STATE OF NORTH CAROLINA County Name, Street Address, City, State, And Zip Code Of Decedent File No. In The General Court Of Justice Superior Court Division Before The Clerk IN THE MATTER OF THE ESTATE OF: TESTAMENTARY Social Security No. (last four digits) Date Of Death County Of Domicile At Time Of Death Date Of Will And Codicil(s), If Any APPLICATION FOR PROBATE AND LETTERS AND ADDENDUM (AOC-E-309) OF ADMINISTRATION CTA G.S. 28A-2A-1, -2, -5; 28A-6-1; 28A-12-4 Place Of Death (if different from County Of Domicile) Name, Street Address, P.O. Box, City, State, And Zip Code Of Co-Applicant Name, Street Address, P.O. Box, City, State, And Zip Code Of Applicant Telephone No. Legal Residence (County, State) Name, Street Address, P.O. Box, City, State, And Zip Code Of Attorney Legal Residence (County, State) Attorney Bar No. Telephone No. Telephone No. I, the undersigned, applying for probate and for letters in the above estate, being first duly sworn, say that: 1. The decedent was domiciled in this county at the time of the decedent's death, or left property or assets in this county, or was a nonresident motorist who died in North Carolina; no other proceeding for probate or for administration is pending in any jurisdiction. 2. The decedent left the paper-writing(s) purporting to be the decedent's Last Will and Testament shown above. 3. and codicil(s), dated as a. I am an executor, devisee, or legatee named in the will, or a next-of-kin or creditor of the decedent. b. I am the person entitled to apply for letters or am applying after all persons having prior right to apply have renounced. c. I am applying subject to G.S. 28A-6-2(1) and move that all necessary notices be issued. d. I am the public administrator appointed by the Court. 4. I am not disqualified pursuant to G.S. 28A-4-2 to administer the estate and have not renounced my right to do so. 5. Following the execution of the will there were no children born to or adopted by the decedent, and the decedent did not thereafter marry or obtain a divorce. (If the facts are otherwise, state them on an attachment.) 6. After diligent inquiry, I have determined that the persons listed below are all the persons entitled to share in the decedent's estate. (If there is a court-appointed guardian for any such person(s), list the guardian's name and address on an attachment.) NAME AGE RELATIONSHIP MAILING ADDRESS AOC-E-201, Rev. 3/16 © 2016 Administrative Office of the Courts Original - File Copy - Applicant (Preliminary Inventory On Reverse) American LegalNet, Inc. www.FormsWorkFlow.com (Give values as of date of decedent's death. Continue on separate attachment if necessary.) PRELIMINARY INVENTORY PART I. PROPERTY OF THE ESTATE 1. Accounts in sole name of decedent (List bank, etc., each account no., and balance.) $ Est. Market Value 2. Joint accounts without right of survivorship (List bank, etc., each account no., balance, and joint owners.) % Owned By Decedent % Owned By Decedent % Owned By Decedent % Owned By Decedent 3. Stocks/bonds/securities in sole name of decedent or jointly owned without right of survivorship 4. Cash and undeposited checks on hand 5. Household furnishings 6. Farm products, livestock, equipment, and tools 7. Vehicles 8. Interests in partnership or sole proprietor businesses 9. Insurance, Retirement Plans, IRAs, annuities, etc., payable to Estate 10. Notes, judgments, and other debts due decedent 11. Miscellaneous personal property 12. Real estate willed to the Estate 13. Estimated annual income of Estate $ % Owned By Decedent (Base bond on this amount, if applicable.) TOTAL PART I. $ PART II. PROPERTY WHICH CAN BE ADDED TO ESTATE IF NEEDED TO PAY CLAIMS 1. Joint accounts with right of survivorship (List bank, etc., each account no., balance, and joint owners.) $ 2. Stocks/bonds/securities registered in beneficiary form and immediately transferred on death or jointly owned with right of survivorship 3. Other personal property recoverable (G.S. 28A-15-10) 4. Real estate owned by decedent and not listed elsewhere TOTAL PART II. $ PART III. OTHER PROPERTY 1. There is is not entireties real estate owned by decedent and spouse. Insurance, Retirement Plans, IRAs, annuities, etc., payable to named 2. There are beneficiaries. 3. There is Signature Of Applicant are not is not a potential claim for wrongful death arising under G.S. 28A-18.2. Signature Of Co-Applicant SWORN/AFFIRMED AND SUBSCRIBED TO BEFORE ME Date Signature Of Person Authorized To Administer Oaths SWORN/AFFIRMED AND SUBSCRIBED TO BEFORE ME Date Signature Of Person Authorized To Administer Oaths Deputy CSC Notary Assistant CSC Clerk Of Superior Court Deputy CSC Date Commission Expires County Where Notarized Assistant CSC Clerk Of Superior Court Notary Date Commission Expires County Where Notarized SEAL SEAL American LegalNet, Inc. www.FormsWorkFlow.com AOC-E-201, Side Two, Rev. 3/16 © 2016 Administrative Office of the Courts