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Probate

NHJB-2117-P (03/25/2013) Page 1 of 4 THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH http://www.courts.state.nh.us Court Name: Case Name: Case Number: (if known) Estate of EXECUTOR’S/ADMINISTRATOR’S ACCOUNTING Original Amended 1. The account for the period beginning and ending Check if final account 2. Executor/administrator name Telephone Mailing address Co-executor/administrator name Telephone Mailing address 3. Attorney name Telephone Firm name Bar ID # Mailing Address 4. Account Summary (totals taken from the following page) TOTAL RECEIPTS $ TOTAL DISBURSEMENTS (expenses) $ BALANCE HELD BY EXECUTOR / ADMINISTRATOR $ 5. Total Value of Estate from the Accounting Worksheet $ ORDER Account allowed. Account allowed pending filing of Account disallowed for the following reasons If this is a final account, receipts for the balance must be filed within 30 days. Date Judge Case Name: Estate of Case Number: EXECUTOR’S/ADMINISTRATOR’S ACCOUNTING NHJB-2117-P (03/25/2013) Page 2 of 4 6. RECEIPTS Schedule A – Inventory Total of Personal Estate or Balance held at Prior Accounting ................................. $ On a separate sheet of paper, list all the personal estate (but not real estate) that was listed on the Inventory form. For accounts other than the first account, list each item included in Schedule 9 of the prior accounting. Schedule B – Net Gains (or losses) on Sales/Other Dispositions $ On a separate sheet of paper, list the Inventory value and sale price for any asset sold (other than real estate), and show the difference between the two amounts. Also list the date of the sale. Schedule C – Income on all personal property, including dividends, during accounting period ...................................... $ On a separate sheet of paper, list all income including dividends and interest received during this accounting period. List the individual amounts and date each was received. Schedule D – Cash received from sale of real estate ................. $ If real estate was listed on the Inventory, and has been sold during this accounting period, on a separate sheet of paper list the address of the real estate, sale price, amounts deducted from sale price, amount received by the estate, and the date of sale. (May also attach a copy of the HUD settlement statement.) Schedule E – Cash collected on rents of real estate ................... $ If real estate was listed on the Inventory, and was not sold but rent was collected during this account period, on a separate sheet of paper, list the amount collected and the months for which the rent was collected. Schedule F – Personal estate not listed on the Inventory ........... $ On a separate sheet of paper, list each asset that was not listed on the Inventory with an explanation as to why it was not listed. Also list the description and value for each asset. Schedule G – Money advanced or contributed to estate ............. $ On a separate sheet of paper, list the name of the person who gave money to the estate, the amount and date given. TOTAL RECEIPTS (Schedules A - G) $ Add the amounts in Schedules A through G. Also enter this amount on Page 1, #4. Case Name: Estate of Case Number: EXECUTOR’S/ADMINISTRATOR’S ACCOUNTING NHJB-2117-P (03/25/2013) Page 3 of 4 7. DISBURSEMENTS (expenses) Schedule 1 – Administrative expenses including taxes ................ $ Administrative expenses are all expenses incurred in administering the estate, such as filing fees, publication fees, bond premiums, etc. On a separate sheet of paper, list the date paid, each expense and the amount. Schedule 2– Attorney and Fiduciary Fees Total Fees (show breakdown below) ........................................... $ Attorney fees $ Exec / Admin fees $ Prior fees allowed to date: Attorney fees $ Exec / Admin fees $ Probate rules require fees to be shown in summary form. This summary is sufficient unless the Court requires further detail. Schedule 3– Funeral and burial expenses ................................... $ List all funeral and burial expenses, the amount and the date paid. Schedule 4– Paid spouse's allowance out of personal estate ..... $ If a Motion for Spousal Allowance has been filed and granted by the court, on a separate sheet of paper, list the name of the spouse, amount disbursed and the date Motion was granted by the court. If Receipt (Form NHJB-2139-P) was not filed, you must file it at this time. Schedule 5– Debts, including expenses of last sickness ............. $ On a separate sheet of paper, list all debts and/or claims paid during this accounting period that existed prior to death. List the last sickness expenses individually. List the amount paid, the date of payment and to whom the payment was made. Schedule 6 – Distribution to legatees, not residuary legatees .... $ On a separate sheet of paper, list each person who received specific bequests under the will. List name, amount received or item received and its value. If Receipts (Form NHJB-2139-P) were not filed for each person, you must file them at this time. Schedule 7 – Interim distributions made with prior court approval $ If a Motion for Distribution was filed and granted by the court during this accounting period, you must list the names that were on the Motion, the amounts distributed, and date the Motion was granted by the court. If Receipts (Form NHJB-2139-P) were not filed for each person, you must file them at this time. Schedule 8 – Other Disbursements ............................................ $ On a separate sheet of paper, list any other disbursements not listed in Schedules 1 through 7 above. List the amount disbursed, date it was disbursed and the name of the person receiving the disbursement. TOTAL DISBURSEMENTS (Schedules 1 - 8) $ Add the amounts in Schedules 1 through 8. Also enter this amount on Page 1, #4. Case Name: Estate of Case Number: EXECUTOR’S/ADMINISTRATOR’S ACCOUNTING NHJB-2117-P (03/25/2013) Page 4 of 4 8. Schedule 9– BALANCE HELD BY EXECUTOR / ADMINISTRATOR (Total Receipts minus Total Disbursements) $ On a separate sheet of paper, list all the assets, except real estate, Remaining in the estate and the value of each asset. If there is no will, a Motion for Order of Distribution (2131-P) must be filed at the same time as this account, if this is a final account. After the Motion is granted by the court, the assets may be distributed and a Receipt (2139-P) must be filed for each person. Also enter this amount on Page 1, #4. 9. Is an information schedule pursuant to Probate Rule 108(E) attached to this accounting? Yes No 10. Have all Federal and State Income Tax Returns of the deceased for the period ending with his/her death been filed and the related taxes paid? Yes No 11. Have all Federal and State Income Tax Returns of the Estate, which are due at the time of filing this account, been filed and the related taxes paid? Yes No 12. Have there been any changes to the beneficiaries of the estate or have any of the beneficiaries’ addresses changed? Yes No If yes, on a separate sheet of paper, list those changes. If any beneficiary has died, attach a death certificate for that person. 13. The undersigned hereby represent(s) that the above accounting is true and accurate to the best of his/her/their knowledge and belief, and certifies that the following has been sent to all persons beneficially interested in this account and all parties appearing of record: a copy of the account which includes a notice to beneficially interested parties stating that the account may be approved unless a written objection is filed within 30 days after the date the account is filed in the probate court. I certify that on this date I provided this document(s) to the parties who have filed an appearance for this case or who are otherwise interested parties by: Hand-delivery OR US Mail OR Email (E-mail only by prior agreement of the parties based on Circuit Court Administrative Order). Date Executor/Adminis. Signature (must be signed in the presence of a Notarial Officer) Date Executor/Adminis. Signature (must be signed in the presence of a Notarial Officer) State of , County of This instrument was acknowledged before me on by Date Executor/Administrator My Commission Expires Affix Seal, if any Signature of Notarial Officer / Title IMPORTANT NOTICE To Beneficially Interested Parties This Account may be approved by the probate court unless a written objection, containing the specific factual or legal basis for the objection, is filed within 30 days after the date the Account is filed in the probate division. Failure to file an objection may forfeit your right to a hearing concerning the Account or your objection, and the probate division may then act without a hearing or any further notice to you. ASSENT and WAIVER OF NOTICE If all the parties interested in the account want to certify that they have examined the account, find it correct and request that it be allowed without further notice to them, please complete an “Assent” form (NHJB-2121-P) and file it with this account. Case Name: Estate of Case Number: EXECUTOR’S/ADMINISTRATOR’S ACCOUNTING NHJB-2117-P (11/02/2015) (Accounting Worksheet) ACCOUNTING WORKSHEET To Calculate Total Value of Estate (Page 1, Item #5) and use for determining any court fees. 1. Total Value of Entire Estate $ For this amount, see Inventory or Amended Inventory, page 1, section 5C. 2. Personal estate not inventoried and other receipts (current) $ For this amount, see this Accounting form, Section 6, schedules B, C, E and F. 3. Personal estate not inventoried and other receipts (previous) $ To calculate this amount, see prior Accounting form. 4. TOTAL Value of Estate $ Add 1+2+3. Enter total on the line to the right and also enter this amount on Page 1, #5 of the Accounting form. If total is over $25,000, filing fee applies. PROBATE DIVISION RULE 108(E). The account shall show significant transactions that do not affect the amount for which the executor/administrator is accountable. 1. The schedule listing such transactions shall consist of an information schedule, which shall be set forth at the end of the other schedules required in an account, setting forth each transaction by a separate number. 2. All changes in investments not reflected as gains or losses reported on other schedules of receipts shall be listed. These would include, but not be limited to, stock dividends; stock splits; changes in name; exchanges; or reorganizations. 3. All new investments made within the accounting period, and in hand at the close thereof, shall be noted on the schedules of assets on hand at the close of the accounting period. Totally new investments, and increased or additional investments in the same investment as shown on the schedules of assets on hand at the beginning of the account period of the account, shall be separately designated or annotated. 4. With regard to book accounts, notes or installment obligations (whether secured or not), detail regarding collections or payments shall be provided to permit reconciliation of the balances shown on schedules of assets on hand at the beginning and the close of the accounting period. 5. The executor/administrator shall also report on the information schedule the details of any events causing or resulting in a change in the manner, method or course of the executor/administrator's administration. Such events would include, but not be limited to, death of an interim income beneficiary; shifting enjoyment of the income to another beneficiary; death of a remainderman during the course of administering an estate; or a beneficiary reaching a designated age, after which time the beneficiary has a right to mandate partial withdrawals of principal. Do not file this page with the court.

