Fill and Sign the Petition for Adjudication of Intestacy and Formal Appointment of

JDF 922 R8/17 PETITION FOR ADJUDICATION OF INTESTACY AND Page 1 of 4 FORMAL APPOINTMENT OF PERSONAL REPRESENTATIVE©2017 Colorado Judicial Department for use in the Courts of Colorado 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 PETITION FOR ADJUDICATION OF INTESTACY AND FORMAL APPOINTMENT OF PERSONAL REPRESENTATIVE ****** Use this form if the Decedent did not leave a will ******* The Petitioner, an interested person pursuant to § 15-10-201(27), C.R.S., makes the following statements:1. Information about the Petitioner:Name: Relationship to Decedent Street Address: Mailing Address, if different: City: State: Zip Code: Home Phone #: Email Address: Work Phone #: 2.The Decedent died on (date) at the age of years. The Decedent was domiciled or resided in the City of County of , State of . 3.Venue for this proceeding is proper in this county because the Decedent:had his or her domicile or residence in this county on the date of death.did not have his or her domicile or residence in Colorado, but had property located in this county on the date of death.4. This Petition is filed within the time period permitted by law. Three years or less have passed since the Decedent’s death, or circumstances described in §15-12-108, C.R.S. authorize tardy probate or appointment. 5.The Petitioner:has not received a Demand for Notice of Filings or Orders and is unaware of any Demand for Notice of Filings or Orders concerning Decedent.has received or is aware of a Demand for Notice of Filings or Orders concerning Decedent. See attached Demand for Notice of Filings or Orders or explanation. JDF 922 R8/17 PETITION FOR ADJUDICATION OF INTESTACY AND Page 2 of 4 FORMAL APPOINTMENT OF PERSONAL REPRESENTATIVE©2017 Colorado Judicial Department for use in the Courts of Colorado 6. No court has appointed a Personal Representative and no such appointment proceeding is pending in this state or elsewhere.A court has appointed a Personal Representative or an appointment proceeding is pending in the State of . (Attach a statement explaining the circumstances and indicating the name and address of the Personal Representative. Attach a certified copy of the appointing document if the appointment has been finalized.) 7.Except as may be disclosed on an attached explanation and after the exercise of reasonable diligence, the Petitioner is unaware of any unrevoked will relating to property located in Colorado.8. Decedent’s marital and family status: a)Did a spouse or partner in a civil union survive the Decedent? Yes NoIf the answer to a) is Yes, also answer the following questions:b) Did the Decedent have a surviving parent? Yes No c)Did the Decedent have surviving children or other descendants? Yes No If the answer to c) is Yes, also answer the following questions:d)Does the Decedent’s surviving spouse or partner in a civil union have surviving descendants who are not descendants of the Decedent? Yes No e)Are all of the Decedent’s surviving descendants also descendants of the surviving spouse or partner in a civil union? Yes No If the answer to e) is No, also answer the following question:f) Are any of the Decedent’s children minors? Yes No 9.List names and addresses of the Decedent’s spouse, partner in a civil union, children, and other heirs as defined by the Colorado law of intestate succession. (§15-11-101, C.R.S. through §15-11-114, C.R.S.) If a guardian or conservator has been appointed for one of the persons listed below, also provide the name and address of the guardian or conservator.  If a minor child is listed, list the child’s parent(s), guardian or conservator. If a spouse, partner in a civil union, or child has predeceased the Decedent, include the date of death.  A sample of this section is included in the Instructions - JDF 907. Name Address (or date of death) Age, only if MinorRelationship (e.g. spouse, partner in a civil union, child, brother, guardian for spouse, etc.) JDF 922 R8/17 PETITION FOR ADJUDICATION OF INTESTACY AND Page 3 of 4 FORMAL APPOINTMENT OF PERSONAL REPRESENTATIVE©2017 Colorado Judicial Department for use in the Courts of Colorado 10. Petitioner is 21 years of age or older and nominates himself/herself to be appointed as Personal Representative. orPetitioner nominates the following person be appointed as Personal Representative.Name: The Nominee is 21 years of age or older. Street Address: Mailing Address, if different: City: State: Zip Code: Home Phone #: Email Address: Work Phone #: The Nominee has priority for appointment because of:statutory priority. (§15-12-203, C.R.S.) reasons stated in the attached explanation.Persons with prior or equal rights to appointment are as follows: They have each renounced their rights to appointment or have been given notice of these proceedings. Any required renouncements accompany this Petition.11.The Personal Representative may receive compensation.The hourly rates to be charged, any amounts to be charged pursuant to a published fee schedule, including the rates and basis for charging fees for any extraordinary services, and any other bases upon which a fee charged to the estate will be calculated, are as stated below or in an attachment to this Petition. *The basis of compensation has not yet been determined.12.The Personal Representative may compensate his, her or its counsel.The hourly rates to be charged, any amounts to be charged pursuant to a published fee schedule, including the rates and basis for charging fees for any extraordinary services, and any other bases upon which a fee charged to the estate will be calculated, are as stated below or in an attachment to this Petition. *The basis of compensation has not yet been determined.* There is a continuing obligation to disclose any material changes to the basis for charging fees. (§ 15-10-602 C.R.S.) JDF 922 R8/17 PETITION FOR ADJUDICATION OF INTESTACY AND Page 4 of 4 FORMAL APPOINTMENT OF PERSONAL REPRESENTATIVE©2017 Colorado Judicial Department for use in the Courts of Colorado 13. No interested person demanded that bond be filed.Bond in the amount of $ has been demanded.14.Unsupervised administration is requested.Supervised administration is requested (additional filing fee required). Terms of the requested supervision are as follows: After notice and hearing, the Petitioner requests that the Court determine that the Decedent died without a will, determine the heirs of the Decedent and formally appoint the Nominee as Personal Representative to serve:without bond with bond in the amount of $ in unsupervised administration in supervised administration (additional filing fee required)and that Letters of Administration be issued or that previously issued Letters be confirmed. Petitioner also requests:a setting aside of prior informal findings as to testacy.a setting aside of prior informal appointment of Personal Representative. 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.) VERIFICATION AND ACKNOWLEDGMENT I (Petitioner) 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 of Petitioner DateThe foregoing instrument was acknowledged before me in the County of ________________, State of Colorado, this ____day of ____________, 20___, by the Petitioner.My Commission Expires: ________________ _____________________________________________Notary Public/Deputy Clerk ______________________________________Signature of Attorney Date