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Probate

1 of 4 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 4/11/17 Civil Law Self-Help Center PET _____________________________ (Name) _____________________________ (Address) _____________________________ (City, State, Zip Code) _____________________________ (Telephone number/E-mail Address) Petitioner, In Proper Person EIGHTH JUDICIAL DISTRICT COURT CLARK COUNTY, NEVADA In the Matter of the Estate of: _______________________________________, Deceased. Case No.: P Dept. No.: PC-1 EX PARTE PETITION FOR ORDER TO RELEASE MEDICAL RECORDS Petitioner, (your name) ___________________________________________, appearing in Proper Person, respectfully alleges and shows as follows: 1. Petitioner files this request pursuant to Nevada Revised Statutes 629.061, and requests that this Court enter an order authorizing the release of medical records of Decedent (name of person who passed away)_______________________________ (hereinafter “Decedent”). 2. Petitioner is the (your relation to the decedent) ___________________ of Decedent (name of person who passed away) ________________________ and resides at (your address) _____________________________________________________________________________ (hereinafter “Petitioner”). A copy of Petitioner’s identification is attached hereto as Exhibit A. 2 of 4 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 4/11/17 Civil Law Self-Help Center 3. Decedent died on the (day, month, and year of death) ____________________________, in (county where the decedent died) _________________________ and, on the date of death, Decedent was a resident of Clark County, Nevada. A certified copy of Decedent’s death certificate is attached herein as Exhibit B. 4. Jurisdiction is proper in this proceeding. 5. Decedent (check one) did not did execute a Last Will and Testament and/or an Order for Cremation and Disposition pursuant to NRS 451.655. If Decedent did execute either a Last Will and Testament or an Order for Cremation and Disposition, it is attached hereto as Exhibit C. 6. The names, relationships, ages, and residence addresses of all the devisees, legatees, heirs, and next-of-kin of Decedent, so far as known to Petitioner, are: (You must include the name, relationship, age (if under 18), and address of (1) decedent’s legally married spouse, (2) all decedent’s children; (3) all other devisees, legatees, heirs, and next-of kin. List all persons, regardless of age, even if estranged or out of state. Include all addresses; if unknown, include last known address or state “unknown.”) Name Relationship to Decedent Age (If under 18, list age; if over 18, write “adult.”) Address Check here if you have more people to include, and attach a continuation sheet. 7. The devisees, legatees, heirs, and next-of-kin of Decedent who are listed above either consent to the release of medical records, and I have attached the appropriate Consents to Order of Release of Medical Records herein; or they have not consented, and an Affidavit in 3 of 4 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 4/11/17 Civil Law Self-Help Center Support of Petition for Order For Release of Medical Records explaining their lack of consent is herein attached as Exhibit D. 8. Petitioner is seeking medical records from: (List names & addresses of all medical facilities and doctors from whom you are seeking records.) Medical Facility Address WHEREFORE, Petitioner prays: That the Court make and enter its order directing the officers of all the aforementioned medical facilities and/or doctors to release Decedent’s medical records to (your name) __________________ of (insert your address)______________________________________. DATED THIS _____ day of _______________, 20___. Respectfully submitted, _____________________________ (signature) _____________________________ (Your name) _____________________________ (Your address) _____________________________ (Your city, state, and zip) _____________________________ (Your phone number) _____________________________ (Your email) PETITIONER, IN PROPER PERSON 4 of 4 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 4/11/17 Civil Law Self-Help Center VERIFICATION IN SUPPORT OF PETITION FOR ORDER TO RELEASE MEDICAL RECORDS STATE OF NEVADA ) )ss COUNTY OF CLARK ) (Your name) ________________________, being first duly sworn, declares under penalty of perjury under the law of the State of Nevada that the foregoing and following is true and correct: I am the Petitioner in the above-entitled action. I have read the foregoing Ex Parte Petition for Order to Release Medical Records, and know the contents thereof. The Petition is true of my own knowledge except as to those matters that are stated on information and belief, and as to those matters, I believe them to be true. DATED THIS _____ day of _______________, 20___. _____________________________ (Signature) _____________________________ (Your name) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 4/11/17 Civil Law Self-Help Center _____________________________ (Name) _____________________________ (Address) _____________________________ (City, State, Zip Code) _____________________________ (Telephone number/E-mail Address) In Proper Person EIGHTH JUDICIAL DISTRICT COURT CLARK COUNTY, NEVADA In the Matter of the Estate of: _______________________________________, Deceased. Case No.: P Dept. No.: PC-1 CONSENT TO ORDER TO RELEASE MEDICAL RECORDS COMES NOW (your name) _________________________________________, (state your relationship to the decedent) _________________ of Decedent, whose address is: (your address) ___________________________________________________, being first duly sworn, declare under penalty of perjury that I am aware of the Ex Parte Petition for Order to Release Medical Records filed by (name of person who is filing the petition) _________________________________________ (“Petitioner”) requesting the release of medical records of the above decedent to Petitioner. I FURTHER ACKNOWLEDGE that I am in agreement with the request to release medical records to Petitioner and hereby consent to the release. DATED THIS _____ day of _______________, 20___. Respectfully submitted, _____________________________ (Signature) _____________________________ (Your name) 1 of 2 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 4/11/17 Civil Law Self-Help Center ORDR _____________________________ (Name) _____________________________ (Address) _____________________________ (City, State, Zip Code) _____________________________ (Telephone number/E-mail Address) Petitioner, In Proper Person EIGHTH JUDICIAL DISTRICT COURT CLARK COUNTY, NEVADA In the Matter of the Estate of: _______________________________________, Deceased. Case No.: P Dept. No.: PC-1 EX PARTE ORDER TO RELEASE MEDICAL RECORDS The Court, upon reading the verified ex-parte petition of (your name) ____________________________, and good cause appearing therefore: IT IS HEREBY ORDERED that the following officers of (List names & addresses of all medical facilities and doctors from whom you are seeking records). Medical Facility Address / / / 2 of 2 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 4/11/17 Civil Law Self-Help Center shall release Decedent’s medical records to (your name) _______________________________ of (your address) _________________________________________________________________. DATED this ____ day of ___________, 20_____. _______________________________ DISTRICT COURT JUDGE Respectfully submitted, _____________________________ (Signature) _____________________________ (Your name) PETITIONER, IN PROPER PERSON 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 4/11/17 Civil Law Self-Help Center EXHIBIT A (Petitioner’s Identification) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 4/11/17 Civil Law Self-Help Center EXHIBIT B (Death Certificate) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 4/11/17 Civil Law Self-Help Center EXHIBIT C (Last Will & Testament) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 4/11/17 Civil Law Self-Help Center EXHIBIT D (Consents and/or Affidavits in Support of Petition) County, Nevada Case No. I. Party Information (provide both home and mailing addresses if different) Plaintiff(s) (name/address/phone):Defendant(s) (name/address/phone): Attorney (name/address/phone):Attorney (name/address/phone): II. Nature of Controversy (please select the one most applicable filing type below) Landlord/TenantNegligenceOther Torts Unlawful DetainerAuto Product Liability Other Landlord/TenantPremises Liability Intentional Misconduct Title to Property Other Negligence Employment Tort Judicial ForeclosureMalpractice Insurance Tort Other Title to PropertyMedical/DentalOther Tort Other Real PropertyLegal Condemnation/Eminent DomainAccounting Other Real PropertyOther Malpractice Probate (select case type and estate value) Construction DefectJudicial Review Summary AdministrationChapter 40Foreclosure Mediation Case General AdministrationOther Construction DefectPetition to Seal Records Special AdministrationContract CaseMental Competency Set AsideUniform Commercial CodeNevada State Agency Appeal Trust/ConservatorshipBuilding and ConstructionDepartment of Motor Vehicle Other ProbateInsurance CarrierWorker's Compensation Estate ValueCommercial InstrumentOther Nevada State Agency Over $200,000Collection of AccountsAppeal Other Between $100,000 and $200,000Employment ContractAppeal from Lower Court Under $100,000 or UnknownOther ContractOther Judicial Review/Appeal Under $2,500 Civil WritOther Civil Filing Writ of Habeas CorpusWrit of ProhibitionCompromise of Minor's Claim Writ of MandamusOther Civil WritForeign Judgment Writ of Quo WarrantOther Civil Matters Signature of initiating party or representative Civil WritOther Civil Filing Date Business Court filings should be filed using the Business Court civil coversheet. DISTRICT COURT CIVIL COVER SHEET (Assigned by Clerk's Office) See other side for family-related case filings. Probate TortsReal Property Construction Defect & Contract Judicial Review/Appeal Civil Case Filing Types Nevada AOC - Research Statistics Unit Pursuant to NRS 3.275 Form PA 201 Rev 3.1

Med Records Packet

Page 1 of 4 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 10/3/2019 Civil Law Self-Help Center EXPP _____________________________ (Name) _____________________________ (Address) _____________________________ (City, State, Zip Code) _____________________________ (Telephone number) _____________________________ (Fax number/E- mail Address) Personal Representative, In Proper Person Other _______________, In Proper Person EIGHTH JUDICIAL DISTRICT COURT CL ARK COUNTY, NEVADA In the Matter of the Estate of: _______________________________________, Deceased. Case No.: P-____________ Dept. No.: PC-1 EX PARTE PETITION TO REDACT RESTRICTED PERSONAL INFORMATION Petitioner, (your name) ___________________________________________, (hereinafter “Petitioner”) appearing in Proper Person, respectfully alleges and shows as follows: 1.Petitioner files this request pursuant to Nevada Rules for Sealing and Redacting Court Records (“SRCR”) 3, and requests that this Court enter an Order redacting: (describe the restricted personal information sought t redacted) ______________________________________________________________________________ ______________________________________________________________________________ _____________________________________________________________________________. as found in the Court’s docket filed in and/or on: (identify pleading or document where restricted personal information is found in court file, to include date the pleading or document was filed) _______________________________________. Page 2 of 4 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 10/3/2019 Civil Law Self-Help Center 2. In accordance with SRCR 3(8), Petitioner is providing a copy of the redacted document with this Ex Parte Petition, which is attached as Exhibit A. WHEREFORE, Petitioner prays: 1. The Court enter an Order redacting the restricted personal information as set forth above. 2. For such other and further relief as the Court deems just and proper. DATED THIS _____ day of _______________, 20___. Respectfully submitted, _____________________________ (Signature) _____________________________ (Your name) _____________________________ (Your address) _____________________________ (Your city, state, and zip) _____________________________ (Your phone number) _____________________________ (Your fax number and/or email) PETITIONER, IN PROPER PERSON Page 3 of 4 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 10/3/2019 Civil Law Self-Help Center VERIFICATION IN SUPPORT OF EX PARTE PETITION TO REDACT RESTRICTED PERSONAL INFORMATION STATE OF ________________) )ss COUNTY OF ______________) (Your name)________________________, being first duly sworn, declares under penalty of perjury under the law of the State of Nevada that the foregoing and following is true and correct: I am the Petitioner in the above-entitled action. I have read the foregoing Ex Parte Petition to Redact Restricted Personal Information, and know the contents thereof. The Ex Parte Petition is true of my own knowledge except as to those matters that are stated on information and belief, and as to those matters, I believe them to be true. Furthermore, this request is made in good faith and not for any improper purpose. DATED THIS _____ day of _______________, 20___. _____________________________ (Signature) _____________________________ (Your name) Page 4 of 4 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 10/3/2019 Civil Law Self-Help Center Exhibit A (Copy of Redacted Document) Page 1 of 2 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 10/3/2019 Civil Law Self-Help Center EXPR _____________________________ (Name) _____________________________ (Address) _____________________________ (City, State, Zip Code) _____________________________ (Telephone number) _____________________________ (Fax number/E- mail Address) Personal Representative, In Proper Person Other _______________, In Proper Person EIGHTH JUDICIAL DISTRICT COURT CL ARK COUNTY, NEVADA In the Matter of the Estate of: _______________________________________, Deceased. Case No.: P-____________ Dept. No.: PC-1 ORDER TO REDACT Based upon the exhibits and petition requesting this Court to enter an Order to Redact restricted personal information pursuant to SCRC3, IT IS ORDERED that the following restricted personal information be redacted from the court records: (describe the restricted personal information sought redacted) ______________________________________________________________________________ ______________________________________________________________________________ _____________________________________________________________________________. as found in the Court’s docket filed in and/or on: (identify pleading or document where restricted personal information is found in court file, to include date the pleading or document was filed) _______________________________________. ... ... Page 2 of 2 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 10/3/2019 Civil Law Self-Help Center IT IS FURTHER ORDERED that pursuant to SRCR 8, the clerk shall replace the original court records in the public court file with the redacted document attached to the Ex Parte Petition to Redact Restricted Personal Information. DATED this ____ day of ___________, 20_____. _______________________________ DISTRICT COURT JUDGE Respectfully submitted, By: ___________________ (signature) ___________________ (print name) IN PROPER PERSON

