New Hampshire estate or inheritance taxes are due; OR all applicable New Hampshire estate and inheritance taxes have been paid and a certificate from the department of revenue administration under RSA 86:32 and/or 87:25 has been filed with the court. Yes No No federal estate tax is due; OR the federal estate tax return has been filed and all taxes reported thereon have been paid. Yes No 7. Court supervision of the administration of the estate is no longer necessary. Yes No 8. The administration of the estate will be completed without further court supervision in accordance with the decedent’s will and applicable law. Yes No Attached are either receipts (NHJB-2139-P) or assents (NHJB-2122-P) from all specific legatees and assents from all other persons beneficially interested, as defined in RSA 550:12. Yes No Yes No 5. 6. 9. 10. If there is real estate in this case, the court has been notified of the sale or transfer of the property by filing either a Return/Notice of Sale form (NHJB-2126-P) or a Notice to Towns and Cities form (NHJB-2142-P) or a copy of the HUD statement. I certify that a copy of this document has been provided to the parties who have filed an appearance for this case or who are otherwise interested parties. Date Executor / Administrator (must be signed in presence of notarial officer) Date Executor / Administrator (must be signed in presence of notarial officer) NHJB-2775-P (09/06/2012) Page 1 of 3 American LegalNet, Inc. www.FormsWorkFlow.com Case Name: Case Number: MOTION FOR SUMMARY ADMINSTRATION State of , County of by This instrument was acknowledged before me on Date My Commission Expires Affix Seal, if any Executor/Administrator(s) Signature of Notarial Officer / Title ORDER Motion for summary administration is granted. Motion for summary administration is denied. Date NHJB-2775-P (09/06/2012) Judge Page 2 of 3 American LegalNet, Inc. www.FormsWorkFlow.com Case Name: Case Number: MOTION FOR SUMMARY ADMINSTRATION ASSENT FOR SUMMARY ADMINISTRATION The undersigned, being all the persons interested under the summary administration law, agree that further court supervision of the administration of the estate is no longer necessary; do not request a final accounting; and request that the motion for summary administration be granted. DATE PRINT NAME BELOW LINE WRITE SIGNATURE ON LINE NHJB-2775-P (09/06/2012) Page 3 of 3 ADDRESS American LegalNet, Inc. www.FormsWorkFlow.com