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 AND LETTERS TESTAMENTARY OF ADMINISTRATION CTA AND ADDENDUM (AOC-E-309) County Of Domicile At Time Of Death G.S. 28A-2A-1, -2, -5; 28A-6-1; 28A-12-4 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 and for letters 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, or was a nonresident motorist who died in North Carolina; no other proceeding for probate or for administration is pending in any jurisdiction. 2. The decedent left the paper-writing(s) purporting to be the decedent’s Last Will and Testament and codicil(s), dated as shown above. 3. a. I am an executor, devisee, or legatee named in the will, or a next-of-kin or creditor of the decedent. b. I am the person entitled to apply for letters or am applying after all persons having prior right to apply have renounced. c. I am applying subject to G.S. 28A-6-2(1) and move that all necessary notices be issued. d. I am the public administrator appointed by the Court. 4. I am not disqualified pursuant to G.S. 28A-4-2 to administer the estate and have not renounced my right to do so. 5. 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.) 6. 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-201, Rev. 8/21 © 2021 Administrative Office of the Courts |
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 14. Is there a pending lawsuit that involves the decedent? Yes No (Base bond on this amount, if applicable.) 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-201, Side Two, Rev. 8/21 © 2021 Administrative Office of the Courts |