Fill and Sign the Relationship to Decedent Form

JDF 916 R8 17 APPLICATION FOR INFORMAL APPOINTMENT OF PERSONAL REPRESENTATIVE Page 1 of 4©2017 Colorado Judicial Department for use in the Courts of ColoradoDistrict 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 APPLICATION FOR INFORMAL APPOINTMENT OF PERSONAL REPRESENTATIVE ****** Use this form if the Decedent did not leave a will ******* The Applicant, an interested person pursuant to §15-10-201(27), C.R.S., makes the following statements:1.Information about the Applicant: 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 ______________, the 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 Application 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 Applicant:has not received a Demand for Notice of Filings or Orders and is unaware of any Demand for Notice of Filings or Orders concerning the Decedent.has received or is aware of a Demand for Notice of Filings or Orders concerning the Decedent. See attached Demand for Notice of Filings or Orders or explanation. JDF 916 R8 17 APPLICATION FOR INFORMAL APPOINTMENT OF PERSONAL REPRESENTATIVE Page 2 of 4©2017 Colorado Judicial Department for use in the Courts of Colorado6. 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 in an attached explanation and after the exercise of reasonable diligence, the Applicant is unaware of any unrevoked will relating to property in Colorado. 8.The names and addresses of the Decedent’s spouse, partner in a civil union, children and other heirs are as follows: 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.)9. Applicant is 21 years of age or older and nominates himself/herself to be appointed as Personal Representative. orApplicant 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 #: 10.The Nominee has priority for appointment because of:statutory priority. (§15-12-203, C.R.S.) reasons stated in the attached explanation. JDF 916 R8 17 APPLICATION FOR INFORMAL APPOINTMENT OF PERSONAL REPRESENTATIVE Page 3 of 4©2017 Colorado Judicial Department for use in the Courts of ColoradoPersons 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 Application.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 Application. *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 Application. *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.)13.No interested person demanded that bond be filed.Bond in the amount of $ has been demanded.The Applicant requests that the Registrar informally appoint the Nominee as Personal Representative in unsupervised administration to serve: without bond with bond in the amount of $and that Letters of Administration be issued.  By checking this box, I am acknowledging I am filling in the blanks and not changing anything else on the form. JDF 916 R8 17 APPLICATION FOR INFORMAL APPOINTMENT OF PERSONAL REPRESENTATIVE Page 4 of 4©2017 Colorado Judicial Department for use in the Courts of Colorado 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 (Applicant) 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 Applicant DateThe foregoing instrument was acknowledged before me in the County of ________________, State of Colorado, this ____day of ____________, 20___, by the Applicant.My Commission Expires: ________________ _____________________________________________ Notary Public/Deputy Clerk ______________________________________Signature of Attorney Date