Probate Court Form No. 16 Motion to Appoint An Administrator D.N.B. , C.T.A. Page 1 of 2 STATE OF VERMONT DISTRICT OF _______________________ PROBATE COURT IN RE THE ESTATE OF _______________________________ DOCKET NO. __________________ LATE OF _______________________ MOTION TO APPOINT AN ADMINISTRATOR D. B. N. , C. T. A. Part I. Request The undersigned represents to the court as follows: That _____________________________ who is appointed to administer the estate of the deceased is not able to complete that duty because ____________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ _____________________________________________________________________________________ That there is real estate remaining to be administered valued at $______________ and personal estate remaining to be administered valued at $___________ and personal estate remaining to be administered valued at $_________________, and That I am ____________________________________ (state relationship) of the deceased. Therefore, I request the court to appoint __________________________ of _______________________ in the county of ______________________________ and the State of ___________________________ as administrator d. b. n. of the estate of the deceased. Dated: __________________________ Signed _________________________________ Print Name: _____________________________ Address: ________________________________ _______________________________________ Telephone: (____) ________________________ Part II. Acceptance of the Appointment I accept appointment as administrator d. b. n. , c. t. a. Dated: ___________________________ Signed: ________________________________ American LegalNet, Inc. www.USCourtForms.com Probate Court Form No. 16 Motion to Appoint An Administrator D. B. N. , C. T. A. {Page 2 of 2) Part III. Consent of Interested Persons Bu our signatures, we, the heirs, surviving spouse, beneficiaries, devisees and legatees of the deceased, consent to the granting of this license. We understand that if all these persons and surviving spouse do not sign below, a hearing will be scheduled by the court and notice of that hearing will be fiben to all interested persons by the applicant or court. Signature Print Name Date _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ American LegalNet, Inc. www.USCourtForms.com