Executor's / Administrator's Accounting

NHJB-2118-P (03/25/2013) Page 1 of 4 THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH http://www.courts.state.nh.us Court Name: Case Name: Case Number: (if known) Trust of TRUSTEE’S ACCOUNTING Original Amended 1. The account for the period beginning and ending Check if final account 2. Trustee name Telephone Mailing address Co-trustee name Telephone Mailing address 3. Attorney name Telephone Firm name Bar ID # Mailing address 4. Account Summary (totals taken from the following page) TOTAL PRINCIPAL RECEIVED $ TOTAL PRINCIPAL DISBURSED $ BALANCE OF PRINCIPAL ON HAND $ TOTAL INCOME RECEIVED $ TOTAL INCOME DISBURSED $ BALANCE OF INCOME ON HAND $ ORDER Account allowed. Account allowed pending filing of Account disallowed for the following reasons If this is a final account, receipts for the balance must be filed within 30 days. Date Judge Case Name: Trust of Case Number: TRUSTEE’S ACCOUNTING NHJB-2118-P (03/25/2013) Page 2 of 4 PRINCIPAL 5. PRINCIPAL RECEIVED Schedule A – Inventory Total of Personal and Real Estate or Balance held at Prior Accounting * .............................. $ On a separate sheet of paper, list all trust assets, including real estate, that were listed on the Inventory form. For accounts other than the first account, list each item included in Schedule H of the prior accounting. Schedule B – Net Gains (or losses) on Sales, Other Dispositions $ On a separate sheet of paper, list the Inventory value and sale price for any asset sold, and show the difference between the two amounts. Also list the date of the sale. Schedule C – Other Receipts ...................................................... $ On a separate sheet of paper, list any additional contributions received by the trust, including the source of the money, the amount and date given. Schedule D – Net gains (or losses) from sale of real estate ....... $ If real estate was listed on the Inventory, and has been sold during this accounting period, on a separate sheet of paper, list the address of the real estate, sale price, amounts deducted from sale price, amount received by the trust and the date of sale. Note: may attach a copy of the HUD settlement statement. TOTAL PRINCIPAL RECEIVED (Schedules A + B + C + D) $ Add the amounts in Schedules A through D. Also enter this amount on Page 1, #4. 6. PRINCIPAL DISBURSED Schedule E – Distribution to Beneficiaries ................................... $ On a separate sheet of paper, list each person who received specific distributions from the principal of the trust. List name, amount received or item received and its value, and the date it was received by the beneficiary. Schedule F – Other payments from principal ............................... $ On a separate sheet of paper, list any other payments made from the principal that are not listed in Schedules E or G, including any attorney fees. List the payment amount, date it was paid, and the name of the person receiving the payment. Schedule G – Trustee Compensation .......................................... $ On a separate sheet of paper, list any trustee’s fees paid from the principal. TOTAL PRINCIPAL DISBURSED (Schedules E + F + G) ........... $ Add the amounts in Schedules E through G. Also enter this amount on Page 1, #4. 7. Schedule H – BALANCE OF PRINCIPAL ON HAND * ............. $ (Total Principal Received minus Total Principal Disbursed) Case Name: Trust of Case Number: TRUSTEE’S ACCOUNTING NHJB-2118-P (03/25/2013) Page 3 of 4 On a separate sheet of paper, list all the assets, including real estate, remaining in the trust and the values of each. Also enter this amount on Page 1, #4. INCOME 8. INCOME RECEIVED Schedule 1 – Balance held at Prior Accounting * ....................... $ List each item included in Schedule 8 of prior accounting. Schedule 2 – Dividends and Interest ........................................... $ On a separate sheet of paper, list all dividend and interest income received during this accounting period. List the source, the individual amounts and date each was received. Schedule 3 – Other Income ......................................................... $ On a separate sheet of paper, list any additional income of the trust, including the source of the income (name), the amount and date received. TOTAL INCOME RECEIVED (Schedules 1 + 2 + 3) .................... $ Add the amounts in Schedules 1 through 3. Also enter this amount on Page 1, #4. 9. INCOME DISBURSED Schedule 4 – Distributions to Beneficiaries ................................. $ On a separate sheet of paper, list each person who received specific distributions from the income of the trust. List name, amount received or item received and its value, and the date it was received. Schedule 5 – Administrative Expenses ....................................... $ Administrative expenses are all expenses incurred in administering the trust, such as filing fees, publication fees, bond premiums, attorney’s fees, etc. On a separate sheet of paper, list each expense, the amount and the date paid. Schedule 6 – Other payments from income ................................ $ On a separate sheet of paper, list any other payments made from the income that are not listed in Schedules 4, 5 or 7. List the payment amount, date it was paid, and the name of the person receiving the payment. Schedule 7 – Trustee Compensation .......................................... $ On a separate sheet of paper, list any trustee’s fees paid from the income. TOTAL INCOME DISBURSED (Schedules 4 + 5 + 6 + 7) ........... $ Add the amounts in Schedules 4 through 7. Also enter this amount on Page 1, #4. 10. Schedule 8 – BALANCE OF INCOME ON HAND* .................... $ (Total Income Received minus Total Income Disbursed) On a separate sheet of paper, list all the income and assets, including real estate, remaining in the trust and the value of each. Also enter this amount on Page 1, #4. *These schedules must list each asset at both book value/cost and current market value at the beginning (Schedules A and 1) and end (Schedules H and 8) of the accounting period. Case Name: Trust of Case Number: TRUSTEE’S ACCOUNTING NHJB-2118-P (03/25/2013) Page 4 of 4 11. Is an Information Schedule pursuant to Probate Rule 108(E) attached to this Accounting? Yes No 12. Have all Federal and State Income Tax Returns of the trust, which are due at the time of filing this accounting been filed and the related taxes paid? Yes No If no, attach explanation in Information Schedule. 13. If the trust is a charitable trust as defined by RSA 7:21, II, does the Uniform Management of Institutional Funds Act (UPMIFA) under RSA 292-B apply? Yes No 14. Have there been any changes to the beneficiaries of the trust or have any of the beneficiaries’ addresses changed? Yes No If yes, on a separate sheet of paper, list those changes. If any beneficiary has died, attach a death certificate for that person. 15. The undersigned hereby represent(s) that the above accounting is true and accurate to the best of his/her/their knowledge and belief, and where required a copy of the account and required filing fee have been sent to the Director of Charitable Trust (RSA 7:28, I and IV) on Date I certify that on this date I provided this document(s) to the parties who have filed an appearance for this case or who are otherwise interested parties by: Hand-delivery OR US Mail OR Email (E-mail only by prior agreement of the parties based on Circuit Court Administrative Order). Date Trustee Signature (must be signed in presence of notarial officer) Date Trustee Signature (must be signed in presence of notarial officer) State of , County of This instrument was acknowledged before me on by Date Trustee My Commission Expires Affix Seal, if any Signature of Notarial Officer / Title IMPORTANT NOTICE To Beneficially Interested Parties This Account may be approved by the Probate Division unless a written objection, containing the specific factual or legal basis for the objection, is filed within 30 days after the date the Account is filed in the Probate Division. Failure to file an objection may forfeit your right to a hearing concerning the Account or your objection, and the Probate Division may then act without a hearing or any further notice to you. ASSENT and WAIVER OF NOTICE If all the parties interested in the account want to certify that they have examined the account, find it correct and request that it be allowed without further notice to them, please complete an “Assent” form (NHJB-2121-P) and file it with this account. Case Name: Trust of Case Number: TRUSTEE’S ACCOUNTING NHJB-2118-P (03/25/2013) PROBATE DIVISION RULE 108(E). The account shall show significant transactions that do not affect the amount for which the trustee is accountable. 1. The schedule listing such transactions shall consist of an information schedule, which shall be set forth at the end of the other schedules required in an account, setting forth each transaction by a separate number. 2. All changes in investments not reflected as gains or losses reported on other schedules of receipts shall be listed. These would include, but not be limited to, stock dividends; stock splits; changes in name; exchanges; or reorganizations. 3. All new investments made within the accounting period, and in hand at the close thereof, shall be noted on the schedules of assets on hand at the close of the accounting period. Totally new investments, and increased or additional investments in the same investment as shown on the schedules of assets on hand at the beginning of the account period of the account, shall be separately designated or annotated. 4. With regard to book accounts, notes or installment obligations (whether secured or not), detail regarding collections or payments shall be provided to permit reconciliation of the balances shown on schedules of assets on hand at the beginning and the close of the accounting period. 5. The trustee shall also report on the information schedule the details of any events causing or resulting in a change in the manner, method or course of the trustee's administration. Such events would include, but not be limited to, death of an interim income beneficiary; shifting enjoyment of the income to another beneficiary; death of a remainderman during the course of administering an estate; or a beneficiary reaching a designated age, after which time the beneficiary has a right to mandate partial withdrawals of principal. Do not file this page with the court.

