Fill and Sign the Named in Will Form

NHJB-2138-P (01/02/2014) Page 1 of 2 THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH http://www.courts.state.nh.us Court Name: Case Name: Case Number: (if known) Trust of PETITION FOR TRUSTEE Named in will Not named in will Named in trust instrument Not named in trust instrument Special needs trust Successor trustee 1. Petitioner Name Telephone Mailing Address Petitioner Name Telephone Mailing Address 2. Attorney Name Telephone Mailing Address Bar ID# 3. Deceased Name ( if applicable) Date of Death Residence (city or town) 4. If petition is for trustee not named in will or tr ust, the named trustee, whose address is , has since resigned, died, been removed, or refused to serve. 5. If a testamentary trust, did the decedent waiv e the requirement for accountings and bond? Yes No 6. List names and addresses of beneficiaries of trust. LIFETIME BENEFICIARY ADDRESS DATE OF BIRTH NAME REMAINDERMAN NAME AD DRESS DATE OF BIRTH Case Name: Trust of Case Number: PETITION FOR TRUSTEE NHJB-2138-P (01/02/2014) Page 2 of 2 7 The value of the trust estate, as nearly as can be ascertained, is: Real Estate .............................................................................. $ Personal Estate ....................................................................... $ Total amount of Estate ............................................................ $ 8. If this is a special needs trus t petition, has a copy of the trust been sent to the Department of Health and Human Services? Yes No The petitioner requests that appointment be granted to of and whose date of birth is I certify that on this date I provided this document(s) to the parties who have filed an appearance for this case or who are otherwise interested parties by: Hand-delivery OR US Mail OR Email (E-mail only by prior agreement of the parties based on Circuit Court Administrative Order). Date Petitioner Signature Date Petitioner Signature ORDER Petition is granted. Letter of trust to issue, conditional on the filing of a fiduciary bond in the amount of $ , without sureties with corporate sureties, within days of this order. Petition is denied. Date Signature of Judge Printed Name of Judge 0.00