STATE OF NORTH CAROLINA County Name Of Decedent/Minor/Incompetent Date Of Birth, If Minor Name Of Fiduciary 1 File No. In The General Court Of Justice Superior Court Division Before The Clerk IN THE MATTER OF THE ESTATE OF: Date Of Death Name Of Fiduciary 2 ESTATES ACTION COVER SHEET Rule 5(b), Rules of Practice For Superior and District Courts All persons listed below may be entitled to share in the decedent's estate (Continue on back if necessary.) 1. 2. 3. Name, Mailing Address. PO Box, City,State And Zip Of Attorney (complete for initial appearance or change of address) 4. 5. 6. Name Of Firm Attorney Bar No. Initial Appearance in Case Change of Address Telephone No. Fax No. Affidavit For Collection Of Personal Property - Intestate (AFCP) Affidavit For Collection Of Personal Property - Testate (AFCT) Amend (AMND) (see NOTE) Ancillary Administration (ANCL) Appointment Of Receiver (APRC) Assignment Of Title (ASOT) Attorney Fee (ATFE) Caveat (CAVT) Collector (COLL) Court Costs (COST) Continue (CNTN) Dismiss (Involuntary) (DISM) Emergency Removal Of Guardian (Without Hearing) Exemplified Administration (EXAD) Extension Of Time (EXTM) (see NOTE) General Guardianship - Incompetent (GUIN) General Guardianship - Minor (GUMI) Guardianship Of The Estate - Incompetent (GUEI) Guardianship Of The Estate - Minor (GUEM) Guardianship Of The Person (GUPE) Interim Guardianship (INGU) Letters Of Administration (LOAD) Limited Personal Representative (LTPR) Modify Guardianship (GUMO) Payments To Clerks 28A-25.6 (PYCL) Petition To Sue As Indigent (OTHR) Proceeding Exam To Discover Assets (PEDA) Date (check appropriate box) APPLICATION Power Of Attorney (POAT) Probate, Letters Testamentary - Administration CTA (PROB) Renunciation Of Interest - Estate (RNIE) Renunciation of Interest - No Estate (RNUN) Renunciation Of Testamentary Trustee (RNTT) Resignation Of Trustee (RSNT) Removal/Substitution Of Administrator (RRFD) Removal/Substitution Of Guardian (RRFD) Removal/Substitution Of Trustee (RSOT) Standby General Guardianship - Minor (SGUG) Standby Guardianship Of Person - Minor (SGUP) Summary Administration (SUMA) Summary Removal Of Personal Representative (Without Hearing) Trust - Cemetery (TCEM) Trust (TRST) Trust Under Will - Qualification Required, No Accountings (TRNQ) Trust Under Will - Qualification And Accounting Required (TRUW) Voluntary Dismissal - With Or Without Prejudice (VOLD) Will For Probate - No Qualification (WLPR) Year's Allowance (YEAL) Other: (specify and list each separately) Signature Of Attorney/Applicant NOTE: All filings in estates shall include as the first page of the filing a cover sheet summarizing the critical elements of the filing in a format prescribed by the Administrative Office of the Courts, and the Clerk of Superior Court shall require a party to refile a filing which does not include the required cover sheet. For subsequent filings the filing party must either include an Estates (AOC-E-650), Motion (AOC-CV-752), or Court Action (AOC-CV-753) cover sheet. (Over) American LegalNet, Inc. www.FormsWorkFlow.com AOC-E-650, Rev. 1/14 � 2014 Administrative Office of the Courts ADDITIONAL PERSON(S) WHO MAY BE ENTITLED TO SHARE IN DECEDENT'S ESTATE 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34. 35. 36. 37. 38. 39. 40. 41. 42. 43. 44. 45. 46. 47. 48. 49. 50. 51. 52. 53. 54. 55. 56. AOC-E-650, Side Two, Rev. 1/14 � 2014 Administrative Office of the Courts American LegalNet, Inc. www.FormsWorkFlow.com