DATE FILEDFORCOURT USE ONLY The undersigned, being a party in interest hereby:assents to the Court222s proceeding to act upon the same at the Probate Court in said:(City/Town)on the day of,, or at any other time or place to which the same may be referred. NameSignatureDateNotary:Name of NotaryStateCountyOn day of , 20the petitioner, known to me or proved through satisfactory evidence, signed the Signature of Notary PublicDateCommission ID#Commission Expiration DateNotary Seal GENERAL WAIVERPC-10.10 (Rev. 07/17) State of Rhode Island and Providence PlantationsProbate CourtPage 1 of 1 STATE OF RHODE ISLANDCounty ofEstate ofAlias PROBATE COURT OF THECity or Town ofNo. SIGN HERE American LegalNet, Inc. www.FormsWorkFlow.com