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                                                                                                File No.
STATE OF NORTH CAROLINA
                                                                                                    In The General Court Of Justice
                                                County                                                  Superior Court Division
                                                                                                        Before The Clerk
              IN THE MATTER OF THE ESTATE OF
Name, Street Address, City, State, And Zip Code Of Decedent                             APPLICATION FOR PROBATE
                                                                                                (WITHOUT QUALIFICATION OF A
                                                                                                PERSONAL REPRESENTATIVE)
                                                                                           AND ADDENDUM (AOC-E-309)
County Of Domicile At Time Of Death
                                                                                                                            G.S. 28A-2A-1, -2, -5
Date Of Death                      Date Of Will And Codicil(s), If Any Place Of Death (if different from County Of Domicile)

Name, Street Address, PO Box, City, State, And Zip Code Of Applicant   Name, Street Address, PO Box, City, State, And Zip Code Of Co-Applicant

Legal Residence (County, State)                                        Legal Residence (County, State)

Name, Street Address, PO Box, City, State, And Zip Code Of Attorney    Attorney Bar No.

I, the undersigned, applying for probate of the decedent’s last will and testament in the above estate, being first duly sworn, say that:
1.   The decedent was domiciled in this county at the time of the decedent’s death or left property or assets in this county.
2.   a.  I am the executor named in the will.
     b.   I am a devisee named in the will, no executor has applied to have the will proved within sixty (60) days after the death of the 
              testator, and the named executor(s) has/each have at least ten (10) days’ notice of my intent to have the will proved. 
     c.    The decedent died on or after January 1, 2012, I am a devisee named in the will, less than sixty (60) days have passed since 
              the death of the testator, no executor has yet applied to have the will proved, the named executor(s) has/each have at least 
              ten (10) days’ notice of my intent to have the will proved, and good cause exists to now probate the will in that                
                                                                                                                                              .
     d.   I am a person interested in this estate, my interest is that  
                                                            , no executor has applied to have the will proved within sixty (60) days after the death 
              of the testator, and the named executor(s) has/each have at least ten (10) days’ notice of my intent to have the will proved.
     e.   The decedent died on or after January 1, 2012, I am a person interested in this estate, my interest is that                          
                                                                       , less than sixty (60) days have passed since the death of the testator, 
              no executor has yet applied to have the will proved, the named executor(s) has/each have at least ten (10) days’ notice of my 
              intent to have the will proved, and good cause exists to now probate the will in that                                             
                                                                                                                                              .
3.   Following the execution of the will, there were no children born to or adopted by the decedent, and the decedent did not thereafter 
   marry or obtain a divorce. (If the facts are otherwise, state them on an attachment.)
4.   After diligent inquiry, I have determined that the persons listed below are all the persons entitled to share in the decedent’s estate. 
   (If there is a court-appointed guardian for any such person(s), list the guardian’s name and address on an attachment.)
                     NAME                                   AGE        RELATIONSHIP                     MAILING ADDRESS

                                                            Original - File     Copy - Applicant
                                                            (Preliminary Inventory On Reverse)
 AOC-E-199, Rev. 8/21
 © 2021 Administrative Office of the Courts



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                                                   PRELIMINARY INVENTORY
(Give values as of date of decedent’s death. Continue on separate attachment if necessary.)
                                                PART  I.PROPERTY OF THE ESTATE
  1. Accounts solely in the name of decedent (List bank, etc., account type, and balance. Do not list account nos.)                     Est. Market Value
                                                                                                                                      $

  2. Joint accounts without right of survivorship (List bank, etc., account type, balance, and joint owners. Do not list account nos.)
                                                                                             % Owned By Decedent
                                                                                             % Owned By Decedent
                                                                                             % Owned By Decedent
                                                                                             % Owned By Decedent
  3.    Stocks/bonds/securities solely in the name of decedent or jointly owned without right of survivorship
                                                                                             % Owned By Decedent
  4. Cash and undeposited checks on hand
  5. Household furnishings
  6. Farm products, livestock, equipment, and tools
  7. Vehicles
  8. Interests in partnership or sole proprietor businesses
  9. Insurance, Retirement Plans, IRAs, annuities, etc., payable to Estate
 10. Notes, judgments, and other debts due decedent
 11. Miscellaneous personal property
 12. Real estate willed to the Estate                                                       $
 13. Estimated annual income of Estate
                                                                                                           TOTAL PART I.              $
                PART II. PROPERTY WHICH CAN BE ADDED TO ESTATE IF NEEDED TO PAY CLAIMS
  1. Joint accounts with right of survivorship (List bank, etc., account type, balance, and joint owners. Do not list account nos.)
                                                                                                                                      $

  2.  Stocks/bonds/securities registered in beneficiary form and immediately transferred on death or jointly- 
 owned with right of survivorship
  3. Other personal property recoverable (G.S. 28A-15-10)
  4. Real estate owned by decedent and not listed elsewhere
                                                                                                       TOTAL PART II.                 $
                                                   PART III. OTHER PROPERTY
  1. There       is     is not     entireties real estate owned by decedent and spouse.
  2.  There      are    are not     Insurance, Retirement Plans, IRAs, annuities, etc., payable to named 
 beneficiaries.
  3.  There      is     is not     a potential claim for wrongful death arising under G.S. 28A-18-2.
Signature Of Applicant                                                    Signature Of Co-Applicant

SWORN/AFFIRMED AND SUBSCRIBED TO BEFORE ME                                SWORN/AFFIRMED AND SUBSCRIBED TO BEFORE ME
Date                   Signature Of Person Authorized To Administer Oaths Date                             Signature Of Person Authorized To Administer Oaths

      Deputy CSC        Assistant CSC           Clerk Of Superior Court                     Deputy CSC      Assistant CSC               Clerk Of Superior Court
        Date Commission Expires                                           Date Commission Expires
 Notary                                                                                                                                                      Notary
        County Where Notarized                                            County Where Notarized
SEAL                                                                                                                                    SEAL
AOC-E-199, Side Two, Rev. 8/21
© 2021 Administrative Office of the Courts






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