Fill and Sign the Special Administration Form

STATE OF WISCONSIN, CIRCUIT COURT,       COUNTY For Official Use IN THE MATTER OF THE ESTATE OF       Special Administration - Petition       Case No.       Under oath, I state that: 1. The decedent, whose date of birth was       , and date of death was       , died domiciled in       County, State of       , with a post office address of:       . 2. I am interested as       . (Relationship to Decede nt) 3. It is necessary to appoint a special administrator because:       I ask that letters of special administration be issued to:       , post office address       , with all the general powers, duties and liabilities as personal representative except:       with only these specific powers:       Subscribed and sworn to before me on       Notary Public/Court Official My commission expires:       Signature of Petitioner       Name Printed or Typed       Address             Telephone NumberName of Attorney       Address       Telephone Number       Bar Number       PR-1850 , 10/00 Special Administration - Petition §§867.07, 867.09, and 879.57, Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material.