Fill and Sign the I as the Domiciliary Foreign Personal Representative 15 1020116 Form

CPC 60 1/07 DOMICILIARY FOREIGN PERSONAL REPRESENTATIVE’S SWORN STATEMENT District Court Denver Probate Court__________________________________ County, ColoradoCourt Address:IN THE MATTER OF THE ESTATE OF:Deceased COURT USE ONLY Attorney or Party Without Attorney (Name and Address): Phone Number: E-mail:FAX Number: Atty. Reg. #::Case Number:Division Courtroom DOMICILIARY FOREIGN PERSONAL REPRESENTATIVE’S SWORN STATEMENT I, _____________________________________, as the domiciliary foreign personal representative (§15-10- 201(16.5) C.R.S.), state that no administration, or application or petition for administration, is pending in Colorado. I hereby file with this Court the following documents:Certified, exemplified or authenticated copies of the foreign court’s order appointing me as personal representative;  Certified, exemplified or authenticated copies of the foreign court’s letters or other documents evidencing or affecting my authority to act as personal representative;Other: _______________________________________________________________________________ As the domiciliary foreign personal representative and being sworn, I verify that the facts set forth in this statement are true to the best of my knowledge, information, and belief.Date: ___________________________ _____________________________________________ Signature of Domiciliary Foreign Personal Representative _____________________________________________ Street_____________________________________________City/State/Zip Code_____________________________________________Daytime Phone Number Subscribed and affirmed, or sworn to before me in the County of ______________________, State of __________________, this ___________ day of _______________, 20______.My Commission Expires: ___________________ _____________________________________________ Notary Public/Deputy Clerk