Probate Decline Form

PROBATE DECLINE FORM

This Probate Decline Form is made as of by Declining Party Name: whose mailing address is and against the Estate as represented by Estate Representative Name: in the matter of the Estate of Decedent Name: , Case Number: , Court: .

RECITALS

WHEREAS, a petition for probate or administration has been filed or is anticipated to be filed concerning the estate of the Decedent named above; and

WHEREAS, the Declining Party has been nominated, appointed, or invited to act as personal representative, executor, administrator, or fiduciary with respect to such estate; and

WHEREAS, the Declining Party desires to formally decline appointment and to set forth the terms, representations, and procedures related to that declination.

NOW THEREFORE, in consideration of the mutual covenants and agreements contained herein, and other good and valuable consideration, the receipt and sufficiency of which are acknowledged, the parties agree as follows:

1. DECLINATION OF APPOINTMENT

1.1 Declination. The Declining Party hereby expressly and irrevocably declines to serve as personal representative, executor, administrator, or other fiduciary of the Estate identified above. The Declining Party will not accept letters testamentary, letters of administration, or otherwise assume fiduciary duties for the Estate.

1.2 No Assumption of Duties. The Declining Party affirms that, except as expressly set forth in this form, the Declining Party will not exercise any power, authority, or control over Estate assets, will not access Estate bank accounts, and will not bind the Estate or make distributions on behalf of the Estate.

2. REASONS FOR DECLINATION

The Declining Party selects the reason(s) for declination below (check all that apply) and may provide additional explanation in the space provided.

3. REPRESENTATIONS AND WARRANTIES

3.1 The Declining Party represents and warrants that: (a) the Declining Party has the full legal capacity to make this declination; (b) the declination is made voluntarily, without duress or undue influence; (c) the Declining Party is not presently in possession of any original testamentary document of the Decedent except as disclosed below; and (d) to the best of the Declining Party's knowledge, information, and belief, there are no material undisclosed conflicts that would prevent another qualified person from serving.

3.2 Disclosure of Documents. If the Declining Party is in possession of any original will, codicil, or other testamentary document, the Declining Party shall identify such documents and deliver them to the filing court or to the Estate Representative as required by law. List documents in custody (if any):

4. NOTICE AND FILING

4.1 Filing Obligation. The Declining Party acknowledges that, where required under applicable probate procedure, a written declination may need to be filed with the Court and/or served on interested persons. The Declining Party agrees to cooperate in a timely manner with filing or service of this form, and to execute any additional documentation reasonably required to effectuate the declination.

4.2 Notice Contact. Notices and filings required under this form shall be delivered to the addresses set forth below unless otherwise updated in writing.

5. RELEASE AND INDEMNITY

5.1 Limited Release. To the extent permitted by law, the Estate Representative and the Estate release the Declining Party from any claim for breach of fiduciary duty or failure to act arising solely from the Declining Party's decision to decline appointment, provided that such declination is not the product of fraud or intentional misconduct.

5.2 Indemnity. The Estate Representative agrees to indemnify and hold harmless the Declining Party from and against any liabilities, losses, claims, or expenses (including reasonable attorneys' fees) arising from acts or omissions of the Estate Representative or third parties after the effective date of declination, except to the extent caused by the gross negligence or willful misconduct of the Declining Party.

6. FURTHER ASSURANCES

Each party agrees to execute and deliver such further documents and to take such further actions as may be reasonably necessary to carry out the intent and purpose of this Probate Decline Form.

7. GOVERNING LAW

This form and any dispute arising out of or related to it shall be governed by and construed in accordance with the substantive law of the state in which the Court is located, without regard to its choice of law rules.

8. ENTIRE AGREEMENT

This form constitutes the entire agreement between the parties with respect to the subject matter herein and supersedes all prior and contemporaneous agreements and understandings, whether written or oral, relating to the Declining Party's appointment to act for the Estate.

9. SEVERABILITY

If any provision of this form is held to be invalid, illegal, or unenforceable in any respect, such provision shall be severed and the remaining provisions shall continue in full force and effect.

10. AMENDMENTS; WAIVER; COUNTERPARTS

No amendment, modification, or waiver of any provision of this form will be effective unless in writing and signed by the parties. Failure by any party to enforce any provision shall not constitute a waiver of that provision. This form may be executed in counterparts, each of which shall be an original and all of which together shall constitute one instrument.

11. CERTIFICATION

The undersigned Declining Party certifies under penalty of perjury under applicable law that the information provided in this form is true and correct to the best of the Declining Party's knowledge, and that the declination is made voluntarily.

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