Ex Parte Petition To Redact Fillable

Page 1 of 1 For forms and information, visit www. civillawselfhelpcenter.org 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 28 © Civil Law Self-Help Center Rev. 8/21/18 RCPT _____________________________ (Name) _____________________________ (Address) _____________________________ (City, State, Zip Code) _____________________________ (Telephone number) _____________________________ (Fax number/E-mail Address) Distributee, In Proper Person Other _______________ EIGHTH JUDICIAL DISTRICT COURT CLARK COUNTY, NEVADA In the Matter of the Estate of: _______________________________________, Deceased. Case No.: P Dept. No.: PC-1 RECEIPT FOR PROPERTY RECEIVED I, (your name) _____________________________, acknowledge receipt of the property described as follows (describe what you received, e.g., cash in the amount of $X) _____________________________________________________________________________ from (person who gave you property) ____________________________, the Personal Representative of the above-referenced estate on (date you got property) __________________. I declare under penalty of perjury under the laws of the State of Nevada that the foregoing is true and correct. Dated: (today’s date) __________________ _____________________________ (Signature) _____________________________ (Your printed name)

Receipt Fillable

1 of 4 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 4/11/17 Civil Law Self-Help Center PET _____________________________ (Name) _____________________________ (Address) _____________________________ (City, State, Zip Code) _____________________________ (Telephone number/E-mail Address) Petitioner, In Proper Person EIGHTH JUDICIAL DISTRICT COURT CLARK COUNTY, NEVADA In the Matter of the Estate of: _______________________________________, Deceased. Case No.: P Dept. No.: PC-1 EX PARTE PETITION FOR ORDER TO OPEN SAFE DEPOSIT BOX Petitioner, (your name) ___________________________________________, (hereinafter “Petitioner”) appearing in Proper Person, respectfully alleges and shows as follows: 1. Petitioner files this request pursuant to Nevada Revised Statutes 136.060, and requests that this Court enter an order authorizing (name of financial institution holding safe deposit box) ________________________ to open the safe deposit box rented by (name of person who passed away) _______________________________ (hereinafter “Decedent”) in the presence of Petitioner, for the purpose of inventorying the contents of the box and ascertaining if the Last Will of Decedent is contained inside the safe deposit box. 2. Petitioner is the (your relation to the decedent) ___________________ of Decedent and resides at (your address) _____________________________________________________________. 2 of 4 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 4/11/17 Civil Law Self-Help Center A copy of Petitioner’s identification is attached hereto as Exhibit A. 3. Decedent died on the (day, month, and year of death) ____________________________, in (county where the decedent died) _________________________ and, on the date of death, Decedent was a resident of Clark County, Nevada. A certified copy of Decedent’s death certificate is attached herein as Exhibit B. 4. The names, relationships, ages, and residence addresses of all the devisees, legatees, heirs, and next-of-kin of Decedent, so far as known to Petitioner, are: (You must include the name, relationship, age (if under 18), and address of (1) decedent’s legally married spouse, (2) all decedent’s children; (3) all other devisees, legatees, heirs, and next-of kin. List all persons, regardless of age, even if estranged or out of state. Include all addresses; if unknown, include last known address or state “unknown.”) Name Relationship to Decedent Age (If under 18, list age; if over 18, write “adult.”) Address Check here if you have more people to include, and attach a continuation sheet. 5. The devisees, legatees, heirs, and next-of-kin of Decedent who are listed above either consent to the opening of the safe deposit box, and I have attached the appropriate Consents to Open and Inventory Safe Deposit Box herein; or they have not consented, and an Affidavit in Support of Petition for Order to Open Safe Deposit Box explaining their lack of consent is herein attached as Exhibit C. 6. That on information and belief, Petitioner alleges that Decedent, at the time of death, was the holder of a safe deposit box at (name of financial institution where safe deposit box is) 3 of 4 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 4/11/17 Civil Law Self-Help Center ____________________________________________________ located at (address of financial institution) _____________________________________________________________________________. The box number is (box number) __________________ and the location of the key is (location of key): ___________________________________________________________. Petitioner believes that Decedent may have executed a Last Will and Testament, but that same has not been located among the Decedent’s personal effects, and would most probably be in the Decedent’s safe deposit box. WHEREFORE, Petitioner prays: 1. That the Court make and enter its order directing the officers of (name of financial institution) ________________________________________ to open the safe deposit box rented by Decedent, in the presence of Petitioner, for the purpose of inventorying the contents of the box and ascertaining if the Last Will of Decedent is contained therein; and 2. If such Will is found, directing that it be removed by Petitioner and deposited with the Clerk of this Court, and that such safe deposit box be then re-locked until such time as further ordered by the above-entitled Court. DATED THIS _____ day of _______________, 20___. Respectfully submitted, _____________________________ (signature) _____________________________ (Your name) _____________________________ (Your address) _____________________________ (Your city, state, and zip) _____________________________ (Your phone number) _____________________________ (Your email) PETITIONER, IN PROPER PERSON 4 of 4 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 4/11/17 Civil Law Self-Help Center VERIFICATION IN SUPPORT OF PETITION FOR ORDER TO OPEN SAFE DEPOSIT BOX STATE OF NEVADA ) )ss COUNTY OF CLARK ) (Your name) ________________________, being first duly sworn, declares under penalty of perjury under the law of the State of Nevada that the foregoing and following is true and correct: I am the Petitioner in the above-entitled action. I have read the foregoing Ex Parte Petition for Order to Open Safe Deposit Box, and know the contents thereof. The Petition is true of my own knowledge except as to those matters that are stated on information and belief, and as to those matters, I believe them to be true. DATED THIS _____ day of _______________, 20___. _____________________________ (signature) _____________________________ (Your name) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 4/11/17 Civil Law Self-Help Center _____________________________ (Name) _____________________________ (Address) _____________________________ (City, State, Zip Code) _____________________________ (Telephone number/E-mail Address) In Proper Person EIGHTH JUDICIAL DISTRICT COURT CLARK COUNTY, NEVADA In the Matter of the Estate of: ______________________________________, Deceased. Case No.: P Dept. No.: PC-1 CONSENT TO OPEN AND INVENTORY SAFE DEPOSIT BOX COMES NOW (your name) __________________________, (state your relationship to the Decedent) ________________________________, whose address is (your address) ___________________________________________________, being first duly sworn, declare under penalty of perjury that I am aware of the Ex Parte Petition for Order to Open Safe Deposit Box filed by (name of person who filed the petition) __________________________ requesting authority to open and inventory the contents of a safe deposit box owned by the decedent located at (name and address of financial institution where safe deposit box is) _____________________________________________________________________ _____________________________________________________________________________. I FURTHER ACKNOWLEDGE that I am in agreement with the request to open and inventory the safe deposit box. DATED THIS _____ day of _______________, 20___. Respectfully submitted, _____________________________ (signature) _____________________________ (Your name) 1 of 2 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 4/11/17 Civil Law Self-Help Center ORDR _____________________________ (Name) _____________________________ (Address) _____________________________ (City, State, Zip Code) _____________________________ (Telephone number/E-mail Address) Petitioner, In Proper Person EIGHTH JUDICIAL DISTRICT COURT CLARK COUNTY, NEVADA In the Matter of the Estate of: _______________________________________, Deceased. Case No.: P Dept. No.: PC-1 EX PARTE ORDER TO OPEN SAFE DEPOSIT BOX The Court, upon reading the verified ex-parte petition of (your name) __________________, and good cause appearing therefore: IT IS HEREBY ORDERED, ADJUDICATED AND DECREED: 1. That the Officers of the (name of financial institution) _____________________________ located at (address of financial institution) _______________________________________, shall open the safe deposit box rented by Decedent, (name of Decedent) ________________________, in the presence of Petitioner, (your name) ________________________, and the officers of the bank for the purpose of inventorying the contents of the box and to place a copy of the inventory in said safe deposit box, and ascertaining if the Last Will and Testament of the Decedent is contained therein; 2. That a copy of the inventory of the contents of the safe deposit box shall be filed with the Clerk of the above Court; and / / / 2 of 2 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 4/11/17 Civil Law Self-Help Center 3. That if the Last Will and Testament of the Decedent is found therein, Petitioner, (your name) ________________________, is directed to remove such Last Will and Testament and file the same with the Clerk of the above Court, and such safe deposit box shall then be re-locked and remain locked until further ordered by the Court. DATED this ____ day of ___________, 20_____. _______________________________ DISTRICT COURT JUDGE Respectfully submitted, _____________________________ (Signature) _____________________________ (Your name) PETITIONER, IN PROPER PERSON 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 4/11/17 Civil Law Self-Help Center EXHIBIT A (Petitioner’s Identification) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 4/11/17 Civil Law Self-Help Center EXHIBIT B (Death Certificate) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 4/11/17 Civil Law Self-Help Center EXHIBIT C (Consents and/or Affidavits in Support of Petition) County, Nevada Case No. I. Party Information (provide both home and mailing addresses if different) Plaintiff(s) (name/address/phone):Defendant(s) (name/address/phone): Attorney (name/address/phone):Attorney (name/address/phone): II. Nature of Controversy (please select the one most applicable filing type below) Landlord/TenantNegligenceOther Torts Unlawful DetainerAuto Product Liability Other Landlord/TenantPremises Liability Intentional Misconduct Title to Property Other Negligence Employment Tort Judicial ForeclosureMalpractice Insurance Tort Other Title to PropertyMedical/DentalOther Tort Other Real PropertyLegal Condemnation/Eminent DomainAccounting Other Real PropertyOther Malpractice Probate (select case type and estate value) Construction DefectJudicial Review Summary AdministrationChapter 40Foreclosure Mediation Case General AdministrationOther Construction DefectPetition to Seal Records Special AdministrationContract CaseMental Competency Set AsideUniform Commercial CodeNevada State Agency Appeal Trust/ConservatorshipBuilding and ConstructionDepartment of Motor Vehicle Other ProbateInsurance CarrierWorker's Compensation Estate ValueCommercial InstrumentOther Nevada State Agency Over $200,000Collection of AccountsAppeal Other Between $100,000 and $200,000Employment ContractAppeal from Lower Court Under $100,000 or UnknownOther ContractOther Judicial Review/Appeal Under $2,500 Civil WritOther Civil Filing Writ of Habeas CorpusWrit of ProhibitionCompromise of Minor's Claim Writ of MandamusOther Civil WritForeign Judgment Writ of Quo WarrantOther Civil Matters Signature of initiating party or representative Civil WritOther Civil Filing Date Business Court filings should be filed using the Business Court civil coversheet. DISTRICT COURT CIVIL COVER SHEET (Assigned by Clerk's Office) See other side for family-related case filings. Probate TortsReal Property Construction Defect & Contract Judicial Review/Appeal Civil Case Filing Types Nevada AOC - Research Statistics Unit Pursuant to NRS 3.275 Form PA 201 Rev 3.1

