COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : FORM SUMMARY Name of Form: : Calendar No. Personal Representative's Statement to Close Estate (Informal : JUDICIAL SUBPOENA Plaintiff(s) Administration) -against- Form Number: Index No. : PR-1816 (previously PR-1315) : Statutory Reference: §§859.07, 865.05 and 865.16, Wisconsin Statutes : Benchbook Reference: PR-6, informal Defendant(s) : ...................................................... Purpose of Form: To verify that the Personal Representative has completed the estate. Who Completes It:THE STATE OF NEW YORK Personal Representative THE PEOPLE OF Distribution of Form: TO Original to court Accompanying Forms: Generally none. GREETINGS: New Form/Modification: Modification, last update 06/00. WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Created a new sentence #2 which reads, “inventoried the assets of , at the Court the locatedand furnished a copy of the inventory to interested estate at County of persons.” Made minor formatting ando'clock in the wording changesnoon, and of any recessed to some at in room , on the day of , 20 , at the numbered sentences. Added action on the part of co-personal or adjourned date, to testify and give evidence as a witness in thissignature section forthe Modifications: the Honorable representative. Previous modification: Added a line to indicate amount of paid Your failure to comply with this subpoena isapunishable as a contempt of“If no and will make you liable to attorney fees. Added line at the bottom stating court proceedings the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a challenging this statement or otherwise involving the personal result of your failure to comply. representative are pending in the court 6 months after this statement is filed, appointment of the personal representative terminates.” This Witness, Honorable , one of the Justices of the statement eliminates the need for an order for discharge. Court in County, day of , 20 Comments: About this form: This form is the product of the Wisconsin Records Management Committee, a committee of the (Attorney must sign above and type name below) Director of State Court's Office and a mandate of the Wisconsin Judicial Conference. Attorney(s) for If you have additional information that does not change the meaning of the form, attach it on a separate page. The form itself shall not be altered. Office and P.O. Address Date: 05/01/02 Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: Page 1 American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : STATE OF WISCONSIN, CIRCUIT COURT, Index No. COUNTY For Official Use : Personal Representative's Calendar No. Statement to Close Estate : (Informal Administration) JUDICIAL SUBPOENA Plaintiff(s) IN THE MATTER OF THE ESTATE OF -against- Case No. : : I state that I, or a prior personal representative whom I have succeeded, have: : 1. Given notice to interested persons and to creditors as required by law and that the time for filing claims has expired prior to the date of this statement. Defendant(s) : ........ .. ..... . .. .... ... ....... ..... . .. ... 2. Inventoried.the. assets .of .the .estate. and .furnished .a copy .of .the .inventory to interested persons. 3. Fully administered the above estate by making payment, settlement, or other disposition of all claims presented, expenses of administration, reasonable funeral and burial expenses, death and other taxes, except as specified below, and furnished OF NEW YORKwriting to all persons whose interests are affected. THE PEOPLE OF THE STATE a full account, in 4. Sent a copy of this statement to all distributees of this estate and to all creditors or other claimants of whom I TO am aware, whose claims are neither paid nor barred, and distributed the assets to the persons entitled to them. 5. Paid attorney fees of $ . 6. Listed below, unpaid claims, expenses or taxes and detailed arrangements which have been made to GREETINGS: accommodate them: None See attached. WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , the Honorable at the Court located at County of in room , on the day of , 20 , at o'clock in the noon, and at any recessed or adjourned date, to testify and give evidence as a witness in this action on the part of the Signature of Personal Representative Signature of Co-personal Representative Name Printed or Typed Address Your failure to comply with this subpoena Name Printed or Typed a contempt of court and will make you liable to is punishable as the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a Address result of your failure to comply. Witness, Honorable County, Subscribed and sworn to before me Court in on , one of the Justices of the day of Subscribed and sworn to before me on , 20 Notary Public/Court Official Notary Public/Court Official (Attorney My commission expires: must sign above and type name below) My commission expires: If no other proceedings challenging this statement or otherwise involving the personal representative are pending in the court 6 months after this statement is filed, appointment of the personal representative Attorney(s) for terminates. Name of Attorney Address Telephone Number Office and P.O. Address Bar Number PR-1816, 05/02 Personal Representative's Statement to Close Estate (Informal Administration) Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. §§859.07, 865.05, 865.16, Wisconsin Statutes No.: This form shall not be modified. It may be supplemented with additional material. American LegalNet, Inc. www.USCourtForms.com