File No.
STATE OF NORTH CAROLINA

                                           County                                                                           In The General Court Of Justice
                                                                                                                               Superior Court Division
                                                                                                                                    Before The Clerk
            IN THE MATTER OF THE ESTATE OF:
Name Of Decedent
                                                                                                                    WAIVER OF 
                                                                                                         PERSONAL REPRESENTATIVE'S BOND

                                                                                                                                    G.S. 28A-8-1(b)(6), (8)

I certify that I am an heir/devisee of the above named decedent, and I am over eighteen (18) years of age.
I waive the statutory requirement for bond for the personal representative named below of this estate, who resides in the 
State of North Carolina, and agree to relieve him/her from the necessity of giving the statutory bond. (NOTE: An express 
requirement in the will for a bond cannot be waived.)
Name Of Personal Representative

I understand that this means that there will be no bond to go against if the personal 
representative does not properly administer the estate and distribute the assets to the heirs.
I have read this Waiver, and I fully understand its meaning and effect.
Date                                                                                      Date

Name Of Heir/Devisee (Type Or Print)                                                      Name Of Heir/Devisee (Type Or Print) 

Signature Of Heir/Devisee                                                                 Signature Of Heir/Devisee

SWORN/AFFIRMED AND SUBSCRIBED TO BEFORE ME                                                SWORN/AFFIRMED AND SUBSCRIBED TO BEFORE ME
Date                      Signature                                                       Date                     Signature

     Deputy CSC                 Assistant CSC                     Clerk Of Superior Court                Deputy CSC                 Assistant CSC                     Clerk Of Superior Court
                Date My Commission Expires                                                Date My Commission Expires
     Notary                                                                                                                                         Notary
                County Where Notarized                                                    County Where Notarized
SEAL                                                                                                                                                SEAL

Date                                                                                      Date

Name Of Heir/Devisee (Type Or Print)                                                      Name Of Heir/Devisee (Type Or Print) 

Signature Of Heir/Devisee                                                                 Signature Of Heir/Devisee

SWORN/AFFIRMED AND SUBSCRIBED TO BEFORE ME                                                SWORN/AFFIRMED AND SUBSCRIBED TO BEFORE ME
Date                      Signature                                                       Date                     Signature

     Deputy CSC                 Assistant CSC                     Clerk Of Superior Court                Deputy CSC                 Assistant CSC                     Clerk Of Superior Court
                Date My Commission Expires                                                Date My Commission Expires
     Notary                                                                                                                                         Notary
                County Where Notarized                                                    County Where Notarized
SEAL                                                                                                                                                SEAL

AOC-E-404, Rev. 4/11                                                                      Original - File
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