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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 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

                                                           Telephone No.                                                      Telephone No.

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

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

                                                                         Telephone 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. 3/18
 © 2018 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 in sole name of decedent (List bank, etc., each account no., and balance.)                             Est. Market Value
                                                                                                                   $

  2. Joint accounts without right of survivorship (List bank, etc., each account no., balance, and joint owners.)
                                                                                            % Owned By Decedent
                                                                                            % Owned By Decedent
                                                                                            % Owned By Decedent
                                                                                            % Owned By Decedent
  3.    Stocks/bonds/securities in sole 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., each account no., balance, and joint owners.)
                                                                                                                   $

  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. 3/18
© 2018 Administrative Office of the Courts






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