Statement Of No Contest {155}

PART 2 IN THE CHANCERY COURT OF HAMILTON COUNTY, TENNESSEE IN THE MATTER OF THE ESTATE OF DECEASED PROBATE DIVISION STATEMENT OF NO CONTEST EXECUTOR(S) FILE N0. STATE OF ____________ COUNTY OF __________ } <name(s)> I/we, ____________________________________________________________________________________, am/are beneficiaries (devisee(s) or legatee(s)) under the Last Will & Testament of the Deceased <probated in common form> or <propounded in solemn form> on <date>. As a devisee or legatee I/we am/are hereby stating that I/we claim nothing under the said will, and that I/we am/are willing that the said will be set aside. _____________________________________ <affiant> _____________________________________ <affiant> _____________________________________ <affiant> _____________________________________ <affiant> ACKNOWLEDGMENT On ____________, before me, ______________________, Notary Public in and for the State of ____________ <date> <notary name> <affiant(s)> <state> personally appeared ________________________________________________________________________, with whom I am personally acquainted (or proved to me on the basis of satisfactory evidence), and who acknowledged that he/she/they executed the foregoing instrument as his/her/their free act and deed and for the purposes therein contained. _________________________________ My Commission Expires _____________. <Notary> STATEMENT OF NO CONTEST Page 1 of 1 page. [Form 155, Rev 2003.12.19] (LRCP 4.04 applies.) American LegalNet, Inc. www.USCourtForms.com