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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 Of Decedent                                                                            PETITION AND ASSIGNMENT
                                                                                            YEAR’S ALLOWANCE
                                                                                     (For Decedents Dying On Or After March 1, 2024)
Date Of Death
                                                                                                                               G.S. 30-15, 30-17, 30-20
I am petitioning for an allowance for a year’s support for the person(s) named and state:
1.   a. The decedent was domiciled in this county on the decedent’s date of death shown above.
      b.  The decedent had no domicile in this State at the time of the decedent’s death, but personal property that belonged to the decedent at
      his or her death, which was on the date shown above, is located in this county.
2.    a. No personal representative has been issued letters.
      b.  A personal representative has been appointed and issued letters, and it has been less than six (6) months since the personal
      representative was issued letters.
3.    a.  The surviving spouse, if any, named below is entitled to an allowance from the personal property of the decedent of the value of sixty
      thousand dollars ($60,000), for a year’s support, and the spouse is not barred from seeking an allowance under G.S. 31A-1 or another
      applicable law.*
      b.  The child(ren), if any, named below is/are entitled to an allowance of ten thousand dollars ($10,000) for a year’s year’s support, and
      the child(ren) is/are not barred from seeking an allowance under G.S. Chapter 31A or other applicable law.*
4.  I request assignment of
      Sixty thousand dollars ($60,000) from the funds or other personal property of the decedent for a year’s support to the surviving spouse. 
      Ten thousand dollars ($10,000) from the funds or other personal property of the decedent for a year’s support to each child named below.
                                              SPOUSE* ENTITLED TO ALLOWANCE
                 Full Name                                                          Complete Address (including zip code)

                                              CHILD(REN)* ENTITLED TO ALLOWANCE
                 Full Name                    Age of Child at                               Complete Address (including zip code)
                                              Decedent’s Death

*NOTE: The right of the surviving spouse to file a claim for an allowance must be exercised during the lifetime of the surviving spouse (i) by the surviving spouse, 
(ii) by the surviving spouse’s agent under a durable power of attorney, or (iii), with approval of the court, by the guardian of the surviving spouse’s estate or 
general guardian. The spouse’s allowance takes priority over any child’s allowance. 
The right of a child to file a claim for an allowance must be exercised during the lifetime of the child. Every child of a decedent who is under the age of 21 years 
at the time of the decedent’s death, including an adopted child or a child in utero, and every child who is under the age of 21 years at the time of the decedent’s 
death with whom the decedent stood in loco parentis at the time of death is entitled to an allowance. The person entitled to file a petition on behalf of the child for 
a child’s allowance shall be in the following order of priority: (1) The general guardian or guardian of the estate of the child, if any. (2) The surviving parent of the 
child if the child resides with the surviving parent. (3) The person with whom the child resides. If the clerk of superior court determines that no person entitled to 
file a petition pursuant to this subsection is a fit or suitable individual, the clerk, upon the clerk’s own motion, may appoint another individual if the clerk determines 
that individual better represents the best interests of the child as the representative. A child’s allowance shall only be awarded after the full spouse’s allowance 
under G.S. 30-15 has been awarded.
Name And Address Of Petitioner (type or print)
                                                                                     Spouse Of Decedent  
                                                                                     Surviving Spouse’s Agent Under A Durable Power Of Attorney 
                                                                                     Guardian Of The Estate Or General Guardian
                                                                                     Other: 

                              Original-File   Copy-Petitioner    Copy-Personal Representative Appointed For Estate
                                                            (Over)
AOC-E-100, Rev. 3/24
© 2024 Administrative Office of the Courts



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                                                           VERIFICATION
I, the undersigned petitioner, have read this Petition and state that its contents are true to my own knowledge except those matters 
stated on information and belief, which I believe are true.
                                                                    Date
SWORN/AFFIRMED AND SUBSCRIBED TO BEFORE ME
Date             Signature Of Person Authorized To Administer Oaths Signature Of Petitioner

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

NOTE TO PETITIONER: If a personal representative has been appointed for the decedent’s estate, a copy of the verified petition must be personally 
delivered or sent by first-class mail by the petitioner to the personal representative.

AOC-E-100, Side Two, Rev. 3/24
© 2024 Administrative Office of the Courts



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Name Of Decedent                                                                                   File No.
                                                                             County
                                          ASSIGNMENT OF YEAR’S ALLOWANCE
I have examined the above petition and have determined the money and other personal property of the decedent. I find that the 
allegations in the petition are true and that each person(s) named in the petition is entitled to the allowance requested.
I ASSIGN to the petitioner the funds or other items of the personal property of the decedent listed below, which I have valued as 
indicated. This property is assigned free and clear of any lien by judgment or execution against the decedent and is to be paid by the 
petitioner to the person(s) entitled. I assess as a DEFICIENCY the amount, if any, shown below, which is to be paid or delivered to the 
proper person when any additional personal assets of the decedent are discovered.
                              Personal Property Assigned                                                                     Value

                                                                                                    TOTAL   $
                                                                                      DEFICIENCY            $
Date             Signature
                                                                                     Assistant CSC   Clerk Of Superior Court        SEAL
NOTE TO CLERK: If a personal representative has been appointed for the decedent’s estate, the clerk of superior court shall provide a copy of any 
order awarding an allowance to the personal representative of the decedent’s estate.
                                          CERTIFICATION
I hereby certify that the foregoing is a True and Correct copy of the report in the Assignment of Year’s Allowance in the matter of the 
above-referenced estate as recorded in this office and shall be sufficient to release the items listed as assigned to the surviving spouse 
or children of the deceased as provided under G.S. 30-15, 30-17, and 30-20.
Date             Signature
                                                          Deputy CSC                  Assistant CSC         Clerk Of Superior Court SEAL

AOC-E-100, Page Two, Rev. 3/24
© 2024 Administrative Office of the Courts






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