Fill and Sign the Applicant an Interested Person Pursuant to 15 10 20127 C Form

JDF 916 SC R6/19 APPLICATION FOR INFORMAL APPOINTMENT OF PERSONAL REPRESENTATIVE Page 1 of 4 ❑ District Court ❑ Denver Probate Court ___________________ County, Colorado Court Address: In the Matter of the Estate of : Deceased COURT USE ONLY Attorney or Party W ithout 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 : City: _______________________ State: ______________ Zip Code:____________________ Mailing Address, if different: City: State: Zip Code: Primary Phone: ___________________________ Alternate Phone: _______________________________ Email Address: 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 tard y 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 Orde rs concerning the Decedent. See attached Demand for Notice of Filings or Orders or explanation. 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 JDF 916 SC R6/19 APPLICATION FOR INFORMAL APPOINTMENT OF PERSONAL REPRESENTATIVE Page 2 of 4 of the personal representative. Attach a certified copy of the appointing document if the ap pointment 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. Decedent’s marital and family status: a) Did a spouse or partner in a civil union survive the decedent? ❑ Yes ❑ No b) Did the decedent have a surviving parent? ❑ Yes ❑ No c) Did the decedent have surviving children or other descendants? ❑ Yes ❑ No 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 u nion ❑ Yes ❑ No f) Are any of the decedent’s children minors? ❑ Yes ❑ No 9. 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 90 7. Name Address or Date of Death Age, only if Minor Relationship (e.g. spouse, partner in a civil union, child, brother, guardian for spouse, etc.) 10. ❑ Applicant is 21 years of age or older and nominates himself or herself to be appointed as personal representative. Or ❑ Applicant is 21 years of age or older and nominates himself/herself to be appointed as co -personal representative along with the following as a co -personal representative. Name: The Nomin ee is 21 years of age or older. Street Address: City: _________________________ State: _________ Zip Code: _________ ____________ Mailing Address, if different: City: State: Zip Code: JDF 916 SC R6/19 APPLICATION FOR INFORMAL APPOINTMENT OF PERSONAL REPRESENTATIVE Page 3 of 4 Primary Phone: _____________________________ Alternate Phone: ____________________________ Email Address: Or ❑ Applicant nominates the fo llowing person be appointed as personal represe ntative. Name: The Nominee is 21 years of age or older. Street Address : City: _________________ State: ___________ Zip Code: ______________________ Mailing Address, if different: City: State: Zip Code: Primary Phone: __________________ Alternate Phone: _________________________ Email Address: 11. 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: All person(s) (other than those identified in Paragraph 10 above) with prior or equal right to appointment have renounced their right to appointment (JDF 912SC ). All required renouncements accompany this application. 12. ❑ Bond i s not required by the will and no interested person demanded that bond be filed. (Skip #1 3 below.) ❑ Bond is required by will or is being demanded by an interested person. (Complete #1 3 below.) ❑ Bond in the amount of $ has been demanded. 13 . Applicant states the following regarding the decedent’s estate , if required by § 15 -12 -604, C.R.S. Estimate d value of real estate $ Estimate d value of personal property $ Annual income expected from all sources $ TOTAL $ 14. 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, a re as stated below or in an attachment to this application. * ❑ The basis of compensation has not yet been determined. * JDF 916 SC R6/19 APPLICATION FOR INFORMAL APPOINTMENT OF PERSONAL REPRESENTATIVE Page 4 of 4 * There is a continuing obligation to disclose any material changes to the basis for charging fees. (§ 15 -10 -602 C.R.S.) 15. 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 cha rging 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.) 16. 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 changin g 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. VERIFICATION I declare under penalty of perjury under the law of Colorado that the foregoing is true and correct. Executed on the ______ day of Executed on the ______ day of (date) (date) _______________________, _________, _______________________, _________, (month) (year) (month) (year) at ______________________________________ at ______________________________________ (city or other location, and state OR country) (city or other location, and state OR country) _______________________________ ______________________ _________ (printed name) (printed name) _______________________________ _______________________________ (Signature of Applicant ) (Signature of Co -Applicant , if any) _______________________________________ __________________ Attorney Signature, (if any) Date Note : • Please remember to add any AKA names in the caption, if applicable.