PR-1947, 10/10 Certificate of Descent 247867.05, Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. STATE OF WISCONSIN, CIRCUIT COURT, COUNTY IN THE MATTER OF THE ESTATE OF Name Amended Certificate of Descent Case No. A Petition for a Certificate of Descent of Property was filed. A hearing was held without notice. THE COURT FINDS: Based upon the evidence presented, 1. The decedent, with date of birth , and date of death , was domiciled in County, State of , with a mailing address of . Decedent has no domicile in Wisconsin. Property of decedent is located in this county. 2. The decedent died intestate. 3. This estate was not ax, is on file with the court. 4. Other: THE COURT CERTIFIES DESCENT AS FOLLOWS: See attached description Name of Heir/Grantee Interest in Property Other: Form completed by: (Name) Address Telephone Number Bar Number American LegalNet, Inc. www.FormsWorkFlow.com