THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH http://www.courts.state.nh.us Court Name: Case Name: Case Number: (if known) Trust of PETITION FOR TRUSTEE Named in will Named in trust instrument Special needs trust 1. Petitioner Name Mailing Address Petitioner Name Mailing Address 2. Attorney Name Mailing Address 3. Deceased Name (if applicable) Not named in will Not named in trust instrument Successor trustee Telephone Telephone Telephone Bar ID# Date of Death Residence (city or town) 4. If petition is for trustee not named in will or trust, the named trustee, whose address is been removed, or 5. refused to serve. , has since resigned, died, If a testamentary trust, did the decedent waive the requirement for accountings and bond? Yes No DATE OF BIRTH 6. List names and addresses of beneficiaries of trust. LIFETIME BENEFICIARY ADDRESS NAME REMAINDERMAN NAME ADDRESS DATE OF BIRTH NHJB-2138-P (01/02/2014) Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com Case Name: Trust of Case Number: PETITION FOR TRUSTEE 7 The value of the trust estate, as nearly as can be ascertained, is: Real Estate .............................................................................. $ Personal Estate ....................................................................... $ Total amount of Estate ............................................................ $ 8. If this is a special needs trust petition, has a copy of the trust been sent to the Department of Health and Human Services? Yes No The petitioner requests that appointment be granted to of and whose date of birth is 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 Petitioner Signature Date Petitioner Signature ORDER Petition is granted. Letter of trust to issue, conditional on the filing of a fiduciary bond in the amount of $ , without sureties with corporate sureties, within days of this order. Petition is denied. Date Signature of Judge Printed Name of Judge NHJB-2138-P (01/02/2014) Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com