Trustee's Accounting

NHJB-2120-P (03/30/2011) Page 1 of 1 THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH http://www.courts.state.nh.us Court Name: Case Name: Case Number: (if known) APPOINTMENT OF RESIDENT AGENT 1. Fiduciary Name Telephone Mailing Address 2. Attorney Name Telephone Mailing Address Bar ID# 3. Deceased/Ward Name Residence (city or town) 4. Fiduciary is: Executor Administrator Ancillary Executor or Administrator Special Administrator Administrator With Will Annexed Administrator De Bonis Non Guardian Conservator Trustee 5. I hereby appoint as my agent to receive notice of claims against the estate of the deceased/ward, and service of process against me as fiduciary. Resident agent mailing address Resident agent telephone number Bar ID# (only if applicable) Date Fiduciary Signature I accept appointment as resident agent. Date Resident Agent Signature

Appointment of Resident Agent

NHJB-2121-P (10/01/2006) Page 1 of 1 THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH http://www.courts.state.nh.us Court Name: Case Name: Case Number: (if known) ASSENT The undersigned, being all the persons interested, assent to the and request that it be allowed. DATE PRINT NAME BELOW LINE ADDRESS WRITE SIGNATURE ON LINE

Assent Form

THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH http://www.courts.state.nh.us Court Name: Case Name: Estate of Case Number: (if known) ASSENT FOR SUMMARY ADMINISTRATION The undersigned, being all the persons interested under the summary administration law, agree that further court supervision of the administration of the estate is no longer necessary; do not request a final accounting; and request that the motion for summary administration be granted. DATE PRINT NAME BELOW LINE WRITE SIGNATURE ON LINE ADDRESS NHJB-2122-P (10/01/2006) Page 1 of 1

Assent for Summary Administration

NHJB-2123-P (10/01/2006) Page 1 of 1 THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH http://www.courts.state.nh.us Court Name: Case Name: Case Number: (if known) Estate of DECLINATION 1. Named Fiduciary Mailing address Telephone number 2. Named Fiduciary Mailing address Telephone number 3. Deceased Name Date of Death Residence (city or town) The undersigned was/were named executor(s)/trustee(s) in the last will and testament of the deceased, and hereby decline(s) to so serve. Date Named Fiduciary Date Named Fiduciary

Declination Form

NHJB-2124-P (02/01/2008) Page 1 of 2 THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH http://www.courts.state.nh.us Court Name: Case Name: Case Number: (if known) Estate of DEPOSITION IN PROOF OF WILL IMPORTANT: This deposition cannot be filed until the corresponding “Motion to Prove Will by Deposition” (NHJB-2130-P) has been granted by the court and the notary appointed. 1. What is your name and where do you reside? Answer: 2. Were you acquainted with the deceased named above? How long were you acquainted with the deceased? Answer: 3. Did the deceased sign the instrument (copy attached), as the deceased's last will and/or codicil, in your presence? What is the date of that instrument? Answer: 4. Did you sign your name as witness to this instrument in the presence of the deceased, and at the deceased's request, and in the presence of the other witnesses? Answer: 5. Did the other witnesses sign their names as witnesses to this instrument in the presence of the deceased, and at the deceased's request, and in your presence and the presence of any other witnesses? Answer: Case Name: Estate of Case Number: DEPOSITION IN PROOF OF WILL NHJB-2124-P (02/01/2008) Page 2 of 2 6. Was the deceased of lawful age in the state where instrument was signed, and of sound mind and under no constraint or undue influence at the time the instrument was executed? Answer: 7. Do you know any other matter or circumstances affecting the validity of this instrument? If so, give the full details. Answer: I hereby swear that the answers on this form are those given during my deposition. Date Witness Deposed I have taken the deposition of at on Upon signing this deposition, the deponent made oath that the foregoing statements made are true, according to his/her best knowledge and belief. Before me, Affix Seal My Commission Expires Notary Public ORDER This deposition is approved by the court. This deposition is not approved by the court. Date Judge

Deposition in Proof of Will

THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH http://www.courts.state.nh.us Court Name: Case Name: Case Number: (if known) INVENTORY OF FIDUCIARY Executor/Administrator Guardian/Conservator Trustee Original Amended (Attach written explanation) 1. Fiduciary Name Fiduciary Name 2. Attorney name Bar ID # 3. BOND AMOUNT ORDERED BY THE COURT $ 4. Answer the following questions only ifprocessing the estate of a deceased person. If you have an attorney, have attorney fee arrangements been discussed? Yes No Have fiduciary fee arrangements been considered? Yes No 5. ESTATE SUMMARY For decedent estates, all values should be as of the date of death. For all other case types, values should be as of the date of the fiduciary’s appointment. A. TOTAL VALUE OF REAL ESTATE ..................................................... $ On a sheet of paper (Attachment A), list each piece of real estate including its street address, city/town where real estate is located, county where deed is recorded, book and page of deed, and the value of each piece of real estate. B. TOTAL VALUE OF PERSONAL ESTATE (from total on second page) ...... $ C. TOTAL VALUE OF ENTIRE ESTATE (Add A and B above) ..................... $ 6. PERSONAL ESTATE DETAIL Enter the total value of the personal property for each category below, and list the specific items and their value for each category on the appropriate attachment. For decedent estates, all values should be as of the date of death. For all other case types, values should be as of the date of the fiduciary’s appointment. A. Cash On Hand (No attachment is required.) .............................................. $ B. Attachment B – Household Furnishings and Effects ............................ $ On a sheet of paper (Attachment B), list the contents of the household and their values. Do not list wearing apparel, Bibles, family pictures, photographs, or other personal trinkets of sentimental rather than intrinsic value. NHJB-2125-P (01/01/2014) Page 1 of 3 Case Name: Case Number: INVENTORY OF FIDUCIARY C. Attachment C – Other Tangible Personal Property .............................. $ On a sheet of paper (Attachment C), list all other tangible personal property including motor or recreational vehicles, farmers' utensils, mechanics tools and livestock. For each motor or recreational vehicle, list the year, make, model and vehicle identification number (VIN). D. Attachment D – Stocks and Bonds ...................................................... $ On a sheet of paper (Attachment D), list stock or bond name, number of shares and value per share. See additional information in the ‘Personal Estate Detail’ box above. E. Attachment E – Deposited in Banks/Financial Institutions ................... $ On a sheet of paper (Attachment E), list the name and address of the bank or financial institution, the account or certificate number, the date of the last interest/dividend paid and the account balance. F. Attachment F – Business Assets ......................................................... $ On a sheet of paper (Attachment F), list all business assets and their values. G. Attachment G – Notes Receivable and Other Written Evidence of Debt Owed to the Deceased or Ward ........................................................... $ On a sheet of paper (Attachment G), list debtor and/or payor, the amount owed, the date of the note and terms of payment. H. Attachment H– Other Miscellaneous Personal Property ...................... $ On a sheet of paper (Attachment H), list any personal property not listed above and the individual values.) TOTAL VALUE OF PERSONAL ESTATE ..................................................... $ Add amounts on lines 6A through 6H (Cash on Hand plus Attachments B through H). Copy the ‘total value of personal estate’ amount to page 1, line 5B of the Estate Summary. 7. The inventory value was determined by: (check all applicable boxes) appraisal taxinformation bank statement other source 8. This section must be completed by the fiduciary completing the form. I/We, the fiduciary, of the estate of , swear that I/we have acted faithfully, impartially and according to my best judgment. I believe that if I have knowledge or possession of any further estate of the deceased, I will immediately amend my inventory. I swear that the foregoing information is true and correct to the best of my knowledge. I understand that making a false statement on this Inventory will subject me to criminal penalties. NHJB-2125-P (01/01/2014) Page 2 of 3 Case Name: Case Number: INVENTORY OF FIDUCIARY I certify that on this date I provided this document(s) to the parties who have filed an appearance for this case or who are otherwise interested parties by: Hand-delivery OR US Mail OR Email (E-mail only by prior agreement of the parties based on Circuit Court Administrative Order). Date Fiduciary Signature Date Fiduciary Signature ATTENTION BENEFICIALLY INTERESTED PARTIES This Inventory may be accepted by the Probate Division unless a written objection, containing the specific factual or legal basis for the objection, is filed within 10 days after the date the Inventory is filed in the Probate Division. Failure to file an objection may forfeit your right to a hearing concerning the Inventory or your objection, and the Probate Division may then act without a hearing or any further notice to you. NHJB-2125-P (01/01/2014) Page 3 of 3