Safe Deposit Packet

1 of 6 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 @ Civil Law Self-Help Center Rev. 11/15/19 Rev. 11/15/19 PSWA _____________________________ (Name) _____________________________ (Address) _____________________________ (City, State, Zip Code) _____________________________ (Telephone number/Fax Number) _____________________________ (E-Mail address) Petitioner, Self-Represented EIGHTH JUDICIAL DISTRICT COURT CLARK COUNTY, NEVADA In the Matter of the Estate of: _______________________________________, Deceased. Case No.: P ________________ Dept. No.: PC-1 PETITION TO SET ASIDE ESTATE WITHOUT ADMINISTRATION Petitioner, (your name) ______________________________________________, appearing self-represented, hereby petitions the Court for an Order setting aside the estate of (name of person who passed away) _____________________________, Deceased, without administration pursuant to NRS 146.070. In support of this Petition, Petitioner respectfully states the following: 1. Petitioner is the (your relation to the decedent) ___________________ of Decedent and resides at (your address) _____________________________________________________________. A copy of Petitioner’s identification is attached hereto as Exhibit A. 2. Decedent died on the (day, month, and year of death) ____________________________, in (county where the decedent died)_________________________ and, on the date of death, Decedent was a 2 of 6 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 @ Civil Law Self-Help Center Rev. 11/15/19 Rev. 11/15/19 resident of (city and state where the decedent lived at time of death)_________________________. A certified copy of Decedent’s death certificate is attached herein as Exhibit B. 3. Jurisdiction is proper in this proceeding. 4. There is no record of a Last Will and Testament and, therefore, Petitioner believes the Decedent died intestate. 5. The Decedent left an estate in Clark County, Nevada, consisting of the following separate property: (List all the property in decedent’s estate, and be specific.  For bank accounts, CDs, stock certificates, etc., include the name of the financial institution & account number.  For vehicles, include year, make, model, & vehicle identification number (VIN).  List all personal property, including furniture, jewelry, cash, etc.  For real property (houses, land, etc.), include property street address, legal description, & assessor’s parcel number (APN). The “Estimated Gross Value” is the value of the property, before deductions. For example, it is the value of a house or a car without subtracting any liens or mortgages.) Type of Property & Description Estimated Gross Value The estimated values of the above assets were determined by the proofs of value attached as Exhibit C. 6. The gross value of the estate is (add up the numbers in the “Estimated Gross Value” column) $_______________. / / / / / / 3 of 6 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 @ Civil Law Self-Help Center Rev. 11/15/19 Rev. 11/15/19 7. At the date of Decedent’s death, there were liens and mortgages on the above property as follows: (List all secured debt—debt where if payments are not made, the lender or lienholder can take the property back. The most common lienholders are mortgage companies and car loan finance companies. Under the “Lienholder” column, list the names of the entities holding the liens or mortgages; under “Estimated Amount Owed,” list the estimated amount owed to each lienholder. Also include any liens and encumbrances that you might believe are unenforceable, and explain why you believe this.) Lienholder Estimated Amount Owed Proof of the above liens and mortgages is attached as Exhibit D. 8. The estimated value of Decedent’s property is (take the total “Estimated Gross Value” that you listed in #5 and subtract the estimated amounts owed above) $___________________. 9. At the date of Decedent’s death, Decedent owed the following unsecured debts: (List all unsecured debt—a debt that is not backed by some kind of asset or collateral. This generally includes credit card bills and medical bills. Under “Unsecured Creditor,” list the name of the entity to whom the debt is owed, and under “Estimated Amount Owed,” list the estimated amount owed.) Unsecured Creditor Estimated Amount Owed Proof of the above unsecured debts is attached as Exhibit E. / / / 4 of 6 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 @ Civil Law Self-Help Center Rev. 11/15/19 Rev. 11/15/19 10. The names, relationships, ages of minors, and residence addresses of all the devisees, legatees, heirs, and next-of-kin of Decedent, so far as known to Petitioner, are: (You must include the name, relationship, age (if under 18) and address of (1) decedent’s legally married spouse, (2) all decedent’s children; (3) all other devisees, legatees, heirs, and next-of kin. If there was no spouse, write “No spouse” or if the spouse is deceased, write “Spouse deceased.” If the Decedent did not have children, or had no living children at the time of death, write “No living children.” List all persons, regardless of age, even if estranged or out of state. Include all addresses; if unknown, include last known address or state “unknown.” Your information will go in the first set of boxes.) Name Relationship to Decedent Age (if under 18, list age; if over 18, write “adult.”) Address Your name here. Your relationship to decedent. Your age or “adult.” Your address. Check here if you have more people to include, and attach a continuation sheet. 11. The devisees, legatees, heirs, and next-of-kin of Decedent who are listed above will be noticed of the instant Petition; otherwise, an Affidavit in Support of Petition to Set Aside explaining their whereabouts is herein attached as Exhibit F. 12. The gross value of the Estate of Decedent, after deducting encumbrances, does not exceed $100,000.00, and therefore the estate may be set aside in its entirety pursuant to NRS 146.070(1) or pursuant to the laws of intestate succession and NRS 134. WHEREFORE, the Petitioner prays: 1. That the gross value of the Estate of Decedent, after deducting any encumbrances, does not exceed $100,000.00. / / / 5 of 6 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 @ Civil Law Self-Help Center Rev. 11/15/19 Rev. 11/15/19 2. That the Decedent’s estate be set aside in the following manner pursuant to NRS 146.070(1) or pursuant to the laws of intestate succession and NRS 134: (List all the people who you are asking to receive property, and in what percentage they’ll receive property, or what they will be receiving. For example, if you are asking that everything goes to you, you might say, “The entirety of the estate to John Doe.” Or if you want to split the estate between you and two others, you might say, “50% of the estate to John Doe and 50% of the estate to Bob Brown.” Or, if you can be more specific as to items, you might say, “The Chase Checking Account #123456 to John Doe; the 2014 Toyota Camry, VIN 123456, to Bob Brown; and the gold ring to Jane Doe.”) ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ _____________________________________________________________________________. 3. For all other necessary and proper orders. DATED THIS _____ day of _______________, 20___. Respectfully submitted, _____________________________ (signature) _____________________________ (Your name) _____________________________ (Your address) _____________________________ (Your city, state, and zip) _____________________________ (Your phone number) _____________________________ (Your email) PETITIONER, SELF-REPRESENTED 6 of 6 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 @ Civil Law Self-Help Center Rev. 11/15/19 Rev. 11/15/19 VERIFICATION IN SUPPORT OF PETITION TO SET ASIDE WITHOUT ADMINISTRATION STATE OF NEVADA ) )ss COUNTY OF CLARK ) (Your name)________________________, being first duly sworn, declares under penalty of perjury under the law of the State of Nevada that the foregoing and following is true and correct: I am the Petitioner in the above-entitled action. I have read the foregoing Petition to Set Aside without Administration, and that the same is true of my own knowledge, except for matters stated therein on information and belief, and as for those matters, I believe them to be true. DATED THIS _____ day of _______________, 20___. ___ __________________________ (Signature) _____________________________ (Your name) 1 of 2 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 @ Civil Law Self-Help Center Rev. 11/15/19 Rev. 11/15/19 NOHE _____________________________ (Name) _____________________________ (Address) _____________________________ (City, State, Zip Code) _____________________________ (Telephone number/Fax Number) _____________________________ (E-Mail address) Petitioner, Self-Represented EIGHTH JUDICIAL DISTRICT COURT CLARK COUNTY, NEVADA In the Matter of the Estate of: _______________________________________, Deceased. Case No.: P Dept. No.: PC-1 NOTICE OF HEARING RE: PETITION TO SET ASIDE ESTATE WITHOUT ADMINISTRATION PLEASE TAKE NOTICE that Petitioner, (your name) __________________________, filed with the Court a Petition Set Aside the Estate to (your name and names of any persons who will receive estate if your petition is granted) ______________________________________________________________________________ ______________________________________________________________________________ without Administration in the matter of the above-named Decedent; that a hearing on the Petition has been set for the ____ day of ___________, 20_____ , at the hour of 9:30 a.m., in the Probate Court, which is located at the Regional Justice Center at 200 Lewis Avenue, Las Vegas, NV 89155. 2 of 2 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 @ Civil Law Self-Help Center Rev. 11/15/19 Rev. 11/15/19 Further details concerning this Petition can be obtained by reviewing the Court file at the Office of the Clerk of Court at 200 Lewis Avenue in Las Vegas, Nevada, or by contacting the Petitioner(s) whose name, address, and telephone number is: (your name) __________________________________________________ (your address) __________________________________________________ (your city, state, zip) __________________________________________________ (your phone number) __________________________________________________ DATED this ____ day of ___________, 20_____. _____________________________ (Signature) _____________________________ (Your name) 1 of 2 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 @ Civil Law Self-Help Center Rev. 8/4/2021 Rev. 11/15/19 CERT _____________________________ (Name) _____________________________ (Address) _____________________________ (City, State, Zip Code) _____________________________ (Telephone number/Fax Number) _____________________________ (E-Mail address) Petitioner, Self-Represented EIGHTH JUDICIAL DISTRICT COURT CLARK COUNTY, NEVADA In the Matter of the Estate of: _______________________________________, Deceased. Case No.: P Dept. No.: PC-1 CERTIFICATE OF MAILING I HEREBY CERTIFY that service of the Notice of Hearing re: Petition Set Aside the Estate Without Administration was made this (day of mailing) ____ day of (month of mailing) ___________________, 20(year of mailing) _____, by depositing a copy of the same in the U.S. Mail, postage prepaid, regular mail, addressed to: (You are required by statute to mail a Notice of Hearing to Medicaid Estate Recovery, regardless of whether Decedent received Medicaid or not, or owed to Medicaid or not. You are also required to mail a Notice of Hearing to all beneficiaries, heirs, and creditors.) 1. HMS, on behalf of State of Nevada Dept. of Health and Human Services, Medicaid Estate Recovery, P.O. Box 12610 Reno, NV 89510 2 of 2 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 @ Civil Law Self-Help Center Rev. 8/4/2021 Rev. 11/15/19 (Include below the names and addresses of every entity and/or person you listed in Question #7, 9, & 10 of your Petition.) 2. __________________________________________________________________ 3. __________________________________________________________________ 4. __________________________________________________________________ 5. __________________________________________________________________ 6. __________________________________________________________________ 7. __________________________________________________________________ 8. __________________________________________________________________ 9. __________________________________________________________________ 10. __________________________________________________________________ DATED THIS _____ day of _______________, 20___. _____________________________ (Signature) _____________________________ (Your name) 1 of 3 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 @ Civil Law Self-Help Center Rev. 11/15/19 Rev. 11/15/19 OSEA _____________________________ (Name) _____________________________ (Address) _____________________________ (City, State, Zip Code) _____________________________ (Telephone number/Fax Number) _____________________________ (E-Mail address) Petitioner, Self-Represented EIGHTH JUDICIAL DISTRICT COURT CLARK COUNTY, NEVADA In the Matter of the Estate of: _______________________________________, Deceased. Case No.: P Dept. No.: PC-1 ORDER TO SET ASIDE ESTATE WITHOUT ADMINISTRATION It appearing to the satisfaction of the Court that a Petition to Set Aside the Estate Without Administration of the above named Decedent has been filed, and that notice of the time and place of the hearing thereon has been duly given in the manner prescribed by law, and that no one has objected or presented any reason why said Petition should not be granted. The Court finds that the gross value of the Nevada Estate of the Decedent, after deducting any encumbrances, does not exceed One Hundred Thousand Dollars ($100,000.00), and this is a proper case for the whole of the Estate to be set aside, pursuant to NRS 146.070(1) or pursuant to the laws of intestate succession and NRS 134. 2 of 3 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 @ Civil Law Self-Help Center Rev. 11/15/19 Rev. 11/15/19 IT IS HEREBY ORDERED, ADJUDICATED AND DECREED: 1.That the Nevada Estate of (decedent’s name) __________________________________, Decedent, is hereby found to include: (List, with specificity, all the property in decedent’s estate. For bank accounts, CDs, stock certificates, etc., include the name of the financial institution & account number. For vehicles, include year, make, model, & vehicle identification number (VIN). List all personal property, including furniture, jewelry, cash, etc. For real property (houses, land, etc.), include property street address, legal description, & assessor’s parcel number (APN). The “Estimated Gross Value” is the value of the property, before deductions. For example, it is the value of a house or a car without subtracting any liens or mortgages.) Type of Property & DescriptionEstimated Gross Value 2. That this Order shall be used as the document transferring the title to said property; and that Decedent’s Estate is hereby transferre d, assigned and set aside in the following manner: (List all the people who will receive property, and in what percentage they’ll receive property, or what they will be receiving. For example, if everything goes to you, you might say, “The entirety of the estate to John Doe.” Or if you want to split the estate between you and two others, you might say, “50% of the estate to John Doe and 50% of the estate to Bob Brown.” Or, if you can be more specific as to items, you might say, “The Chase Checking Account #123456 to John Doe; the 2014 Toyota Camry, VIN 123456, to Bob Brown; and the gold ring to Jane Doe.”) ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ _____________________________________________________________________________. / / / / / / 3 of 3 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 @ Civil Law Self-Help Center Rev. 11/15/19 Rev. 11/15/19 4. That said Estate shall not be further administered upon. DATED this ____ day of ___________, 20_____. _______________________________ DISTRICT COURT JUDGE Respectfully submitted, By: ___________________ (signature) ___________________ (print name) SELF-REPRESENTED 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 © 11/15/19 Civil Law Self-Help Center EXHIBIT A (Petitioner’s Identification) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 © 11/15/19 Civil Law Self-Help Center EXHIBIT B (Death Certificate) MAKE SURE YOU HAVE REDACTED THE DECEDENT’S SOCIAL SECURITY NUMBER!!! 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 © 11/15/19 Civil Law Self-Help Center EXHIBIT C (Proof of Value of Assets) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 © 11/15/19 Civil Law Self-Help Center EXHIBIT D (Proof of Value of Liens & Mortgages) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 © 11/15/19 Civil Law Self-Help Center EXHIBIT E (Proof of Unsecured Debts) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 © 11/15/19 Civil Law Self-Help Center EXHIBIT F (Affidavit in Support of Petition)

