Petition For Testate Administration {078P}

Page 1 of 3 pages. PETITION FOR TESTATE ADMINISTRATION Form 078P, Rev. 2017.10.13 IN THE CHANCERY COURT OF HAMILTON COUNTY, TENNESSEE PETITION FOR TESTATE ADMINISTRATION P ART 2 P ROBATE D IVISION F ILE N 0 . I N T HE M ATTER OF T HE E STATE OF D ECE DENT 1. P ETITIONER ( S ) Relationship of Petitioner(s) to D ecedent : 2. D ECEDENT Decedent died on at the age of at Date City & State Decedent's residence at time of death was: , , Street and Number City State Zip Code 3 . P ERSONAL R EPRESENTATIVE ( S ) , L AST W ILL , AND O THER D OCUMENTS (a) Petitioner(s) seek to have appointed as personal representative(s) for this estate and verily believe said person(s) stand ready, willing, and qualified to undertake the office as required by law and will furnish bond as directed by the C OURT . (b) The document(s) offered for probate were executed on and the names of all attesting witnesses are: The ORIGINAL document(s) offered for probate are herewith presented to the COURT for probate. A true copy of the document(s) is tendered herewith as exhibit to this petition. (c) Petitioner(s) is/are not aware of any instrument revoking the document(s) being offered for probate. Petitioner(s) aver that a search has been made for a subsequently dated will or codicil and none has been found and verily believe the document(s) being offered for probate constitute Decedent's last will and testament. 4 . D EVI SEES & L EGATEES , P OTENTIAL H EIRS & D ISABILITY 4 (a) D evisees and legatees under the will are : Name Age Relation Mailing Address Zip Code 4 ( B ) Persons who are not devisees and legatees under the will who would otherwise be en titled to Decedent222s property as heirs at law if there were no will are : Name Age Relation Mailing Address Zip Code 4 (c) Persons listed in 4(a) and 4 (b) who are under disability are: American LegalNet, Inc. www.FormsWorkFlow.com Page 2 of 3 pages. PETITION FOR TESTATE ADMINISTRATION Form 078P, Rev. 2017.10.13 4 (d) There is/is not a Conservatorship/G uardianship matter pending or resolved, with Docket No.: 5. VALUE Estimated fair market value of 1. non-probate assets Personalty Real Estate in: 2. assets to be administered Personalty Real Estate in: * 3.Total e stimated gross value of this e state for inheritance tax purposes * Real estate is a non - probate asset unless specifically devised to the estate or required to be sold to pay debts. 6 . T ENN C ARE At time of death, was Decedent enrolled in TennCare? Yes No Unknown 7 . B OND NOT WAIVED WAIVED in Will at: 8 . I NVENTORY NOT WAIVED WAIVED in Will at: PREMISES CONSIDERED, PETITIONER(S) PRAY 1. That the will be proved and established, probate of said will be granted, and the same order ed for record. 2. That the C LERK & M ASTER qualify the personal representative and issue letters for testate administration . 3. That notice by publication be given for creditors of Decedent's estate requiring them to file their claims. T.C.A. 247 30-2-306(a). not be given. T.C.A. 247 30 - 2 - 306(e). 4. That if bond is required and if the inventory reveals the estate exceeds the amount as set out in this petition, the personal representative be required to increase the bond accordingly. 5. That inventory be waived or that 60 days be allowed for filing. T.C.A. 247 30 - 2 - 301(a). 6. That affidavits to each devisee or legatee be waived or that 60 days be allowed for filing. T. C. A. 247 30 - 2 - 301(b)(1)(A). 7. That, for a decedent who was 55 years or older at time of death, the affidavit of notice to TennCare be filed within 60 days. T. C. A. 247 30 - 2 - 301(b)(5). Petitioner Address Petitioner Address Petitioner Address Petitioner Address WE ARE SURETY FOR COSTS IN THIS CAUSE. Attorneys for Petitioner By BPR# Address Tel. N0. Fax N0. C HANCERY C OURT OF HAMILTON COUNTY TENNESSEE } Sworn to and subscribed before me this day of , 20. ROBIN L. MILLER, CLERK & MASTER By Deputy Probate Clerk American LegalNet, Inc. www.FormsWorkFlow.com Page 3 of 3 pages. PETITION FOR TESTATE ADMINISTRATION Form 078P, Rev. 2017.10.13 M ASTER 222 S O RDER From an examination of Petitioner(s) and witnesses under oath it appears the facts stated in the petition are true, the will dated is the true and entire last will of Decedent, executed and proved according to law, to the best knowledge of Petitioner(s) the estimated gross value of this estate for inheritance tax purposes is $, and that after proper qualification and pursuant to T. C. A. 247 16-16-201 letters are to be issued to: BOND : Waived Set at $ INVENTORY : Waived 60 days to file accurate inventory of the probate estate. T.C.A. 247 30 - 2 - 301(a). AFFIDAVIT OF NOTICE TO EACH DEVISEE OR LEGATEE: Waived 60 days to file affidavit. T. C. A. 247 30-2-301(b). AFFIDAVIT OF NOTICE TO TENNCARE: N/A 60 days to file affidavit. T. C. A. 247 30-2-301(b)(5). This day of , 20. ROBIN L. MILLER, CLERK & MASTER IF REQUIRED UNDER THIS ORDER, THE INVENTORY, AFFIDAVIT OF NOTICE TO DEVISEE/LEGATEE AND NOTICE TO TENNCARE IS DUE , 20. FAILURE TO FILE ANY REQUIRED DOCUMENT CHECKED ABOVE SHALL RESULT IN A SHOW CAUSE HEARING IN THE CLERK & MASTER222S OFFICE ON , 20 AT 8:30 A.M., AND A BOND SHALL IMMEDIATELY BE REQUIRED OF THE PERSONAL REPRESENTATIVE. American LegalNet, Inc. www.FormsWorkFlow.com