Inventory of Fiduciary

NHJB-2126-P (03/15/2010) Page 1 of 2 THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH http://www.courts.state.nh.us Court Name: Case Name: Case Number: (if known) RETURN / NOTICE OF SALE (This form is required for all sales of real estate or timber and wood, with or without a license to sell.) Property location (as listed on the Inventory) Recorded at County Registry of Deeds, Book , Page PUBLIC SALE I, , certify the following: a. Notice of the public sale was posted at and , two public places in the town of , and an advertisement of the sale was placed in the , a newspaper with circulation in the town of b. The property was sold at public auction: On the following date To the highest bidder, namely, For the sum of $ ; the net proceeds from the sale are $ c. I executed: a deed, if real estate a bill of sale or other appropriate documents, if timber and wood Date Signature (must be signed in the presence of a Notarial Officer.) State of , County of This instrument was acknowledged before me on by My Commission Expires Affix Seal, if any Signature of Notarial Officer / Title Case Name: Case Number: RETURN OF SALE NHJB-2126-P (03/15/2010) Page 2 of 2 PRIVATE SALE I, , certify the following: a. The property was sold by private sale: On the following date To Buyer’s relationship to deceased, ward, and/or fiduciary For the sum of $ ; the net proceeds from the sale are $ b. I executed: a deed, if real estate a bill of sale or other appropriate documents, if timber and wood Date Signature (must be signed in the presence of a Notarial Officer.) State of , County of This instrument was acknowledged before me on by My Commission Expires Affix Seal, if any Signature of Notarial Officer / Title Return / Notice of Sale approved. Date Judge

Return/Notice of Sale

NHJB-2127-P (03/25/2013) Page 1 of 1 THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH http://www.courts.state.nh.us Court Name: Case Name: Case Number: (if known) Estate of NOTICE TO SURVIVING SPOUSE, LEGATEES, HEIRS AT LAW AND RETURN OF NOTICE YOU ARE HEREBY NOTIFIED that the will of the deceased was proved and allowed by the court on , and the executor/administrator(s) listed below has/have been appointed. You have received this notice because you appear to have an interest in this matter as either: the surviving spouse of the deceased, a legatee specifically named in the will, or an heir at law of the deceased. Executor/Administrator Name Telephone Mailing Address Executor/Administrator Name Telephone Mailing Address Attorney for Executor/Administrator Telephone Mailing Address Bar ID# I/We certify that a copy of this notice was given to the persons or entities named below within 60 days of appointment, as required by RSA 552:15. If notice is given to a trust, the copy should go to the trustees. I certify that on this date I provided this document(s) to the parties who have filed an appearance for this case or who are otherwise interested parties by: Hand-delivery OR US Mail OR Email (E-mail only by prior agreement of the parties based on Circuit Court Administrative Order). Date Executor/Administrator or Attorney Signature Date Executor/Administrator or Attorney Signature THE ORIGINAL FORM MUST BE FILED IN THE PROBATE DIVISION WITHIN 90 DAYS OF APPOINTMENT.

Notice to Surviving Spouse, Legatees, Heirs at Law and Return of Notice

NHJB-2130-P (03/25/2013) Page 1 of 1 THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH http://www.courts.state.nh.us Court Name: Case Name: Case Number: (if known) Estate of MOTION TO PROVE WILL BY DEPOSITION 1. Petitioner Name Telephone Mailing Address Petitioner Name Telephone Mailing Address 2. Attorney Name Telephone Mailing Address Bar ID# 3. Deceased Name Date of Death Residence (city or town) 4. Witness to be deposed Mailing address 5. Other subscribing witnesses 6. Reason witnesses cannot appear in court The petitioner request that a duly appointed notary public, whose mailing address is be appointed commissioner to take the deposition of the witness to be deposed in relation to the execution of the will. This witness is being deposed for the following reason: I certify that on this date I provided this document(s) to the parties who have filed an appearance for this case or who are otherwise interested parties by: Hand-delivery OR US Mail OR Email (E-mail only by prior agreement of the parties based on Circuit Court Administrative Order). Date Petitioner Signature Date Petitioner Signature ORDER Appointment and authorization to take the deposition is granted. Appointment and authorization to take the deposition is denied. Date Judge