Set Aside Intestate Packet

1 of 6 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 11/21/19 Civil Law Self-Help Center PPW _____________________________ (Name) _____________________________ (Address) _____________________________ (City, State, Zip Code) _____________________________ (Telephone number/Fax Number) _____________________________ (E-Mail address) Petitioner, Self-Represented EIGHTH JUDICIAL DISTRICT COURT CLARK COUNTY, NEVADA In the Matter of the Estate of: _______________________________________, Deceased. Case No.: P ________________ Dept. No.: PC-1 PETITION TO PROVE WILL AND SET ASIDE ESTATE WITHOUT ADMINISTRATION Petitioner, (your name) ______________________________________________, appearing self-represented, hereby petitions the Court for an Order proving the Will and setting aside the estate of (name of person who passed away) _____________________________, Deceased, without administration pursuant to NRS 146.070. In support of this Petition, Petitioner respectfully states the following: 1. Petitioner is the (your relation to the decedent) ___________________ of Decedent and resides at (your address) _____________________________________________________________. A copy of Petitioner’s identification is attached hereto as Exhibit A. 2 of 6 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 11/21/19 Civil Law Self-Help Center 2. Decedent died on the (day, month, and year of death) ____________________________, in (county where the decedent died)_________________________ and, on the date of death, Decedent was a resident of (city and state where the decedent lived at time of death)_________________________. A certified copy of Decedent’s death certificate is attached herein as Exhibit B. 3. Jurisdiction is proper in this proceeding. 4. Petitioner believes that Decedent executed his/her Last Will and Testament on the (day, month, and year Will was executed or signed) ____ day of ____________, 20_____ , and the Will names the following devisees: (list all the people who are written in the Will to receive something) ______________________________________________________________________________ _____________________________________________________________________________. The original Will was filed with the Clerk of the Court on the (day, month, and year Will was filed) ____ day of ____________, 20____, and a copy of said Will is attached as Exhibit C. I believe the Will is valid based on the following (state all the evidence that you know that proves the Will is valid): ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ / / / / / / / / / / / / 3 of 6 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 11/21/19 Civil Law Self-Help Center 5. The Decedent left an estate in Clark County, Nevada, consisting of the following separate property: (List all the property in decedent’s estate, and be specific. • For bank accounts, CDs, stock certificates, etc., include the name of the financial institution & account number. • For vehicles, include year, make, model, & vehicle identification number (VIN). • List all personal property, including furniture, jewelry, cash, etc. • For real property (houses, land, etc.), include property street address, legal description, & assessor’s parcel number (APN). The “Estimated Gross Value” is the value of the property, before deductions. For example, it is the value of a house or a car without subtracting any liens or mortgages.) Type of Property & Description Estimated Gross Value Proof of the value of the above assets is attached as Exhibit D. 6. The gross value of the estate is (add up the numbers in the “Estimated Gross Value” column) $_______________. 7. At the date of Decedent’s death, there were liens and mortgages on the above property as follows: (List all secured debt—debt where if payments are not made, the lender or lienholder can take the property back. The most common lienholders are mortgage companies and car loan finance companies. Under the “Lienholder” column, list the names of the entities holding the liens or mortgages; under “Estimated Amount Owed,” list the estimated amount owed to each lienholder. Also include any liens and encumbrances that you might believe are unenforceable, and explain why you believe this.) Lienholder Estimated Amount Owed Proof of the above liens and mortgages is attached as Exhibit E. 4 of 6 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 11/21/19 Civil Law Self-Help Center 8. The estimated value of Decedent’s property is (take the total “Estimated Gross Value” that you listed in #5 and subtract the estimated amounts owed above) $___________________. 9. At the date of Decedent’s death, Decedent owed the following unsecured debts: (List all unsecured debt—a debt that is not backed by some kind of asset or collateral. This generally includes credit card bills and medical bills. Under “Unsecured Creditor,” list the name of the entity to whom the debt is owed, and under “Estimated Amount Owed,” list the estimated amount owed.) Unsecured Creditor Estimated Amount Owed Proof of the above unsecured debts is attached as Exhibit F. 10. The names, relationships, ages of minors, and residence addresses of all the devisees, legatees, heirs, and next-of-kin of Decedent, so far as known to Petitioner, are: (You must include the name, relationship, age (if under 18) and address of (1) decedent’s legally married spouse, (2) all decedent’s children; (3) all other devisees, legatees, heirs, and next-of kin. If there was no spouse, write “No spouse” or if the spouse is deceased, write “Spouse deceased.” If the Decedent did not have children, or had no living children at the time of death, write “No living children.” List all persons, regardless of age, even if estranged or out of state. Include all addresses; if unknown, include last known address or state “unknown.” Your information will go in the first set of boxes.) Name Relationship to Decedent Age (if under 18, list age; if over 18, write “adult.”) Address Your name here. Your relationship to decedent. Your age or “adult.” Your address. Check here if you have more people to include, and attach a continuation sheet. 5 of 6 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 11/21/19 Civil Law Self-Help Center 11. The devisees, legatees, heirs, and next-of-kin of Decedent who are listed above will be noticed of the instant Petition; otherwise, an Affidavit in Support of Petition to Set Aside explaining their whereabouts is herein attached as Exhibit G. 12. The gross value of the Estate of Decedent, after deducting encumbrances, does not exceed $100,000.00, and therefore the estate may be set aside in its entirety pursuant to NRS 146.070(1) or pursuant to NRS 146.070(2). WHEREFORE, the Petitioner prays: 1. That the Will be proved as the Last Will of the Decedent. 2. That the gross value of the Estate of Decedent, after deducting any encumbrances, does not exceed $100,000.00. 3. That the Decedent’s estate be set aside in the following manner pursuant to NRS 146.070(1) or pursuant to NRS 146.070(2): (List all the people who you are asking to receive property, and in what percentage they’ll receive property, or what they will be receiving. For example, if you are asking that everything goes to you, you might say, “The entirety of the estate to John Doe.” Or if you want to split the estate between you and two others, you might say, “50% of the estate to John Doe and 50% of the estate to Bob Brown.” Or, if you can be more specific as to items, you might say, “The Chase Checking Account #123456 to John Doe; the 2014 Toyota Camry, VIN 123456, to Bob Brown; and the gold ring to Jane Doe.”) ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ / / / / / / / / / 6 of 6 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 11/21/19 Civil Law Self-Help Center 4. For all other necessary and proper orders. DATED THIS _____ day of _______________, 20___. Respectfully submitted, _____________________________ (signature) _____________________________ (Your name) _____________________________ (Your address) _____________________________ (Your city, state, and zip) _____________________________ (Your phone number) _____________________________ (Your email) PETITIONER, SELF-REPRESENTED VERIFICATION IN SUPPORT OF PETITION TO PROVE WILL AND SET ASIDE WITHOUT ADMINISTRATION STATE OF NEVADA ) )ss COUNTY OF CLARK ) (Your name) ________________________, being first duly sworn, declares under penalty of perjury under the law of the State of Nevada that the foregoing and following is true and correct: I am the Petitioner in the above-entitled action. I have read the foregoing Petition to Prove Will and Set Aside without Administration, and that the same is true of my own knowledge, except for matters stated therein on information and belief, and as for those matters, I believe them to be true. DATED THIS _____ day of _______________, 20___. _____________________________ (signature) _____________________________ (Your name) 1 of 2 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 11/21/19 Civil Law Self-Help Center NOHE _____________________________ (Name) _____________________________ (Address) _____________________________ (City, State, Zip Code) _____________________________ (Telephone number/Fax Number) _____________________________ (E-Mail address) Petitioner, Self-Represented EIGHTH JUDICIAL DISTRICT COURT CLARK COUNTY, NEVADA In the Matter of the Estate of: _______________________________________, Deceased. Case No.: P Dept. No.: PC-1 NOTICE OF HEARING RE: PETITION TO PROVE WILL AND SET ASIDE ESTATE WITHOUT ADMINISTRATION PLEASE TAKE NOTICE that Petitioner, (your name) __________________________, filed with the Court a Petition to Prove Will and Set Aside the Estate to (your name and names of any persons who will receive estate if your petition is granted) ______________________________________________________________________________ ______________________________________________________________________________ without Administration in the matter of the above-named Decedent; that a hearing on the Petition has been set for the ____ day of ___________, 20_____ , at the hour of 9:30 a.m., in the Probate Court, which is located at the Regional Justice Center at 200 Lewis Avenue, Las Vegas, NV. / / / 2 of 2 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 11/21/19 Civil Law Self-Help Center Further details concerning this Petition can be obtained by reviewing the Court file at the Office of the Clerk of Court at 200 Lewis Avenue in Las Vegas, Nevada, or by contacting the Petitioner(s) or the attorney for the Petitioner(s) whose name, address, and telephone number is: (your name) __________________________________________________ (your address) __________________________________________________ (your city, state, zip) __________________________________________________ (your phone number) __________________________________________________ DATED this ____ day of ___________, 20_____. _____________________________ (signature) _____________________________ (Your name) 1 of 2 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 8/4/21 Civil Law Self-Help Center CERT _____________________________ (Name) _____________________________ (Address) _____________________________ (City, State, Zip Code) _____________________________ (Telephone number/Fax Number) _____________________________ (E-Mail address) Petitioner, Self-Represented EIGHTH JUDICIAL DISTRICT COURT CLARK COUNTY, NEVADA In the Matter of the Estate of: _______________________________________, Deceased. Case No.: P Dept. No.: PC-1 CERTIFICATE OF MAILING I HEREBY CERTIFY that service of the Notice of Hearing re: Petition to Prove Will and Set Aside the Estate Without Administration was made this (day of mailing) ____ day of (month of mailing) ___________________, 20(year of mailing) _____, by depositing a copy of the same in the U.S. Mail, postage prepaid, regular mail, addressed to: (You are required by statute to mail a Notice of Hearing to Medicaid Estate Recovery, regardless of whether Decedent received Medicaid or not, or owed to Medicaid or not. You are also required to mail a Notice of Hearing to all beneficiaries, heirs, and creditors.) 1. HMS, on behalf of State of Nevada Dept. of Health and Human Services, Medicaid Estate Recovery, P.O. Box 12610 Reno, NV 89510 2 of 2 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 8/4/21 Civil Law Self-Help Center (Include below the names and addresses of every entity and/or person you listed in Question #7, 9, & 10 of your Petition.) 2. __________________________________________________________________ 3. __________________________________________________________________ 4. __________________________________________________________________ 5. __________________________________________________________________ 6. __________________________________________________________________ 7. __________________________________________________________________ 8. __________________________________________________________________ 9. __________________________________________________________________ 10. __________________________________________________________________ DATED THIS _____ day of _______________, 20___. _____________________________ (Signature) _____________________________ (Your name) 1 of 2 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 4/11/17 Civil Law Self-Help Center OSEA _____________________________ (Name) _____________________________ (Address) _____________________________ (City, State, Zip Code) _____________________________ (Telephone number/E-mail Address) Petitioner, Self-Represented EIGHTH JUDICIAL DISTRICT COURT CLARK COUNTY, NEVADA In the Matter of the Estate of: _______________________________________, Deceased. Case No.: P Dept. No.: PC-1 ORDER TO PROVE WILL AND SET ASIDE ESTATE WITHOUT ADMINISTRATION It appearing to the satisfaction of the Court that a Petition to Prove Will and Set Aside The Estate Without Administration of the above named Decedent has been filed, and that notice of the time and place of the hearing thereon has been duly given in the manner prescribed by law, and that no one has objected or presented any reason why said Petition should not be granted. The Court finds that the gross value of the Nevada Estate of the Decedent, after deducting any encumbrances, does not exceed One Hundred Thousand Dollars ($100,000.00), and this is a proper case for the whole of the Estate to be set aside, pursuant to the Last Will and Testament of the Decedent and NRS 146.070(1) or pursuant to NRS 146.020(2). 2 of 2 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 4/11/17 Civil Law Self-Help Center IT IS HEREBY ORDERED, ADJUDICATED AND DECREED: 1. That the Will of the Decedent filed herein dated the (insert date of Will) ____ day of ______________, 20______, is hereby proved to be a legal and valid Will. 2. That the Nevada Estate of (decedent’s name) __________________________________, Decedent, is hereby found to include: (List, with specificity, all the property in decedent’s estate. • For bank accounts, CDs, stock certificates, etc., include the name of the financial institution & account number. • For vehicles, include year, make, model, & vehicle identification number (VIN). • List all personal property, including furniture, jewelry, cash, etc. • For real property (houses, land, etc.), include property street address, legal description, & assessor’s parcel number (APN). • The “Estimated Gross Value” is the value of the property, before deductions. For example, it is the value of a house or a car without subtracting any liens or mortgages.) Type of Property & Description Estimated Gross Value 3. That this Order shall be used as the document transferring the title to said property; and that Decedent’s Estate is hereby transferred, assigned and set aside in the following manner: (List all the people who will receive property, and in what percentage they’ll receive property, or what they will be receiving. For example, if everything goes to you, you might say, “The entirety of the estate to John Doe.” Or if you want to split the estate between you and two others, you might say, “50% of the estate to John Doe and 50% of the estate to Bob Brown.” Or, if you can be more specific as to items, you might say, “The Chase Checking Account #123456 to John Doe; the 2014 Toyota Camry, VIN 123456, to Bob Brown; and the gold ring to Jane Doe.”) ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ _____________________________________________________________________________. / / / 3 of 2 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 4/11/17 Civil Law Self-Help Center 4. That said Estate shall not be further administered upon. DATED this ____ day of ___________, 20_____. _______________________________ DISTRICT COURT JUDGE Respectfully submitted, By: ___________________ (Signature) ___________________ (Print name) SELF-REPRESENTED 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 11/21/19 Civil Law Self-Help Center EXHIBIT A (Petitioner’s Identification) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 11/21/19 Civil Law Self-Help Center EXHIBIT B (Death Certificate) MAKE SURE YOU HAVE REDACTED THE DECEDENT’S SOCIAL SECURITY NUMBER!!! 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 11/21/19 Civil Law Self-Help Center EXHIBIT C (Last Will & Testament) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 11/21/19 Civil Law Self-Help Center EXHIBIT D (Proof of Value of Assets) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 11/21/19 Civil Law Self-Help Center EXHIBIT E (Proof of Liens & Mortgages) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 11/21/19 Civil Law Self-Help Center EXHIBIT F (Proof of Unsecured Debts) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 11/21/19 Civil Law Self-Help Center EXHIBIT G (Affidavit in Support of Petition)

