Administration Petition {PC-1.1}

DATE FILEDFORCOURT USE ONLY Respectfully represents:Name of the DeceasedPersonal estate $estimated atResided inCity/Town Date of Death (Died Intestate)Petitioner:NameRelationship to DeceasedStreet AddressCity/TownStateZipCodePhoneNumberRespectfully requests:Name of NomineeRelationship toDeceasedStreet AddressCity/TownStateZip CodeName of Co-Nominee (if any)Relationship toDeceasedStreet AddressCity/TownStateZip CodeDeceased left the following surviving spouse and heirs at law:NAMERELATIONSHIPADDRESSSpouse Petitioner: To the best of my knowledge or belief, the statement(s) contained within this document are truthful and accurate.Signature of PetitionerDateNotary:Name of NotaryStateCountyOnday of, 20 the petitioner, known to me or proved through satisfactory evidence, signed the Signature of Notary PublicDateCommission ID#Commission Expiration DateNotary Seal(Indicate any minors or incompetents.) ADMINISTRATION PETITION(or any other suitable person be appointed to administer.)PC-1.1 (Rev. 07/17) State of Rhode Island and Providence PlantationsProbate CourtPage 1 of 2 STATE OF RHODE ISLANDCounty ofEstate ofAlias PROBATE COURT OF THECity or Town ofNo. IGN HERE American LegalNet, Inc. www.FormsWorkFlow.com Deceased left the following surviving spouse and heirs at law:NAMERELATIONSHIPADDRESS(Indicate any minors or incompetents.)PC-1.1 (Rev. 07/17) Page 1A of 2 American LegalNet, Inc. www.FormsWorkFlow.com DECREEUpon hearing, it is hereby ordered and decreed:Fiduciary NameStreet AddressCity/TownStateZip CodeEmailPhone NumberCo-Fiduciary NameStreet AddressCity/TownStateZip CodeEmailPhone NumberBond Fixed at: $ With Surety Without Surety APPRAISER(S): Check box if Appraiser(s) is/are the same as above OR Complete Appraiser(s) information below.Appraiser NameStreet AddressCity/TownStateZip CodeEmailPhone NumberCo-Appraiser NameStreet AddressCity/TownStateZip CodeEmailPhone NumberRESIDENT AGENTResident Agent NameStreet AddressCity/TownStateZip CodeEmailPhone NumberEntered as an order and decree of the court on:Probate JudgeDateSignature of Probate JudgePC-1.1 (Rev. 07/17) Page 2 of 2 IGN HERE American LegalNet, Inc. www.FormsWorkFlow.com