Motion to Prove Will by Deposition

NHJB-2131-P (03/25/2013) Page 1 of 2 THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH http://www.courts.state.nh.us Court Name: Case Name: Case Number: (if known) Estate of MOTION FOR ORDER OF DISTRIBUTION Interim (intestate or testate) Final (intestate) 1. Petitioner Name Telephone Mailing Address Petitioner Name Telephone Mailing Address 2. Attorney Name Telephone Mailing Address Bar ID# 3. If interim distribution is requested, please answer the following questions. If you answer "no" to any question, attach explanation. a. Have all federal and state estate taxes and inheritance taxes been paid? Yes No b. Have all debts of the estate been paid? Yes No c. Have all specific legatees named in the will been paid? Yes No d. Balance prior to requested distribution $ e. Sufficient funds have been reserved for future expenses. Yes No f. Distribution is requested as follows: NAME OF RESIDUARY LEGATEE AMOUNT REQUESTED $ $ $ $ $ TOTAL $ 4. If final distribution is requested, list the names and relationship to the deceased of all the heirs of the estate, and their respective shares of the estate. If any child listed is not also the child of the surviving spouse, check the box in the relationship column. NAME RELATIONSHIP SHARE/AMOUNT $ $ $ $ $ TOTAL $ Case Name: Estate of Case Number: MOTION FOR ORDER OF DISTRIBUTION NHJB-2131-P (03/25/2013) Page 2 of 2 The petitioner requests that an order of distribution be made to those persons named in such sums as are set forth above. I certify that on this date I provided this document(s) to the parties who have filed an appearance for this case or who are otherwise interested parties by: Hand-delivery OR US Mail OR Email (E-mail only by prior agreement of the parties based on Circuit Court Administrative Order) . Date Petitioner Signature Date Petitioner Signature ORDER Motion is granted and the court orders that distribution be made as specified in the foregoing motion, subject to payment of debts, taxes and timely filed will contest, if any, and all in accordance with New Hampshire laws. Motion is denied. Date Judge

Motion for Order of Distribution

NHJB-2132-P (03/25/2013) Page 1 of 1 THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH http://www.courts.state.nh.us Court Name: Case Name: Case Number: (if known) MOTION FOR EXTENSION OF TIME FOR THE FILING OF (select one): Inventory Account Voluntary Statement Annual Report Waiver of Administration Affidavit Other 1. Fiduciary Name Capacity Mailing Address Fiduciary Name Capacity Mailing Address 2. Attorney Name Telephone Mailing Address Bar ID# 3. If an extension for an Account or Annual Report is requested, the document due is for the period beginning and ending 4. I am requesting that I be granted an extension of time to file the above form on the following date: 5. Reason for Extension: 6. Have other extensions postponing this filing been previously granted? Yes No If yes, please give details, including the number of previous extensions I certify that on this date I provided this document(s) to the parties who have filed an appearance for this case or who are otherwise interested parties by: Hand-delivery OR US Mail OR Email (E-mail only by prior agreement of the parties based on Circuit Court Administrative Order) . Date Fiduciary or Attorney Signature Date Fiduciary or Attorney Signature ORDER Motion for extension of time is granted. Filing date is extended to Failure to file the document by that date may result in the issuance of: default citation show cause order other penalties to be determined by court. Motion for extension of time is denied. Date Judge FOR COURT USE ONLY: Due Date Default Date Citation Date Default Sent Citation Sent

Motion for Extension of Time

NHJB-2134-P (03/25/2013) Page 1 of 2 THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH http://www.courts.state.nh.us Court Name: Case Name: Case Number: (if known) MOTION AND LICENSE TO MORTGAGE REAL ESTATE 1. Petitioner Name Telephone Mailing Address 2. Attorney Name Telephone Mailing Address Bar ID# 3. The deceased at the time of death owned, or the ward currently owns, the certain real estate identified below. (Attach copy of legal description.) PROPERTY LOCATION % OWNED COUNTY BOOK/PAGE / / / 4. This real estate is currently valued at $ 5. It is necessary to raise the sum of $ for the following purpose: To pay just demands of the estate or debts of the ward To make necessary or desirable repairs to preserve the real estate To facilitate settlement of the estate To provide for ward's care, maintenance, rehabilitation, training or education To provide for care, maintenance, rehabilitation, training or education of the ward's dependents Other (please specify) 6. The interests of the deceased's or ward's estate require that the fiduciary shall have power to mortgage this real estate to secure payment of a note in the amount of $ with interest at the rate of percent (%) per year, with the following terms: 7. List resources available to pay mortgage 8. Have all persons interested in this matter consented to this request? Yes (Attach consents.) No Case Name: Case Number: MOTION AND LICENSE TO MORTGAGE REAL ESTATE NHJB-2134-P (03/25/2013) Page 2 of 2 The petitioner asks that a license to mortgage this real estate for the sum of $ for the purpose stated above, and in agreement with the laws of the State of New Hampshire, be issued. I certify that on this date I provided this document(s) to the parties who have filed an appearance for this case or who are otherwise interested parties by: Hand-delivery OR US Mail OR Email (E-mail only by prior agreement of the parties based on Circuit Court Administrative Order). Date Petitioner Signature (must be signed in the presence of a notarial officer) State of , County of This instrument was acknowledged before me on by Date Petitioner My Commission Expires Affix Seal, if any Signature of Notarial Officer / Title ORDER AND LICENSE The motion is granted and the fiduciary is licensed upon the terms and conditions specified above. This license is only valid for 90 days from the date of this order. The fiduciary shall notify the court of the net proceeds of the mortgage within thirty (30) days following receipt of such proceeds. Date Judge