Set Aside Testate Packet

Page 1 of 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 Name: ______________________ Address: ______________________ ______________________ Phone: ______________________ Email: ______________________ P etitioner, In Proper Person DISTRICT COURT CLARK COUNTY, NEVADA In the Matter of the Estate of: , Deceased. Case No.: P________________ Dept. No.: PC-1 AFFIDAVIT/DECLARATION IN SUPPORT OF _____________________________________________________________ I, __________________, declare under penalty of perjury under the law of the State of Nevada that I am over 18 years of age and state the following:_____________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ _____________________________________________________________________________. DATED this ______ day of _________________________, 20___. _____________________________________________ (signature) Petitioner

Probate Generic Affidavit Fillable Secured

1 of 5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 4/11/17 Civil Law Self-Help Center PET _____________________________ (Name) _____________________________ (Address) _____________________________ (City, State, Zip Code) _____________________________ (Telephone number/E-mail Address) Petitioner, In Proper Person EIGHTH JUDICIAL DISTRICT COURT CLARK COUNTY, NEVADA In the Matter of the Estate of: _______________________________________, Deceased. Case No.: P Dept. No.: PC-1 PETITION FOR SPECIAL LETTERS OF ADMINISTRATION 1. Petitioner, (your name) ___________________________________________, (hereinafter “Petitioner”) appearing in Proper Person, respectfully alleges and shows as follows: 2. Petitioner files this request pursuant to Nevada Revised Statutes Chapter 140, and requests that this Court enter an order authorizing the appointment of a Special Administrator over the estate of (name of person who passed away)_______________________________ (hereinafter “Decedent”). 3. Petitioner is the (your relation to the decedent) ___________________ of Decedent, is is not over the age of 18 years of age, is is not a resident of the State of Nevada, and resides at (your address) _____________________________________________________________. A copy of Petitioner’s identification is attached hereto as Exhibit A. 2 of 5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 4/11/17 Civil Law Self-Help Center 4. Decedent, (person who died) __________________________________, died on (day, month, and year of death) ___________________________. A certified copy of Decedent’s death certificate is attached as Exhibit B. 5. The Decedent was at the time of death, a resident of the County of Clark, State of Nevada. Decedent’s estate consists of real and/or personal property, and the exact value and character of said property has not been determined. 6. Decedent knows of no other person authorized to care for the property belonging to the estate. Because there is danger of the property being neglected and greatly damaged, Petitioner requests that an appointment of a special administrator be made to take charge of and care for the property of the estate. 7. Special Administration is needed for the following reason(s): (state why you need to be appointed Special Administrator) ______________________________________________________________________________ ______________________________________________________________________________ _____________________________________________________________________________. 8. Petitioner is willing to act as Special Administrator of the estate to ascertain the assets and protect the same and for the reasons stated in Number 3 above. 9. Petitioner (check one) has has never been convicted of a felony. Petitioner is qualified under NRS 139.010 to serve as Special Administrator of the Estate. / / / / / / 3 of 5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 4/11/17 Civil Law Self-Help Center 10. The names, relationships, ages, and residence addresses of all the devisees, legatees, heirs, and next-of-kin of Decedent, so far as known to Petitioner, are: (You must include the name, relationship, age (if under 18) and address of (1) decedent’s legally married spouse, (2) all decedent’s children; (3) all other devisees, legatees, heirs, and next-of kin. List all persons, regardless of age, even if estranged or out of state. Include all addresses; if unknown, include last known address or state “unknown.”) Name Relationship to Decedent Age (If under 18, list age; if over 18, write “adult.”) Address Check here if you have more people to include, and attach a continuation sheet. 11. The devisees, legatees, heirs, and next-of-kin of Decedent who are listed above either consent to the appointment of Special Administrator, and I have attached the appropriate Nomination of Special Administrator herein; or they have not consented, and an Affidavit in Support of Petition for Order Appointing Special Administrator explaining their lack of consent is herein attached as Exhibit C. / / / / / / 4 of 5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 4/11/17 Civil Law Self-Help Center WHEREFORE, Petitioner prays that he/she be appointed Special Administrator of the Estate of (name of person who passed away) ________________________, deceased, with all liquid assets placed in a blocked account, with authority to take possession of said property, and specifically to: (state actions you plan to take as special administrator) ______________________________________________________________________________ _____________________________________________________________________________. DATED this ______ day of ______________________, 20____. Respectfully submitted, _____________________________ (signature) _____________________________ (Your name) _____________________________ (Your address) _____________________________ (Your city, state, and zip) _____________________________ (Your phone number) _____________________________ (Your email) PETITIONER, IN PROPER PERSON 5 of 5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 4/11/17 Civil Law Self-Help Center VERIFICATION IN SUPPORT OF PETITION FOR SPECIAL LETTERS OF ADMINISTRATION STATE OF NEVADA ) )ss COUNTY OF CLARK ) (Your name)________________________, being first duly sworn, declares under penalty of perjury under the law of the State of Nevada that the foregoing and following is true and correct: I am the Petitioner in the above-entitled action. I have read the foregoing Petition for Special Letters of Administration, and know the contents thereof. The Petition is true of my own knowledge except as to those matters that are stated on information and belief, and as to those matters, I believe them to be true. DATED THIS _____ day of _______________, 20___. _____________________________ (Signature) _____________________________ (Your name) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 4/11/17 Civil Law Self-Help Center LETT EIGHTH JUDICIAL DISTRICT COURT CLARK COUNTY, NEVADA In the Matter of the Estate of: _______________________________________, Deceased. Case No.: P Dept. No.: PC-1 LETTERS OF SPECIAL ADMINISTRATION On the (insert date of Order Appointing Special Administrator) _____ day of ____________________, 20_____, the Court entered an Order appointing (your name) __________________________________________ as Special Administrator of the Decedent’s Estate. The Order includes: A directive for no bond; A directive for the establishment of blocked accounts; A directive for the posting of bond in the sum of $_______________; or A directive for both the establishment of blocked accounts for sums in excess of $_______________ and the posting of bond in the sum of $_______________. The Special Administrator, having duly qualified, may act and has the authority and duties of Special Administrator. In testimony of which, I have this date signed these Letters and affixed the seal of the Court. CLERK OF COURT By: ____________________________________ Deputy Clerk Date OATH I, (your name) _________________________, whose mailing address is (your address) ____________________________________________________________________, solemnly affirm that I will faithfully perform according to law the duties of Special Administrator and that all matters stated in any petition or paper filed with the Court by me are true of my own knowledge or, if any matters are stated on information and belief, I believe them to be true. ___________________________________________ ADMINISTRATOR SUBSCRIBED AND AFFIRMED before me this _______ day of ____________________, 20____. County of _______________ State of _________ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 4/11/17 Civil Law Self-Help Center _____________________________ (Name) _____________________________ (Address) _____________________________ (City, State, Zip Code) _____________________________ (Telephone number/E-mail Address) In Proper Person EIGHTH JUDICIAL DISTRICT COURT CLARK COUNTY, NEVADA In the Matter of the Estate of: _______________________________________, Deceased. Case No.: P Dept. No.: PC-1 NOMINATION OF SPECIAL ADMINISTRATOR I, (your name) __________________________, (your relationship to decedent) _________________ of decedent, whose address is (address) _________________________________________________ declare under penalty of perjury that I hereby nominate (name of Petitioner) _____________________, who resides at (Petitioner’s address) _____________________________________________________, to serve as Special Administrator of the Estate of (decedent’s name)___________________________. DATED THIS _____ day of _______________, 20___. Respectfully submitted, _____________________________ (signature) _____________________________ (Your name) 1 of 2 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 4/11/17 Civil Law Self-Help Center ORDR _____________________________ (Name) _____________________________ (Address) _____________________________ (City, State, Zip Code) _____________________________ (Telephone number/E-mail Address) Petitioner, In Proper Person EIGHTH JUDICIAL DISTRICT COURT CLARK COUNTY, NEVADA In the Matter of the Estate of: _______________________________________, Deceased. Case No.: P Dept. No.: PC-1 ORDER APPOINTING SPECIAL ADMINISTRATOR Upon submission of a verified Ex Parte Petition for Appointment of Special Administrator and for Issuance of Special Letters of Administration, representing as follows: 1. That Decedent, (name of person who died) ______________________________________, died intestate on the (day, month, and year of death) __________________________, in the County of Clark, State of Nevada. 2. That Decedent was a resident of Clark County, Nevada, at the time of their death. NOW, THEREFORE, IT IS HEREBY ORDERED that (your name) _________________ __________________________ is appointed as Special Administrator and that Special Letters of Administration be issued, without bond, to the Petitioner, (your name) ________________________, upon taking the oath of office, for the purpose of administering the estate in accordance with 2 of 2 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 4/11/17 Civil Law Self-Help Center Nevada Revised Statutes Chapter 140.040, which provides as follows: NRS 140.040 Powers, duties and immunity from liability for certain claims. 1. A special administrator shall: (a) Collect and preserve for the executor or administrator when appointed all the goods, chattels and receivables of the decedent, and all incomes, rents, issues, profits, claims and demands of the estate. (b) Take charge and management of the real property and enter upon and preserve it from damage, waste and injury. 2. A special administrator may: (a) For all necessary purposes, commence, maintain or defend actions and other legal proceedings as a personal representative. (b) Without prior order of the court, sell any perishable property of the estate, as provided in NRS 148.170 . (c) Exercise such other powers as have been conferred by the order of appointment. (d) Obtain leave of the court to borrow money or to lease or mortgage real property in the same manner as an executor or administrator. 3. A special administrator is not liable: (a) To any creditor on any claim against the estate; or (b) For any claim against the decedent except a claim involving wrongful death, personal injury or property damage if the estate contains no assets other than a policy of liability insurance. IT IS FURTHER ORDERED: (check one box) All moneys received by this estate will be placed in a blocked account until further order by the court and proof of the blocked account shall be filed with the court within thirty (30) days from the date of entry of this court order. All moneys received by this estate will be placed in the attorney’s trust account until further order by the court. IT IS FURTHER ORDERED that any settlements of any lawsuits affecting the Decedent’s estate are subject to this court’s approval. DATED this ____ day of ___________, 20_____. _______________________________ DISTRICT COURT JUDGE Respectfully submitted, _____________________________ (signature) _____________________________ (Your name) PETITIONER, IN PROPER PERSON 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 4/11/17 Civil Law Self-Help Center EXHIBIT A (Petitioner’s Identification) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 4/11/17 Civil Law Self-Help Center EXHIBIT B (Death Certificate) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 4/11/17 Civil Law Self-Help Center EXHIBIT C (Nominations and/or Affidavits in Support of Petition) County, Nevada Case No. I. Party Information (provide both home and mailing addresses if different) Plaintiff(s) (name/address/phone):Defendant(s) (name/address/phone): Attorney (name/address/phone):Attorney (name/address/phone): II. Nature of Controversy (please select the one most applicable filing type below) Landlord/TenantNegligenceOther Torts Unlawful DetainerAuto Product Liability Other Landlord/TenantPremises Liability Intentional Misconduct Title to Property Other Negligence Employment Tort Judicial ForeclosureMalpractice Insurance Tort Other Title to PropertyMedical/DentalOther Tort Other Real PropertyLegal Condemnation/Eminent DomainAccounting Other Real PropertyOther Malpractice Probate (select case type and estate value) Construction DefectJudicial Review Summary AdministrationChapter 40Foreclosure Mediation Case General AdministrationOther Construction DefectPetition to Seal Records Special AdministrationContract CaseMental Competency Set AsideUniform Commercial CodeNevada State Agency Appeal Trust/ConservatorshipBuilding and ConstructionDepartment of Motor Vehicle Other ProbateInsurance CarrierWorker's Compensation Estate ValueCommercial InstrumentOther Nevada State Agency Over $200,000Collection of AccountsAppeal Other Between $100,000 and $200,000Employment ContractAppeal from Lower Court Under $100,000 or UnknownOther ContractOther Judicial Review/Appeal Under $2,500 Civil WritOther Civil Filing Writ of Habeas CorpusWrit of ProhibitionCompromise of Minor's Claim Writ of MandamusOther Civil WritForeign Judgment Writ of Quo WarrantOther Civil Matters Signature of initiating party or representative Civil WritOther Civil Filing Date Business Court filings should be filed using the Business Court civil coversheet. DISTRICT COURT CIVIL COVER SHEET (Assigned by Clerk's Office) See other side for family-related case filings. Probate TortsReal Property Construction Defect & Contract Judicial Review/Appeal Civil Case Filing Types Nevada AOC - Research Statistics Unit Pursuant to NRS 3.275 Form PA 201 Rev 3.1

