Fill and Sign the 6 419 E Servicenebraska Judicial Branch Form

TO THE PERSONAL REPRESENTATIVE OR TRUSTEE: This form is to be filed only with the Court. Do not send this form t o the interested parties. Fill out one form for each deceased or settlor. IN THE COUNTY COURT OF _________________ COUNTY, NEBRASKA THIS DOCUMENT IS CONFIDENTIAL AND SHALL NOT BE MADE PART OF THE COURT FILE OR PROVIDED TO THE PUBLIC PURSUANT TO NEB. CT. R. § 6 -1464. IN THE MATTER OF Case No.______________ ________________________. PERSONAL AND FINANCIAL INFORMATION OF PARTIES FOR ESTATES AND TRUSTS Full Name of the Deceased or Settlor : Full Date of Birth of the Deceased or Settlor : Full Social Security Number of the Deceased or Settlor : FINANCIAL INFORMATION OF THE DECEASED OR SETTLOR NAME AND ADDRESS OF FINANCIAL INSTITUTIONS FULL ACCOUNT NUMBER(S) 1.______________________________________________________________________ 2.______________________________________________________________________ 3.______________________________________________________________________ 4.______________________________________________________________________ Date Signature (s) Name (s) Bar Number and Firm Name (attorneys only) Street Addres s/P.O. Box Number City/State/ZIP Code Phone E- mail Address Instructions: When parties are required to report personal and financial information t o the court, the complete information shall be provided on Appendix 8. On pleadings or documents to be filed with the court, financial account numbers, dates of birth, and Social Security numbers, where required, should reference Appendix 8: (i.e., “See Appendix 8”) . Financial account numbers should be listed by the last f our digits of the financial account w hen the account is reported on a pleading or document filed with the Court. This form is ne ither approved nor disapproved by any court o r j udicial tribunal. U se of this form provides no i mmunity from error. Appendi x 8 ado pt ed July 13, 2 010; a mended August 28, 2 013; a mended January 22, 2015. Nebraska State Court Form PERSONAL AND FINANCIAL INFORMATION OF PARTIES FOR ESTATES AND TRUSTS Based on Appendix 8 (Neb. Ct. R.Chapter 6, Article 14) CC 15:4 New 08/16 Neb. Ct. R. §6- 1464 Page 1 of 1 Personal and Financial Information of Parties for Estates and Trusts CC 15:4 New. 08/16