Motion and License to Mortgage Real Estate

NHJB-2136-P (03/25/2013) Page 1 of 2 THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH http://www.courts.state.nh.us Court Name: Case Name: Case Number: (if known) Estate of MOTION AND LICENSE TO SELL REAL ESTATE TO PAY DEMANDS 1. Fiduciary Name Telephone Mailing Address Fiduciary Name Telephone Mailing Address 2. Attorney Name Telephone Mailing Address Bar ID# 3. The personal estate of the deceased is not sufficient to pay the debts and legacies of the estate. The deceased at the time of death owned certain real estate identified below. (Attach copy of legal description.) PROPERTY LOCATION COUNTY BOOK/PAGE / / / 4. STATEMENT OF DEBTS AND ASSETS DEBTS A. Debts/legacies against the estate, per schedule attached $ B. Funeral expenses $ C. Allowance to widow $ D. Estimated expenses of administration $ TOTAL ESTATE DEBTS $ ASSETS A. Personal property per inventory $ B. Income earned from all sources $ C. Personal property not appraised $ TOTAL ESTATE ASSETS $ TOTAL DEFICIT $ Case Name: Estate of Case Number: MOTION AND LICENSE TO SELL REAL ESTATE TO PAY DEMANDS NHJB-2136-P (03/25/2013) Page 2 of 2 5. I, , do solemnly swear that in disposing of the estate of the deceased as I may be licensed to sell, I will use my best judgment if the property is sold at public auction in fixing and advertising the time and place of sale, and will exert my utmost endeavor that the same shall be sold in such manner as will be of the greatest advantage to the persons interested in the estate, without any sinister or selfish view or motive whatever. So help me God. I request that I be licensed to sell at public auction, or private sale, the whole of the real estate in accordance with New Hampshire law. I certify that on this date I provided a copy of this document to the parties who have filed an appearance for this case or who are otherwise interested parties by: Hand-delivery OR US Mail OR Email (E-mail only by prior agreement of the parties based on Circuit Court Administrative Order) . Date Fiduciary Signature (must be signed in the presence of a notarial officer) Date Fiduciary Signature (must be signed in the presence of a notarial officer) State of , County of This instrument was acknowledged before me on by Date Fiduciary My Commission Expires Affix Seal, if any Signature of Notarial Officer / Title ASSENTS I, , the surviving spouse of the deceased, hereby assent to the sale of the whole of the real estate herein described, including the homestead right, and any other interest therein, and the reversion(s) thereof. Date Surviving Spouse Signature IF THERE IS NO SURVIVING SPOUSE OF THE DECEASED BUT THERE ARE MINOR CHILDREN. I, , guardian of the minor child(ren) of the deceased, hereby consent to the sale of the whole of the real estate herein described. Date Guardian of Minor Signature ORDER AND LICENSE The motion is granted and the fiduciary is licensed upon the terms and conditions specified above. This license is only valid for two years from the date of this order. A return of sale must be returned to the court within one year of the sale. The fiduciary shall notify the court of the net proceeds of the sale within thirty (30) days following receipt of such proceeds. Motion is denied and no license is issued. Date Judge

Motion and License to Sell Real Estate to Pay Demands

NHJB-2137-P (10/01/2006) Page 1 of 1 THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH http://www.courts.state.nh.us Court Name: Case Name: Case Number: (if known) FIDUCIARY BOND 1. Principal Telephone (fiduciary liable for bond) Mailing address Principal Telephone (fiduciary liable for bond) Mailing address 2. Amount of bond (total value of estate unless otherwise ordered by the court) $ To the judge of probate for the county of I, THE PRINCIPAL NAMED ABOVE, AGREE TO PAY THE JUDGE OF PROBATE THE AMOUNT OF THIS BOND IF I DO NOT FAITHFULLY PERFORM THE DUTIES OF MY OFFICE AS FIDUCIARY AS REQUIRED BY NEW HAMPSHIRE LAW. THIS OBLIGATION SHALL CONTINUE UNTIL I FULFILL ALL OF MY DUTIES AND SHALL BE BINDING ON MY ESTATE. Date Principal Date Principal ORDER This bond is: approved not approved Date Judge

Fiduciary Bond

NHJB-2138-P (03/01/2021) Page 1 of 2 Named in will Not named in will Named in trust instrument Special needs trust Successor trustee (testamentary or SNT only) 1. Petitioner Name Telephone Mailing Address Petitioner Name Telephone Mailing Address 2. Attorney Name Telephone Mailing Address Bar ID# 3. Deceased Name (if applicable) Date of Death Residence (city or town) 4. If petition is for trustee not named in will or trust, the named trustee, whose address is , has since resigned, died, been removed, or refused to serve. 5. If a testamentary trust, did the decedent waive the requirement for accountings and bond? Yes No 6. List names and addresses of beneficiaries of trust. LIFETIME BENEFICIARY ADDRESS DATE OF BIRTH NAME REMAINDERMAN NAME ADDRESS DATE OF BIRTH THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH http://www.courts.state.nh.us Court Name: Case Name: Case Number: (if known) Trust of PETITION FOR TRUSTEE RSA 463:19 II, 564 Case Name: Trust of Case Number: PETITION FOR TRUSTEE NHJB-2138-P (03/01/2021) Page 2 of 2 7 The value of the trust estate, as nearly as can be ascertained, is: Real Estate .............................................................................. $ Personal Estate ....................................................................... $ Total amount of Estate ............................................................ $ 8. Is this a special needs trust petition? Yes No If yes, has a copy of the Petition for Trustee and a copy of the trust been sent to: Department of Health and Human Services Office of Operations Support 129 Pleasant St. Concord NH 03301 Date sent: 9. The petitioner requests that appointment be granted to Name of Town/City State Zip Code I certify that on this date I provided this document(s) to the parties who have filed an appearance for this case or who are otherwise interested parties by: Hand-delivery OR US Mail OR Email (E-mail only by prior agreement of the parties based on Circuit Court Administrative Order). Date Petitioner Signature Date Petitioner Signature ORDER Petition is granted. Letter of trust to issue, conditional on the filing of a fiduciary bond in the amount of $ , without sureties with corporate sureties, within days of this order. Petition is denied. Date Signature of Judge Printed Name of Judge

Petition for Trustee

NHJB-2139-P (03/11/2011) Page 1 of 1 THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH http://www.courts.state.nh.us Court Name: Case Name: Case Number: (if known) RECEIPT 1. RECEIVED FROM , serving as: Executor Administrator Ancillary Executor or Administrator Special Administrator Administrator With Will Annexed Administrator De Bonis Non Guardian Conservator Trustee 2. The amount of money and/or personal property at inventory value: $ , in full partial satisfaction of the following: Distribution(s) according to terms of trust Distributive share upon termination of trust Balance upon termination of guardianship Balance upon termination of conservatorship Distributive share of decedent's estate Residuary share under decedent's will Money bequeathed under decedent's will Personal property bequeathed under decedent's will (specify) Other (specify) Date Recipient Print Name of Recipient

Receipt Form

NHJB-2140-P (03/25/2013) Page 1 of 1 THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH http://www.courts.state.nh.us Court Name: Case Name: Case Number: (if known) RESIGNATION OF FIDUCIARY 1. Fiduciary Name Telephone Mailing Address 2. Attorney Name Telephone Mailing Address Bar ID# 3. Fiduciary was appointed to serve as: Executor Administrator Ancillary Executor or Administrator Special Administrator Administrator With Will Annexed Administrator De Bonis Non Guardian Conservator Trustee 4. It has become inconvenient or impractical for the fiduciary to hold or attempt to discharge such trust any longer because: The fiduciary requests that his/her resignation be accepted and that some suitable person be appointed in his/her place. I certify that on this date I provided this document(s) to the parties who have filed an appearance for this case or who are otherwise interested parties by: Hand-delivery OR US Mail OR Email (E-mail only by prior agreement of the parties based on Circuit Court Administrative Order). Date Fiduciary Signature ORDER Resignation is accepted conditioned on approval of final account for the period ending and to be filed by . Resignation is declined. Date Judge of Probate