Special Administrator Packet

Page 1 of 4 For forms and information, visit www. civillawselfhelpcenter.org 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 28 © 9/26/18 Civil Law Self-Help Center SR _____________________________ (Name) _____________________________ (Address) _____________________________ (City, State, Zip Code) _____________________________ (Telephone number) _____________________________ (Fax number/E-mail address) Personal Representative, In Proper Person Other _______________, In Proper Person EIGHTH JUDICIAL DISTRICT COURT CLARK COUNTY, NEVADA In the Matter of the Estate of: _______________________________________, Deceased. Case No.: P _________________ Dept. No.: PC-1 STATUS REPORT OF PERSONAL REPRESENTATIVE/ADMINISTRATOR PURSUANT TO NRS 143.035 AND REQUEST TO CLOSE CASE Pursuant to NRS 143.035, the Personal Representative/Administrator is required to file a report explaining why the estate has not been closed within 6 months after the personal representative’s appointment, where no federal estate tax return is required; or within 18 months after the personal representative’s appointment, where a federal estate tax return is required to be filed for the estate. 1. Petitioner was appointed the Personal Representative/Administrator by this court on (date order of appointment was filed) ______________ and Letters of Administration/Testamentary (the “Letters”) were subsequently issued on (date Letters were issued by the court)________________. Page 2 of 4 For forms and information, visit www. civillawselfhelpcenter.org 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 28 © 9/26/18 Civil Law Self-Help Center 2. Petitioner sought the appointment and obtained the Letters for the purpose of (briefly describe the reason you wanted to be appointed the personal representative/administrator of the estate and nature of the assets, debts, claims, etc. that you were aware of at the time you sought the appointment): ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 3. Attached and incorporated into this Report as Exhibit A is an Inventory, Appraisal, and/or Record of Value outlining the assets, debts, claims, etc. of the above- referenced estate. 4. Petitioner took the following steps/actions to administer the above-referenced estate (briefly describe the steps/actions you have taken as personal representative/administrator to identify, collect, marshal, distribute, transfer, pay, and/or administer the assets, debts, claims (for and against the estate), etc. Please attach a separate sheet if necessary): ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 5. Petitioner requests that the court issue an order statistically closing the case and understands that such closure will not release Petitioner from any liability related to the actions she/he took, or failed to take, as the personal representative/administrator in this matter. In support of closure, the Petitioner states (describe the reason why the court should close the above-referenced matter): ______________________________________________________________________________ ______________________________________________________________________________ Page 3 of 4 For forms and information, visit www. civillawselfhelpcenter.org 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 28 © 9/26/18 Civil Law Self-Help Center ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ I declare under penalty of perjury under the law of the State of Nevada that the foregoing is true and correct. DATED THIS _____ day of _______________, 20___. _____________________________ (Signature) _____________________________ (Your name) Page 4 of 4 For forms and information, visit www. civillawselfhelpcenter.org 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 28 © 9/26/18 Civil Law Self-Help Center EXHIBIT A (Inventory, Appraisal, and/or Record of Value)

Status Request To Close Fillable

1 of 6 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 11/21/19 Civil Law Self-Help Center PPRO _____________________________ (Name) _____________________________ (Address) _____________________________ (City, State, Zip Code) _____________________________ (Telephone number/Fax Number) _____________________________ (E-Mail address) Petitioner, Self-Represented EIGHTH JUDICIAL DISTRICT COURT CLARK COUNTY, NEVADA In the Matter of the Estate of: _______________________________________, Deceased. Case No.: P Dept. No.: PC-1 EX PARTE PETITION FOR ORDER DIRECTING TRANSFER OF PROPERTY UNDER NRS 146.080 Petitioner, (your name) ___________________________________________, (hereinafter “Petitioner”) appearing self-represented, respectfully alleges and shows as follows: 1.Petitioner files this request pursuant to Nevada Revised Statutes 146.080, and requests that this Court enter an order authorizing the transfer of property of the estate of (name of person who died) _______________________________ (hereinafter “Decedent”). 2.Petitioner is the (your relation to the decedent) ___________________ of Decedent and resides at (your address) _____________________________________________________________. A copy of Petitioner’s identification is attached hereto as Exhibit A. 2 of 6 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 11/21/19 Civil Law Self-Help Center 3.Decedent died on the (day, month, and year of death) ____________________________, in (county where the decedent died) _________________________. At least forty days have passed since the date of death. On the date of death, Decedent was a resident of (city and state where the decedent lived at time of death) _________________________. A certified copy of Decedent’s death certificate is attached herein as Exhibit B. 4. Check one: a.Petitioner believes that Decedent did not execute a will. b.Petitioner believes Decedent executed his/her Last Will and Testament on the (day, month, and year Will was executed or signed) ____ day of ____________, 20_____, and the Will names the following devisees: (list all the people who are named to receive something under the Will) __________________________________________________________________ ________________________________________________________________. The original Will was filed with the Clerk of the Court on the (day, month, and year Will was filed) ____ day of ____________, 20____, and a copy of said Will is attached as Exhibit C. 5.The Decedent left an estate in Clark County, Nevada, consisting of the following separate property: ( List all the property in decedent’s estate, and be specific. For bank accounts, CDs, stock certificates, etc., include the name of the financial institution & account number. List all personal property, including furniture, jewelry, cash, etc.) Type of Property & DescriptionEstimated Gross Value 3 of 6 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 11/21/19 Civil Law Self-Help Center The estimated values of the Decedent’s assets were determined by the proofs of value attached as Exhibit D. 6.At the date of Decedent’s death, there were liens and mortgages as follows: (List all the liens and mortgages of record on the date of Decedent’s death. This is all secured debt—debt where if payments are not made, the lender or lienholder can take the property back. The most common lienholders that are not related to real property are car loan finance companies. Under the “Lienholder” column, list the names of the entities holding the liens; under “Estimated Amount of Lien/Mortgage,” list the estimated amount owed to each lienholder.) LienholderEstimated Amount of Lien/Mortgage Proof of the above liens and mortgages is attached as Exhibit E. 7.The estimated value of Decedent’s property is (list the total estimate of the value of all the property of Decedent) $___________________. / / / / / / / / / / / / / / / 4 of 6 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 11/21/19 Civil Law Self-Help Center 8.The names, relationships, ages of minors, and residence addresses of all the devisees, legatees, heirs, and next-of-kin of Decedent, so far as known to Petitioner, are: (You must include the name, relationship, age (if under 18) and address of (1) decedent’s legally married spouse, (2) all decedent’s children; (3) all other devisees, legatees, heirs, and next-of kin. List all persons, regardless of age, even if estranged or out of state. Include all addresses; if unknown, include last known address or state “unknown.” Your information will go in the first set of boxes.) Name Relationship to Decedent Age (if under 18, list age; if over 18, write “adult.”) Address Your name here. Your relationship to decedent. Your age. Your address. Check here if you have more people to include, and attach a continuation sheet. 9.Pursuant to NRS 146.080, the following information regarding my relationship to Decedent and the Decedent’s property, to the best of Petitioner’s knowledge, is as follows: a.I am the surviving spouse of the decedent and the gross value of the estate, excluding the value of any motor vehicles registered to decedent, is not more than $100,000.00. b.I am not the surviving spouse of the decedent, and the gross value of the estate, excluding the value of any motor vehicles registered to decedent, is not more than $25,000.00. 10.Pe titioner attaches the Affidavit of Entitlement for Estate pursuant to NRS 146.080 as Exhibit F. / / / / / / 5 of 6 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 11/21/19 Civil Law Self-Help Center 11.It is appropriate that the Decedent’s property be distributed as stated in the Affidavit of Entitlement to Estate and in the following manner pursuant to NRS 146.080: (List all the people who you are asking to receive property, and in what percentage they’ll receive property, or what they will be receiving. For example, if you are asking that everything goes to you, you might say, “The entirety of the estate to John Doe.” Or if you want to split the estate between you and two others, you might say, “50% of the estate to John Doe and 50% of the estate to Bob Brown.” Or, if you can be more specific as to items, you might say, “The Chase Checking Account #123456 to John Doe and the gold ring to Jane Doe.”) ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ _____________________________________________________________________________. WHEREFORE, Petitioner prays: 1. That this Court find that the gross value of Decedent’s estate does not exceed $100,000, excluding the value of motor vehicles registered to Decedent, if Petitioner is the spouse of Decedent; or that the gross value of the Decedent’s estate does not exceed $25,000, excluding the value of motor vehicles registered to Decedent, if Petitioner is not the spouse of Decedent; and 2. That at least forty days have passed since the date of Decedent’s death, 3. That the Court issue an order directing the transfer of the Decedent’s property estate be transferred as follows: (List all the people who you are asking to receive property, and in what percentage they’ll receive property, or what they will be receiving. For example, if you are asking that everything goes to you, you might say, “The entirety of the estate to John Doe.” Or if you want to split the estate between you and two others, you might say, “50% of the estate to John Doe and 50% of the estate to Bob Brown.” Or, if you can be more specific as to items, you might say, “The Chase Checking Account #123456 to John Doe and and the gold ring to Jane Doe.”) ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ _____________________________________________________________________________. 6 of 6 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 11/21/19 Civil Law Self-Help Center 4. For such other and further relief as the Court deems just and proper. DATED THIS _____ day of _______________, 20___. Respectfully submitted, _____________________________ (Signature) _____________________________ (Your name) _____________________________ (Your address) _____________________________ (Your city, state, and zip) _____________________________ (Your phone number) _____________________________ (Your email) PETITIONER, SELF-REPRESENTED VERIFICATION IN SUPPORT OF EX PARTE PETITION FOR ORDER DIRECTING TRANSFER OF PROPERTY UNDER NRS 146.080 STATE OF NEVADA ) )ss COUNTY OF CLARK ) (Your name)________________________, being first duly sworn, declares under penalty of perjury under the law of the State of Nevada that the foregoing and following is true and correct: I am the Petitioner in the above-entitled action. I have read the foregoing Ex Parte Petition for Order Directing Transfer of Property Under NRS 146.080, and know the contents thereof. The Petition is true of my own knowledge except as to those matters that are stated on information and belief, and as to those matters, I believe them to be true. DATED THIS _____ day of _______________, 20___. _____________________________ (Signature) _____________________________ (Your name) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 11/21/19 Civil Law Self-Help Center ODTP _____________________________ (Name) _____________________________ (Address) _____________________________ (City, State, Zip Code) _____________________________ (Telephone number/Fax Number) _____________________________ (E-Mail address) Petitioner, Self-Represented EIGHTH JUDICIAL DISTRICT COURT CLARK COUNTY, NEVADA In the Matter of the Estate of: _______________________________________, Deceased. Case No.: P Dept. No.: PC-1 EX PARTE ORDER DIRECTING TRANSFER OF PROPERTY This Court, upon review of the verified ex parte petition of (your name) _______________________ in the above-entitled matter, having considered the Petition and examined the evidence, and being fully advised, finds: 1. Under the provisions of NRS 146.080(6), no notice of hearing is required by law; 2.The facts alleged in the Petition are true and correct; 3.At least forty days have passed since the death of the above-named Decedent; 4.Petitioner is the spouse of the Decedent, and the gross value of Decedent’s estate does not exceed $100,000.00 excluding the value of motor vehicles registered to Decedent; or Petitioner is not the spouse of the Decedent, and the gross value of Decedent’s estate does not exceed $25,000.00 excluding the value of motor vehicles registered to Decedent. 5.The Ex Parte Petition for Order Directing Transfer of Property ought to be granted. 1 of 2 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 11/21/19 Civil Law Self-Help Center IT IS HEREBY ORDERED, ADJUDICATED AND DECREED: 1.That the Nevada Estate of (decedent’s name) __________________________________, Decedent, is hereby found to include: (List, with specificity, all the property in decedent’s estate. For bank accounts, CDs, stock certificates, etc., include the name of the financial institution & account number. List all personal property, including furniture, jewelry, cash, etc.) Type of Property & DescriptionEstimated Gross Value 2.That this Order shall be used as the document transferring the title to said property; and he Decedent’s property be distributed as stated in the Affidavit of Entitlement to Estate and in the following manner pursuant to NRS 146.080: (Lis t all the people who will receive property, and in what percentage they’ll receive property, or what they will be receiving. For example, if everything goes to you, you might say, “The entirety of the estate to John Doe.” Or if you want to split the estate between you and two others, you might say, “50% of the estate to John Doe and 50% of the estate to Bob Brown.” Or, if you can be more specific as to items, you might say, “The Chase Checking Account #123456 to John Doe and the gold ring to Jane Doe.”) ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ _____________________________________________________________________________. DAT ED this ____ day of ___________, 20_____. _______________________________ DI STRICT COURT JUDGE Respectfully submitted, _____________________________ (Signature) _____________________________ (Your name) PETITIONER, SELF-REPRESENTED 2 of 2 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 11/21/19 Civil Law Self-Help Center EXHIBIT A (Petitioner’s Identification) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 11/21/19 Civil Law Self-Help Center EXHIBIT B (Decedent’s Death Certificate) MAKE SURE YOU HAVE REDACTED THE DECEDENT’S SOCIAL SECURITY NUMBER!!! 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 11/21/19 Civil Law Self-Help Center EXHIBIT C (Last Will & Testament) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 11/21/19 Civil Law Self-Help Center EXHIBIT D (Proof of Value of Assets) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 11/21/19 Civil Law Self-Help Center EXHIBIT E (Proof of Liens & Mortgages) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 11/21/19 Civil Law Self-Help Center EXHIBIT F (Affidavit of Entitlement for Estate)

