COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Probate .Court Form No. 55 .... .. .. : Report of Executor or Administrator in Small Estate : Index No. Calendar No. STATE OF VERMONT Plaintiff(s) DISTRICT OF _______________________ -against- :PROBATE COURT JUDICIAL SUBPOENA IN RE THE ESTATE OF _______________________________ LATE OF ______________________ :DOCKET NO. __________________ : : Defendant(s) : REPORT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OF .EXECUTOR. OR .ADMINISTRATOR IN SMALL ESTATE I, ____________________________________, executor/administrator of the above named estate report to the court as follows: THE PEOPLE OF THE STATE OF NEW YORK 1. I have paid the funeral expenses of the deceased. TO 2. I have paid all known debts of the deceased, and have attached a list of debts paid showing person paid, amount paid and nature of debts. GREETINGS: 3. I have paid the expenses of administration. WE COMMAND YOU, that balance of the estate in accordanceaside, the termseach of Willattend before 4. I have paid over the all business and excuses being laid with you and of the you or in , the Honorable accordance with law if there is noat the Court Will. located at County of I,have attachedday ofreceipts as are20 such in room 5. on the , required by the court. in the , at o'clock noon, and at any recessed or adjourned date, to testify and give evidence as a witness in this action on the part of the Dated at __________________________ this ________ day of _______________, 20___. Subscribed and sworn to on this __________________ day of ___________________, 20_____. Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a Before me, result of your failure to comply. Witness, Honorable Court in County, day of _______________________________________ , one of the Justices of the Notary Public, Judge, Register , 20 (Attorney must sign above and type name below) Report accepted, fiduciary discharged and estate closed. Attorney(s) for Dated: _________________________________ (SEAL) _______________________________________ Probate Judge Probate Court, District of _______________________ Office and P.O. Address Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com