STATE OF SOUTH CAROLINA ) ) ) IN THE PROBATE COURT COUNTY OF: ) FILING OF A WILL FOR RECORD ) ) CASE NUMBER: INTHE MATTER OF: Applicant/Petitioner: Address: Telephone: I. ALL APPLICANTS/PETITIONERS MUST COMPLETE THIS SECTION. 1. Nature of interest of undersigned: 2. Decedent information: Name: Social Security Number: Date of Birth: Date of Death: Age at date of death: Domicile at date of death: (county) 3. (state) Venue for this proceeding is proper in this county because: Decedent was domiciled in this county at date of death. Decedent was not domiciled in South Carolina, but property of Decedent was located in this county at date of death. Decedent has a right to take legal action in this county because: 4a. Names and addresses of devisees, including dates of birth of minors: Name Date of Birth Address Relationship to Decedent (use additional sheet if necessary) Names and addresses of intestate heirs who are not devisees, including date of births of minors: 4b. Name Date of Birth Address Relationship to Decedent (use additional sheet if necessary) FORM #306PC (1/91) 62-2-901 Page 1 of 4 American LegalNet, Inc. www.FormsWorkflow.com 5. 6. To the best of my knowledge, was the decedent a patient in a South Carolina Mental Health facility during his/her lifetime? No Yes If yes, please explain on page 3. 7. Has a guardian or conservator ever been appointed for this person? No Yes If yes, please explain on page 3. 8. Has a personal representative of the decedent been appointed prior to this date by a court in this state or elsewhere? No Yes If yes, please state details, including name and address of such Personal Representative, on page 3. 9. Have you received or are you aware of any demands for notice of any probate or appointment proceeding concerning the decedent that may have been filed in this state or elsewhere? No Yes If yes, please state details, including name and addresses, on page 3. 10. Have more than ten years passed since the decedent’s death? No Yes If yes, please state circumstances authorizing tardy probate on page 3. 11. The decedent died with a personal estate of about the value of $ about the value of $ . 12. II. Did decedent have any change of marital status or the birth or adoption of any children after execution of the Will (if one exists), or has any child of the decedent been born since his death, or is any birth of a child of the decedent anticipated? (This includes illegitimate children.) No Yes If yes, please explain on page 3. After the exercise of reasonable diligence, are you aware of any unrevoked will and/or codicil(s), other that the one(s) attached hereto, relating to property in this state? No Yes If yes, please explain on page 3 and then proceed to Section II. and real estate of PLEASE COMPLETE THIS SECTION REGARDING THE WILL. 1. Regarding the decedent’s will: the original is attached the original is in the Court’s possession an authenticated copy of a will probated in another jurisdiction is attached an authenticated copy of a will not probated in another jurisdiction is attached the will is lost, destroyed, or otherwise unavailable; however, a description of its contents is attached 2. Do you believe, to the best of your knowledge, the will described above was validly executed? Yes No If no, please explain below. 3. The date of execution of the will was: codicil(s): FORM #306PC (1/91) . Page 2 of 4 American LegalNet, Inc. www.FormsWorkflow.com 4. Are you aware of any instrument or document amending or revoking the will? No Yes If yes, please explain below. 5. Have you exercised reasonable diligence to determine there is no instrument or document revoking the will? Yes No If no, please explain below. 6. Do you believe the will defined in “1” above, is the decedent’s last will? Yes No If no, please explain below. COMPLETE EXPLANATION (S) FOR QUESTIONS IN SECTIONS I AND II HERE. (If more space is required, use additional sheet.) FORM #306PC (1/91) Page 3 of 4 American LegalNet, Inc. www.FormsWorkflow.com III. PLEASE COMPLETE VERIFICATION. Pursuant to Section 62-2-901, S.C. Code of Laws, 1976, as amended, the undersigned delivers the Will of the above referenced decedent and hereby requests that the will be filed as unprobated will. The undersigned, being sworn, states that the facts set forth in the foregoing statement are true to the best of the undersigned’s knowledge, information and belief, and hereby submits to the Court’s jurisdiction in this matter. SWORN to before me this day of , 20 Signature: Name: Address: Notary Public for South Carolina My Commission Expires: Telephone (O): (H): FORM #306PC (1/91) Page 4 of 4 American LegalNet, Inc. www.FormsWorkflow.com