Fill and Sign the Nomination Personal Form

 District Court  Denver Probate Court __________________ County, Colorado Court 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 RENUNCIATION AND/OR NOMINATION OF PERSONAL REPRESENTATIVE I, (name), make the following statements to this Court. 1.  I have priority for appointment as Personal Representative of this estate because I am nominated by the Decedent’s Will or under a power conferred by the Will. I renounce my right to appointment. 2.  I have priority for appointment as Personal Representative of this estate pursuant to paragraphs (b) to (e) of §15-12-203(1), C.R.S.*  Having the right to nominate a qualified person to act as Personal Representative, I nominate .  I renounce my right to appointment. 3.  I am between the age of 18 and 21 and would be entitled to appointment as Personal Representative but for my age.  Having the right to nominate a qualified person to act as Personal Representative, I nominate .  I renounce my right to nominate a Personal Representative. 4.  Other: ____________________________________________________________________________________________________  By checking this box, I am acknowledging I am filling in the blanks and not changing anything else on the form.  By checking this box, I am acknowledging that I have made a change to the original content of this form. (Checking this box requires you to remove JDF number and copyright at the bottom of the form.) JDF 912 R8 17 RENUNCIATION AND/OR NOMINATION OF PERSONAL REPRESENTATIVE Page 1 of 2 ©2017 Colorado Judicial Department for use in the Courts of Colorado VERIFICATION AND ACKNOWLEDGMENT I verify that the facts set forth in this document are true as far as I know or am informed. I understand that penalties for perjury follow deliberate falsification of the facts stated herein. (§15-10-310, C.R.S.) Signature Date Type or Print name Address City, State, Zip Code Phone Number E-Mail Address The foregoing instrument was acknowledged before me in the County of ________________, State of Colorado, this ______ day of __________, 20____, by ___________________________. My Commission Expires: _________________ _____________________________________________ Notary Public/Deputy Clerk *Note: Persons with priority for appointment as Personal Representative who also have the right to nominate a Personal Representative are set forth §15-12-203(1), C.R.S. and have priority in the following order: (b) The surviving spouse or partner in a civil union of the Decedent who is a devisee of the Decedent; (b.5) A person given priority to be a personal representative in a designated beneficiary agreement made pursuant to §15-22- 101, et. seq.; (c) other devisees of the Decedent; (d) the surviving spouse or partner in a civil union of the Decedent; (e) other heirs of the Decedent. JDF 912 R8 17 RENUNCIATION AND/OR NOMINATION OF PERSONAL REPRESENTATIVE Page 2 of 2 ©2017 Colorado Judicial Department for use in the Courts of Colorado