Transfer Of Property Packet Fillable

Page 1 of 2 For forms and information, visit www. civillawselfhelpcenter.org 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 28 © 8/16/18 Civil Law Self-Help Center CERT _____________________________ (Name) _____________________________ (Address) _____________________________ (City, State, Zip Code) _____________________________ (Telephone number) _____________________________ (Fax number/E-mail Address) Personal Representative, In Proper Person Other _______________, In Proper Person EIGHTH JUDICIAL DISTRICT COURT CLARK COUNTY, NEVADA In the Matter of the Estate of: _______________________________________, Deceased. Case No.: P Dept. No.: PC-1 CERTIFICATE OF MAILING I HEREBY CERTIFY that service of the _________________________________(title of pleading/document) was made this (day of mailing) ____ day of (month of mailing) ___________________, 20(year of mailing) _____, by depositing a copy of the same in the U.S. Mail, postage prepaid, regular mail, addressed to: (Include below the names and addresses of every heir/ beneficiary to the estate under a purported will or through intestate succession, all known creditors, and any person/entity who has an interest in the above-captioned case) 1. __________________________________________________________________ 2. __________________________________________________________________ 3. __________________________________________________________________ 4. __________________________________________________________________ 5. __________________________________________________________________ 6. __________________________________________________________________ Page 2 of 2 For forms and information, visit www. civillawselfhelpcenter.org 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 28 © 8/16/18 Civil Law Self-Help Center 7. __________________________________________________________________ 8. __________________________________________________________________ 9. __________________________________________________________________ DATED THIS _____ day of _______________, 20___. _____________________________ (Signature) _____________________________ (Your name)

Generic Com Probate Fillable

1 of 2 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 © 9/25/18 Civil Law Self-Help Center MCSD _____________________________ (Name) _____________________________ (Address) _____________________________ (City, State, Zip Code) _____________________________ (Telephone number/E-mail Address) Petitioner, In Proper Person EIGHTH JUDICIAL DISTRICT COURT CLARK COUNTY, NEVADA In the Matter of the Estate of: _______________________________________, Deceased. Case No.: (insert older case)P __________ Dept. No.: PC-1 EX PARTE MOTION TO CONSOLIDATE CASES Petitioner, (your name) ___________________________________________, (hereinafter “Petitioner”) appearing in Proper Person, respectfully requests the consolidation of Case No. (insert newer case number) ________________ into Case No. (insert older case number) ________________. Two cases involving the above-referenced decedent were inadvertently filed. / / / / / / 2 of 2 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 © 9/25/18 Civil Law Self-Help Center WHEREFORE, Petitioner prays: 1. That the Court make and enter its order to consolidate Case No. (insert newer case number) ________________ into Case No. (insert older case number) ________________ and make Case No. ________________ the lead case. 2. For such other and further relief as the Court deems just and proper. DATED THIS _____ day of _______________, 20___. Respectfully submitted, _____________________________ (Signature) _____________________________ (Your name) _____________________________ (Your address) _____________________________ (Your city, state, and zip) _____________________________ (Your phone number) _____________________________ (Your email) PETITIONER, IN PROPER PERSON 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 © 9/25/18 Civil Law Self-Help Center ORDR _____________________________ (Name) _____________________________ (Address) _____________________________ (City, State, Zip Code) _____________________________ (Telephone number/E-mail Address) Petitioner, In Proper Person EIGHTH JUDICIAL DISTRICT COURT CLARK COUNTY, NEVADA In the Matter of the Estate of: _______________________________________, Deceased. Case No.: (insert older case)P __________ Dept. No.: PC-1 ORDER CONSOLIDATING CASES Based upon the ex parte motion of (your name) _______________________: IT IS ORDERED that Case No. (insert newer case number) ________________ is hereby consolidated into Case No. (insert older case number) ________________. Case No. (insert older case number) ________________ shall be the lead case. DATED this ____ day of ___________, 20_____. _______________________________ DISTRICT COURT JUDGE Respectfully submitted, _____________________________ (Signature) _____________________________ (Your name) PETITIONER, IN PROPER PERSON

Motion To Consolidate Packet Fillable

1 of 4 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 4/11/17 Civil Law Self-Help Center PET _____________________________ (Name) _____________________________ (Address) _____________________________ (City, State, Zip Code) _____________________________ (Telephone number/E-mail Address) Petitioner, In Proper Person EIGHTH JUDICIAL DISTRICT COURT CLARK COUNTY, NEVADA In the Matter of the Estate of: _______________________________________, Deceased. Case No.: P Dept. No.: PC-1 EX PARTE PETITION FOR ORDER OF CREMATION P etitioner, (your name) ___________________________________________, (hereinafter “Petitioner”) appearing in Proper Person, respectfully alleges and shows as follows: 1.Petitioner files this request pursuant to Nevada Revised Statutes Chapter 451, and requests that this Court enter an order authorizing (name of funeral home) ________________________ to cremate the human remains of (name of person who passed away)_______________________________ (hereinafter “Decedent”). 2.Petitioner is the (your relation to the decedent) ___________________ of Decedent and resides at (your address) _____________________________________________________________. A copy of Petitioner’s identification is attached hereto as Exhibit A. 2 of 4 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 4/11/17 Civil Law Self-Help Center 3.Decedent died on the (day, month, and year of death) ____________________________, in (county where the decedent died) _________________________ and, on the date of death, Decedent was a resident of Clark County, Nevada. 4.Decedent (check one) did not did execute a Last Will and Testament and/or an Order for Cremation and Disposition pursuant to NRS 451.655. If Decedent did execute either a Last Will and Testament or an Order for Cremation and Disposition, it is attached hereto as Exhibit B. 5.The names, relationships, ages, and residence addresses of all the devisees, legatees, heirs, and next-of-kin of Decedent, so far as known to Petitioner, are: (You must include the name, relationship, age (if under 18), and address of (1) decedent’s legally married spouse, (2) all decedent’s children; (3) all other devisees, legatees, heirs, and next-of kin. List all persons, regardless of age, even if estranged or out of state. Include all addresses; if unknown, include last known address or state “unknown.”) Name Relationship to Decedent Age (If under 18 , list age; if over 18, write “adult.”) Address Check here if you have more people to include, and attach a continuation sheet. 6.The devisees, legatees, heirs, and next-of-kin of Decedent who are listed above either consent to the cremation, and I have attached the appropriate Consents to Order of Cremation herein; or they have not consented, and an Affidavit in Support of Petition for Order of Cremation explaining their lack of consent is herein attached as Exhibit C. 3 of 4 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 4/11/17 Civil Law Self-Help Center 7. Petitioner is Decedent’s closest living relative and/or personal representative and has a right to control the disposition of the Decedent’s human remains. 8. There are no objections to cremation of the Decedent’s human remains. WHEREFORE, Petitioner prays: 1. That the Court make and enter its order directing the cremation of the human remains of (name of person who passed away)________________________; 2. For such other and further relief as the Court deems just and proper. DATED THIS _____ day of _______________, 20___. Respectfully submitted, _____________________________ (Signature) _____________________________ (Your name) _____________________________ (Your address) _____________________________ (Your city, state, and zip) _____________________________ (Your phone number) _____________________________ (Your email) PETITIONER, IN PROPER PERSON 4 of 4 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 4/11/17 Civil Law Self-Help Center VERIFICATION IN SUPPORT OF EX PARTE PETITION FOR ORDER OF CREMATION STATE OF NEVADA ) )ss COUNTY OF CLARK ) (Your name)________________________, being first duly sworn, declares under penalty of perjury under the law of the State of Nevada that the foregoing and following is true and correct: I am the Petitioner in the above-entitled action. I have read the foregoing Ex Parte Petition for Order of Cremation, and know the contents thereof. The Petition is true of my own knowledge except as to those matters that are stated on information and belief, and as to those matters, I believe them to be true. DATED THIS _____ day of _______________, 20___. _____________________________ (Signature) _____________________________ (Your name) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 4/11/17 Civil Law Self-Help Center _____________________________ (Name) _____________________________ (Address) _____________________________ (City, State, Zip Code) _____________________________ (Telephone number/E-mail Address) In Proper Person EIGHTH JUDICIAL DISTRICT COURT CLARK COUNTY, NEVADA In the Matter of the Estate of: _______________________________________, Deceased. Case No.: P Dept. No.: PC-1 CONSENT TO ORDER OF CREMATION COMES NOW (your name) _________________________________________, (state your relationship to the decedent) _________________ of Decedent, whose address is: (your address) ___________________________________________________, being first duly sworn, declare under penalty of perjury that I am aware of the Ex Parte Petition for Order for Cremation filed by (name of person who is filing the petition) _________________________________________ requesting cremation of the above decedent. I FURTHER ACKNOWLEDGE that I am in agreement with the request to cremate and hereby consent to the cremation. DATED THIS _____ day of _______________, 20___. Respectfully submitted, _____________________________ (Signature) _____________________________ (Your name) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 4/11/17 Civil Law Self-Help Center ORDR _____________________________ (Name) _____________________________ (Address) _____________________________ (City, State, Zip Code) _____________________________ (Telephone number/E-mail Address) Petitioner, In Proper Person EIGHTH JUDICIAL DISTRICT COURT CLARK COUNTY, NEVADA In the Matter of the Estate of: _______________________________________, Deceased. Case No.: P Dept. No.: PC-1 EX PARTE ORDER FOR CREMATION Based upon the ex-parte petition of (your name) _______________________ requesting this Court to enter an order permitting (name of funeral home)_____________________________________ to prepare the above-referenced Decedent’s remains for cremation, IT IS ORDERED that (name of funeral home) ________________________________________ is directed to cremate the Decedent’s remains in accordance with his/her last wishes. DATED this ____ day of ___________, 20_____. _______________________________ DISTRICT COURT JUDGE Respectfully submitted, _____________________________ (Signature) _____________________________ (Your name) PETITIONER, IN PROPER PERSON 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 4/11/17 Civil Law Self-Help Center EXHIBIT A (Petitioner’s Identification) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 4/11/17 Civil Law Self-Help Center EXHIBIT B (Last Will & Testament) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 4/11/17 Civil Law Self-Help Center 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © 4/11/17 Civil Law Self-Help Center EXHIBIT C (Consents and/or Affidavits in Support of Petition) County, Nevada Case No. I. Party Information (provide both home and mailing addresses if different) Plaintiff(s) (name/address/phone):Defendant(s) (name/address/phone): Attorney (name/address/phone):Attorney (name/address/phone): II. Nature of Controversy (please select the one most applicable filing type below) Landlord/TenantNegligenceOther Torts Unlawful DetainerAuto Product Liability Other Landlord/TenantPremises Liability Intentional Misconduct Title to Property Other Negligence Employment Tort Judicial ForeclosureMalpractice Insurance Tort Other Title to PropertyMedical/DentalOther Tort Other Real PropertyLegal Condemnation/Eminent DomainAccounting Other Real PropertyOther Malpractice Probate (select case type and estate value) Construction DefectJudicial Review Summary AdministrationChapter 40Foreclosure Mediation Case General AdministrationOther Construction DefectPetition to Seal Records Special AdministrationContract CaseMental Competency Set AsideUniform Commercial CodeNevada State Agency Appeal Trust/ConservatorshipBuilding and ConstructionDepartment of Motor Vehicle Other ProbateInsurance CarrierWorker's Compensation Estate ValueCommercial InstrumentOther Nevada State Agency Over $200,000Collection of AccountsAppeal Other Between $100,000 and $200,000Employment ContractAppeal from Lower Court Under $100,000 or UnknownOther ContractOther Judicial Review/Appeal Under $2,500 Civil WritOther Civil Filing Writ of Habeas CorpusWrit of ProhibitionCompromise of Minor's Claim Writ of MandamusOther Civil WritForeign Judgment Writ of Quo WarrantOther Civil Matters Signature of initiating party or representative Civil WritOther Civil Filing Date Business Court filings should be filed using the Business Court civil coversheet. DISTRICT COURT CIVIL COVER SHEET (Assigned by Clerk's Office) See other side for family-related case filings. Probate TortsReal Property Construction Defect & Contract Judicial Review/Appeal Civil Case Filing Types Nevada AOC - Research Statistics Unit Pursuant to NRS 3.275 Form PA 201 Rev 3.1

Cremation Packet Fillable

1 of 2 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © Civil Law Self-Help Center Rev. 4/13/2021 CRCL (Name) (Address) (City, State, Zip) (Telephone) (E-mail Address/Facsimile) DISTRICT COURT CLARK COUNTY, NEVADA In the Matter of the Estate of: Deceased. Case No.: P________________ Dept. No.: PC-1 CREDITOR’S CLAIM 1. I, (state your name) ______________________, am the creditor in the above-referenced matter. or: I, (state your name) ______________________, am not the creditor, but I am authorized to file and am doing so because (explain why you are filing and not the actual creditor) ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ 2 of 2 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 © Civil Law Self-Help Center Rev. 4/13/2021 2. Creditor presents a claim against the Estate of the above-named Decedent. a. The claim amount, without interest, is (state the amount of your claim without interest) $________ b. Interest (if no interest, leave this entire line blank) at the rate of _______ on the claim is $ _______ c. The total amount of the claim (claim + interest) is $_______ d. This claim is based on (describe claim and attach copies of supporting documentation) ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ 3. I affirm that the amount of the claim is justly due or is a just demand and will become due on the date set forth above; that all payments have been credited; that there are no offsets known to affiant which have been credited. 4. The address listed on page 1 is my mailing address. 5. I declare under penalty of perjury under the law of the State of Nevada that the foregoing is true and correct. DATED this ______ day of _________________________, 20___. _____________________________ (Signature) _____________________________ (Your name) STOP HERE. DO NOT FILL OUT BELOW THIS LINE. It is for the Personal Representative to complete. __________________________________________________________ The foregoing claim filed in the Estate of the above-named Decedent is: Rejected Allowed in the sum of $ ________. _____________________________ Personal Representative _____________________________ Date Creditor: If your claim is rejected, you have 20 days to petition the court or 60 days in which to file suit or the claim is forever barred. NRS 147.130.

