THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH http://www.courts.state.nh.us Court Name: Case Name: Case Number: (if known) Estate of PETITION FOR ESTATE ADMINISTRATION 1. Petitioner Name Mailing Address 2. Petitioner Name Mailing Address 3. Attorney Name Mailing Address 4. Deceased Name Residence (street, city or town) 5. 6. Deceased died: With will Yes 7. 8. Petitioner was: Named Without will No Not named in will of the deceased. Executor Special Administrator Administrator De Bonis Non Administrator Telephone Bar ID# Date of Death Telephone Telephone Was will declared valid pursuant to RSA 552:18? If "Yes" indicate court in which will was declared valid: Petitioner asks to serve as: Ancillary Executor or Administrator Administrator With Will Annexed 9. If applicable, the named executor or previous administrator or executor, of cannot serve or continue to serve because 10. The petitioner is filing this petition pursuant to Waiver of Full Administration under RSA 553:32. Yes No 11. IF WAIVER OF ADMINISTRATION OR ANCILLARY ADMINISTRATION, and if the deceased owned real estate in New Hampshire, list the location of the real estate, including the book and page numbers. (If necessary attach additional paper for other real estate) COUNTY CITY BOOK & PAGE # NHJB-2145-P (03/01/2016) Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com Case Name: Estate of Case Number: PETITION FOR ESTATE ADMINISTRATION 12. The value of the estate of the deceased consists, as nearly as can be ascertained, of: Real Estate ......................................................................... Personal Estate .................................................................. Total amount of Estate ........................................................ 13. The petitioner requests that administration be granted to: Name(s) $ $ $ of City/town, state and whose date of birth is Month/day/year I certify that on this date I provided this document(s) to the parties who have filed an appearance for this case or who are otherwise interested parties by: Hand-delivery OR US Mail OR Email (E-mail only by prior agreement of the parties based on Circuit Court Administrative Order). Date Date Petitioner Signature Petitioner Signature A CERTIFIED COPY OF THE DEATH CERTIFICATE MUST ACCOMPANY THIS PETITION. IF DECEASED DIED WITH A WILL, THE ORIGINAL WILL MUST ACCOMPANY THIS PETITION. ORDER Petition for Waiver of Full Administration is granted; letters of appointment to be issued. Petition for administration is granted; letters of appointment to be issued. Prior to the issuance of said letters, the fiduciary is ordered to file with the court, within 30 days of this order, a fiduciary bond in the amount of $ , without sureties with corporate sureties. Failure to file the bond within 30 days may result in dismissal of the case. Date Signature of Judge Printed Name of Judge NHJB-2145-P (03/01/2016) Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com