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First And Final Report Of Personal Representative PR-165 - California

First And Final Report Of Personal Representative Form. This is a California form and can be used in Probate San Diego Local County .
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ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): FOR COURT USE ONLY TELEPHONE NO.: ATTORNEY FOR (Name): FAX NO.(Optional): SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN DIEGO CENTRAL DIVISION, MADGE BRADLEY, 1409 4TH AVE., SAN DIEGO, CA 92101 ESTATE OF FIRST AND FINAL REPORT OF PERSONAL REPRESENTATIVE; PETITION FOR FINAL DISTRIBUTION ON WAIVER OF ACCOUNT OR ACCOUNT; AND FOR PAYMENT OF COMPENSATION TO PERSONAL REPRESENTATIVE OR WAIVER OF FEES; AND PAYMENT OF COMPENSATION TO ATTORNEY OR WAIVER OF FEES AND ATTORNEY EXTRAORDINARY SERVICES; AND PERSONAL REPRESENTATIVE EXTRAORDINARY SERVICES; WITHHOLDING Petitioner(s) (name(s)) 1. Decedent (name) on (date) State of California, at time of 2. 3. Will dated this court on Petitioner qualified as on (date) 4. On . executor administrator at (place) his her death. and codicil dated CASE NUMBER allege(s): died testate intestate being a resident of the County of San Diego, was/were admitted to Probate Court by order of the administrator with will annexed and Letters were issued to petitioner . At all times since then, petitioner has been and now is duly qualified as the personal by order of this court, petitioner was authorized to administer the estate with no authority. . full limited authority representative of the decedent's estate. and without court supervision under the Independent Administration of Estate Act, or This authority has not been revoked. 5. Petitioner's report covers the period of (date of death) proceeding. A summary of accounting and accounting schedules are attached as attachment 5. 6. Notice of Petition to Administer Estate (JC Form #DE-121) has been published for the period and in the manner as prescribed by law, and within thirty (30) days after completion of the publication, there was filed with the clerk of this court, an affidavit, showing the publication in the manner and form required by law. 7. More than four (4) months have elapsed since the issuance of Letters. Reasonable efforts were made to identify creditors of the estate and a Notice of Administration (JC Form #DE-157) The time for filing and presenting creditor's claims has expired. 8. OR Notice was sent as follows: Date Mailed Sales and Use Tax Use Fuel Tax Cigarette Tax Unemployment Insurance SDSC PR-165 (Rev. 5/14) through All beneficiaries and/or heirs waive an accounting by petitioner and the required Waivers of Accounting are filed in this has has not been sent to all known creditors of the estate. Other than taxes or creditor claims addressed in this petition, petitioner has no reason to believe that any public entity listed in Prob. Code § 9201 has any basis for making a claim against the estate. Date Mailed Motor Vehicle Fuel License Tax Franchise and Income Tax Alcohol Beverage Tax State Hospital for Mentally Disordered FIRST AND FINAL REPORT OF PERSONAL REPRESENTATIVE; Prob. Code §§ 10831, 10951, 10954, PETITION FOR FINAL DISTRIBUTION ON; WAIVER OF ACCOUNT OR; ACCOUNT 11640 et seq. Page 1 of 6 American LegalNet, Inc. www.FormsWorkFlow.com IN THE MATTER OF CASE NUMBER 9. a. The notice required by Prob. Code § 9202(a) was served on the California Department of Health Care Services on (date) OR The decedent did did not receive and was was not the surviving spouse or registered domestic partner of a person who received Medi-Cal benefits. , with a copy of the decedent's death certificate and with a copy of the death certificate of the . decedent's pre-deceased spouse or registered domestic partner (name) b. Petitioner knows of no heir that is confined in a prison or facility under the jurisdiction of the Department of Corrections or the Department of Youth Authority or confined in any county jail, road camp, industrial farm, or other local correctional facility to which notice is required under Prob. Code § 9202(b); therefore, no notice is required to be given to the Director of the California Victim Compensation and Government Claims Board. OR Notice was given as required under Prob. Code § 9202(b) on (date) . . c. The notice given pursuant to Prob. Code § 9202(c) was mailed to the Franchise Tax Board on (date) 10. No Requests for Special Notice (JC Form #DE-154) have been filed in this proceeding. OR The following requests for special notice have been filed in this proceeding: Name Date Filed Relationship Continued on attachment 10. 11. Petitioner has performed all required duties as personal representative of the estate. All costs of administration incurred to date, including costs of publication and the probate referee's fees have been paid, and the estate is now in a condition to be closed. 12. The following Inventory and Appraisal(s) (JC Form #DE-160) have been filed with the court: Date Filed Partial No.: ________ Partial No.: ________ Partial No.: ________ Continued on attachment 12. 13. The estate consists 14. entirely of of a combination of decedent's separate community quasi-community property. Petitioner alleges that no family or affiliate relationships exist between petitioner and any agent hired by petitioner during the period of administration. OR The following family or affiliates were hired: Name Capacity Retained Relationship Final Final Final Type Supplemental Supplemental Supplemental Corrected/Amended Corrected/Amended Corrected/Amended Amount Continued on attachment 14. 15. There was no cash to invest in interest bearing accounts. OR At all times during the period of administration, petitioner has kept all surplus cash in interest bearing accounts. SDSC PR-165 (Rev. 5/14) FIRST AND FINAL REPORT OF PERSONAL REPRESENTATIVE; Prob. Code §§ 10831, 10951, 10954, PETITION FOR FINAL DISTRIBUTION ON; WAIVER OF ACCOUNT OR; ACCOUNT 11640 et seq. Page 2 of 6 American LegalNet, Inc. www.FormsWorkFlow.com IN THE MATTER OF CASE NUMBER 16. Petitioner did not take any action without prior court approval under the Independent Administration of Estates Act for which notice of proposed action was required. OR Petitioner took the following action without prior court approval under the Independent Administration of Estate Act for which notice of proposed action was required. Nature of action: Date action was taken: When and to whom notice was given (name & date) When notice was waived, and if so, by whom: Objections received: Nature of action: Date action was taken: When and to whom notice was given (name & date) When notice was waived, and if so, by whom: Objections received: Continued on attachment 16. 17. No Creditor's Cla
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