Creditors Claim Fillable

1 of 4 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 © 9/26/18 Civil Law Self-Help Center PFDC _____________________________ (Name) _____________________________ (Address) _____________________________ (City, State, Zip Code) _____________________________ (Telephone number) _____________________________ (Fax number/E-mail Address) Personal Representative, In Proper Person Other _______________, In Proper Person EIGHTH JUDICIAL DISTRICT COURT CLARK COUNTY, NEVADA In the Matter of the Estate of: _______________________________________, Deceased. Case No.: P Dept. No.: PC-1 Date of Hearing: _________ Time of Hearing: _________ PETITION FOR ORDER OF DISCHARGE Petitioner, (your name) ___________________________________________, (hereinafter “Petitioner”) appearing in Proper Person, respectfully alleges and shows as follows: 1. Petitioner files this request pursuant to Nevada Revised Statutes 151.230, and requests that this Court enter an Order of Final Discharge, discharging the Personal Representative and closing this case. 2. Attached and incorporated in this Petition as Exhibit A is an Inventory, Appraisal, and/or Record of Value. 3. Petitioner (check whether you did/ did not distribute and/or administer the estate based on an order approving a final accounting and request for distribution) did did not administer the estate pursuant to an Order Approving Final Accounting and Distribution. 2 of 4 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 © 9/26/18 Civil Law Self-Help Center 4. A list of property distributed in this matter is as follows: (List all the property owned by the decedent, or in which decedent held an interest in, immediately preceding her/his death, including property that was transferred outside of probate, such as 401ks/ IRAs, jointly titled accounts/assets, property with transfer on death designations, beneficiary deeds/documents, etc. Be specific. List to whom the property was distributed. Then state what you are attaching to prove the person received the property, like a transfer document, receipt, or statement.) Description of Property and How Title Was Held Name the Person Who Received the Property Proof Attached 5. A list of the administrative expenses incurred/paid by the estate and creditor payments: (List all the administrative expenses and creditor claims incurred, paid, or accepted by the estate. Include proof of payment if expense/claim was paid.) Administrative Expenses/Creditor Description of expense/claim Proof of Payment Attached 3 of 4 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 © 9/26/18 Civil Law Self-Help Center 6. The following creditors filed claims in this matter but did not receive payment and will be noticed of this petition. (list all the creditors who filed claims but did/will not receive a payment from the estate) Creditor Name and Reason for Nonpayment WHEREFORE, Petitioner prays: 1. The Court enter an Order of Final Discharge, discharging the Personal Representative from any further duties, liabilities and responsibilities in relation to this case. 2. That the Court vacate the Letters issued to the Personal Representative in this case. 3. That the Court declare the estate to be fully distributed, settled, and closed. 4. For such other and further relief as the Court deems just and proper. DATED THIS _____ day of _______________, 20___. Respectfully submitted, _____________________________ (Signature) _____________________________ (Your name) _____________________________ (Your address) _____________________________ (Your city, state, and zip) _____________________________ (Your phone number) _____________________________ (Your fax number and/or email) PETITIONER, IN PROPER PERSON 4 of 4 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 © 9/26/18 Civil Law Self-Help Center VERIFICATION IN SUPPORT OF PETITION FOR ORDER OF DISCHARGE STATE OF NEVADA ) )ss COUNTY OF CLARK ) (Your name)________________________, being first duly sworn, declares under penalty of perjury under the law of the State of Nevada that the foregoing and following is true and correct: I am the Petitioner in the above-entitled action. I have read the foregoing Petition for Order of Discharge, and know the contents thereof. The Petition is true of my own knowledge except as to those matters that are stated on information and belief, and as to those matters, I believe them to be true. DATED THIS _____ day of _______________, 20___. _____________________________ (Signature) _____________________________ (Your name) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 © 9/26/18 Civil Law Self-Help Center EXHIBIT A (Inventory, Appraisal, and/or Record of Value) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 © 9/26/18 Civil Law Self-Help Center NOTC _____________________________ (Name) _____________________________ (Address) _____________________________ (City, State, Zip Code) _____________________________ (Telephone number) _____________________________ (Fax number/E-mail Address) Personal Representative, In Proper Person Other _______________, In Proper Person EIGHTH JUDICIAL DISTRICT COURT CLARK COUNTY, NEVADA In the Matter of the Estate of: _______________________________________, Deceased. Case No.: P Dept. No.: PC-1 NOTICE OF HEARING RE: PETITION FOR ORDER OF DISCHARGE PLEASE TAKE NOTICE that Petitioner, (your name) __________________________, filed with the Court a Petition for Order of Discharge in the matter of the above-named Decedent; that a hearing on the Petition has been set for the ____ day of ___________, 20_____, at the hour of 9:30 a.m., in the Probate Court, which is located at the Regional Justice Center at 200 Lewis Avenue, Las Vegas, NV 89155. DATED this ____ day of ___________, 20_____. _____________________________ (Signature) _____________________________ (Your name) 1 of 2 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 CERT _____________________________ (Name) _____________________________ (Address) _____________________________ (City, State, Zip Code) _____________________________ (Telephone number) _____________________________ (Fax number/E-mail Address) Personal Representative, In Proper Person Other _______________, In Proper Person EIGHTH JUDICIAL DISTRICT COURT CLARK COUNTY, NEVADA In the Matter of the Estate of: _______________________________________, Deceased. Case No.: P Dept. No.: PC-1 CERTIFICATE OF MAILING I HEREBY CERTIFY that service of the Petition for Order of Final Discharge and Notice of Hearing re: Petition for Order of Final Discharge was made this (day of mailing) ____ day of (month of mailing) ___________________, 20(year of mailing) _____, by depositing a copy of the same in the U.S. Mail, postage prepaid, regular mail, addressed to: (Include below the names and addresses of every interested party and include all heirs/beneficiaries, under a purported will or by intestate succession, and those creditors identified in your petition) 1. __________________________________________________________________ 2. __________________________________________________________________ 3. __________________________________________________________________ 4. __________________________________________________________________ 5. __________________________________________________________________ 2 of 2 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 6. __________________________________________________________________ 7. __________________________________________________________________ 8. __________________________________________________________________ 9. __________________________________________________________________ DATED THIS _____ day of _______________, 20___. _____________________________ (Signature) _____________________________ (Your name) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 © 9/26/18 Civil Law Self-Help Center OFDS _____________________________ (Name) _____________________________ (Address) _____________________________ (City, State, Zip Code) _____________________________ (Telephone number) _____________________________ (Fax number/E-mail Address) Personal Representative, In Proper Person Other _______________, In Proper Person EIGHTH JUDICIAL DISTRICT COURT CLARK COUNTY, NEVADA In the Matter of the Estate of: _______________________________________, Deceased. Case No.: P Dept. No.: PC-1 ORDER OF FINAL DISCHARGE Date of Hearing: __________ Time of Hearing: _________ Based upon the exhibits and petition requesting this Court to enter an Order of Final Discharge, IT IS ORDERED that (your name) _______________________ has fully and faithfully performed the duties as Personal Representative of the Estate of Decedent and is hereby discharged from further duties, liabilities and responsibilities; the Letters of Administration/Testamentary are vacated, and the Estate is declared to be fully distributed, settled, and closed, and that the sureties are released and the bond, if any, is exonerated from all liabilities hereafter incurred. IT IS FURTHER ORDERED that this case shall be closed. DATED this ____ day of ___________, 20_____. _______________________________ DISTRICT COURT JUDGE

Petition For Discharge Fillable

Page 1 of 4 For forms and information, visit www. civillawselfhelpcenter.org 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 28 © 8/16/18 Civil Law Self-Help Center IARV _____________________________ (Name) _____________________________ (Address) _____________________________ (City, State, Zip Code) _____________________________ (Telephone number) _____________________________ (Fax number/E-mail Address) Personal Representative, In Proper Person Other _______________, In Proper Person EIGHTH JUDICIAL DISTRICT COURT CLARK COUNTY, NEVADA In the Matter of the Estate of: _______________________________________, Deceased. Case No.: P Dept. No.: PC-1 INVENTORY, APPRAISAL, AND/OR RECORD OF VALUE Original (check if this is your first time filing this document) Supplemental (check if you have something to add to the last Inventory you filed) Amended (check if you have to change something to the last Inventory you filed) As Personal Representative of the above-referenced estate, I submit this Inventory, Appraisal, and/or Record of Value pursuant to NRS 144.040. The following is a complete and accurate inventory, appraisal, and/or record of value of all real and personal property of this estate, and includes debts of the estate, according to the best of my knowledge and ability. I am attaching appraisals of the listed assets, or, for all the assets for which no appraisal is submitted, I attach a Verified Record of Value. Page 2 of 4 For forms and information, visit www. civillawselfhelpcenter.org 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 28 © 8/16/18 Civil Law Self-Help Center Gross Asset Value (state value of property without deductions) Lienholders & Amount (list any mortgagees or entities who are owed money for the asset, and state how much is owed) Estate’s Interest (state the decedent’s % of interest in the property) Separate or Community Property (state whether estate’s interest is community or separate property) Net Value of Estate’s Interest (state dollar amount of estate’s interest = (gross asset value – amount owed for asset) x % of estate’s interest ) REAL PROPERTY (list all real property and include legal descriptions. Provide an appraisal report or other documentation to support valuation, such as current printout from Zillow.com) VEHICLES (list all vehicles and include VINs. Provide an appraisal report or other documentation to support valuation, such as Kelly Blue Book) PERSONAL PROPERTY (list all cash, bank accounts, partnership interests, notes, bonds, securities, and all collectables) MISCELLANEOUS PERSONAL PROPERTY (list and describe, to include pending or potential legal claims involving the estate, such as personal injury/wrongful death claims. Include case number if lawsuit initiated.) Page 3 of 4 For forms and information, visit www. civillawselfhelpcenter.org 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 28 © 8/16/18 Civil Law Self-Help Center Unsecured Creditor (list any entities who are owed money but are not backed by some kind of asset or collateral; generally unsecured creditors are credit cards and medical bills) Estimated Amount Owed (list how much is owed) OATH OF PERSONAL REPRESENTATIVE STATE OF NEVADA ) )ss COUNTY OF CLARK ) I, the undersigned Personal Representative of the Estate of the above-named Decedent, solemnly affirm that the foregoing Inventory, Appraisal, and/or Record of Value is a true statement of all assets of the estate which have come into my possession or of which I have knowledge, and includes all money and claims of the Decedent. I declare under penalty of perjury under the law of the State of Nevada that the foregoing is true and correct. DATED THIS _____ day of _______________, 20___. _____________________________ (Signature) _____________________________ (Your name) Page 4 of 4 For forms and information, visit www. civillawselfhelpcenter.org 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 28 © 8/16/18 Civil Law Self-Help Center VERIFIED RECORD OF VALUE STATE OF NEVADA ) )ss COUNTY OF CLARK ) (Your name)________________________, being first duly sworn, declares under penalty of perjury under the law of the State of Nevada that the foregoing and following is true and correct: I am the Personal Representative in the above-entitled action. I am submitting the foregoing Inventory, Appraisal, and/or Record of Value, and know the contents thereof. This document shall serve as the Record of Value in support of the foregoing and in lieu of appraisals. The values listed in the Inventory, Appraisal, and/or Record of Value are true and to the best of my own knowledge, and I believe them to be true. DATED THIS _____ day of _______________, 20___. _____________________________ (Signature) _____________________________ (Your name)

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