700-00027 226 Affidavit of No Assets (07/2018) Page 1 of 1 STATE OF VERMONT SUPERIOR COURT PROBATE DIVISION Unit Docket No.: In re: AFFIDAVIT OF NO ASSETS Petitioner , being duly sworn states as follows: 1. That he/she is the of , deceased, late of , Vermont, who died on , and that was nominated to be Executor under the purported Last Will and Testament of the late . 2. That the Petitioner is well acquainted with the personal affairs of the late and to the best of his / her knowledge and all information available to him / her, that there are no assets to be distributed at the time of death. 3. A certified copy of the death certificate is attached to this petition. Accordingly, I believe the establishment of an estate for is unnecessary. Date Signature of Petitioner Relationship to Decedent Printed Name Mailing Address Telephone/Email Signed and sworn to before me: Date Signature of Notary Expiration Date American LegalNet, Inc. www.FormsWorkFlow.com