Resignation of Fiduciary

NHJB-2142-P (07/01/2011) Page 1 of 1 THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH http://www.courts.state.nh.us Court Name: Case Name: Case Number: (if known) Estate of NOTICE TO TOWNS AND CITIES PURSUANT TO RSA 554:18-a Notice is hereby given that ownership of the real estate specified below has been passed by inheritance or devise from the deceased to the parties listed. 1. Deceased Name Date of Death Residence (city or town) 2. Location of Real Estate 3. Names and addresses of recipients NAME MAILING ADDRESS 4. The deed to this real estate is recorded in the County Registry of Deeds, Volume/Book , Page 5. I certify to the Probate Division that this notice was sent to the Assessor of the City of or Selectmen of the Town of as required by law. Date Fiduciary Signature Date Fiduciary Signature TO BE FILED WITH THE CITY ASSESSOR OR TOWN SELECTMEN AND THE PROBATE DIVISION PRIOR TO PRESENTING THE FINAL ACCOUNT.

Notice to Town and Cities Pursuant to RSA 554:18-a

NHJB-2144-P (11/01/2014) Page 1 of 1 THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH http://www.courts.state.nh.us Court Name: Case Name: Case Number: (if known) Estate of WAIVER OF FULL ADMINISTRATION AFFIDAVIT I, was appointed fiduciary of the above estate on , and under oath depose and say as follows: 1. To the best of my knowledge and belief, there are no outstanding debts or obligations attributable to the deceased's estate. 2. I certify that six months have passed since my date of appointment (specified above) and that no interested person has petitioned for full administration of this estate. 3. I certify that the following is all the real estate owned by the deceased at the time of his/her death, and that it has passed to LOCATION OF REAL ESTATE COUNTY REGISTRY OF DEEDS BOOK/PAGE / / 4. If real estate is listed in #3 above, I certify that I have notified either the assessor of the city of or the selectmen of the town of as required by RSA 554:18-a, by providing them with a copy of this form. Date Signature Telephone Number Mailing Address State of , County of This instrument was acknowledged before me on by My Commission Expires Affix Seal, if any Signature of Notarial Officer / Title ORDER This affidavit is approved. Date Signature of Judge Printed Name of Judge

Waiver of Full Administration Affidavit

NHJB-2146-P (08/17/2012) Page 1 of 1 THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH http://www.courts.state.nh.us Court Name: Case Name: Case Number: (if known) Estate of AFFIDAVIT OF COUNSEL AS TO PROPRIETY OF A FOREIGN WILL/CODICIL TO BE ADMITTED INTO PROBATE I, of , state the following under oath: 1. That I am an attorney in good standing admitted and licensed to practice law in the state or country of 2. That I have personally examined the will/codicil of , dated . 3. That I am acquainted or have familiarized myself with the statutory requirements for the proper execution of a will/codicil in the state/country of on the date the will/codicil of is purported to have been executed. 4. That the will/codicil of , appears to have been executed in accordance with the statutory requirements in effect in the state/country of on the date the will/codicil is recited as having been executed, or in accordance with the provisions of the Uniform International Wills Act. 5. If a self-proved will, that this will was properly executed as self-proved under one of the following: the Uniform International Will Act the laws of the state/country of Date Attorney Signature Telephone Number Mailing Address State of , County of This instrument was acknowledged before me on by My Commission Expires Affix Seal, if any Signature of Notarial Officer / Title

Affidavit of Counsel as to Propriety of a Foreign Will/Codicil to be Admitted into Probate

NHJB-2149-P (11/25/2013) Page 1 of 3 THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH http://www.courts.state.nh.us Court Name: Case Name: Case Number: (if known) Estate of MOTION FOR SUMMARY ADMINISTRATION AND ASSENT 1. Executor/Administrator Name Telephone Mailing Address Executor/Administrator Name Telephone Mailing Address 2. Attorney Name Telephone Mailing Address Bar ID# 3. The estate of the decedent has been open for at least 6 months. Yes No 4. To the best of my knowledge and belief, there are no outstanding debts, obligations or unpaid or unresolved claims attributable to the deceased’s estate. Yes No 5. No New Hampshire estate or inheritance taxes are due; OR all applicable New Hampshire estate and inheritance taxes have been paid and a certificate from the department of revenue administration under RSA 86:32 and/or 87:25 has been filed with the court. Yes No 6. No federal estate tax is due; OR the federal estate tax return has been filed and all taxes reported thereon have been paid. Yes No 7. Court supervision of the administration of the estate is no longer necessary. Yes No 8. The administration of the estate will be completed without further court supervision in accordance with the decedent’s will and applicable law. Yes No 9. Attached are either receipts (NHJB-2139-P) or assents (NHJB-2122-P) from all specific legatees and assents from all other persons beneficially interested, as defined in RSA 550:12. Yes No 10. If there is real estate in this case, the court has been notified of the sale or transfer of the property by filing either a Return/Notice of Sale form (NHJB-2126-P) or a Notice to Towns and Cities form (NHJB-2142-P). Yes No Case Name: Case Number: MOTION FOR SUMMARY ADMINISTRATION NHJB-2149-P (11/25/2013) Page 2 of 3 I certify that on this date I provided this document(s) to the parties who have filed an appearance for this case or who are otherwise interested parties by: Hand-delivery OR US Mail OR Email (E-mail only by prior agreement of the parties based on Circuit Court Administrative Order). Date Executor / Administrator (must be signed in presence of notarial officer) Date Executor / Administrator (must be signed in presence of notarial officer) State of , County of This instrument was acknowledged before me on by Date Executor/Administrator(s) My Commission Expires Affix Seal, if any Signature of Notarial Officer / Title ORDER Motion for summary administration is granted. Motion for summary administration is denied. Date Judge Case Name: Case Number: MOTION FOR SUMMARY ADMINISTRATION NHJB-2149-P (11/25/2013) Page 3 of 3 ASSENT FOR SUMMARY ADMINISTRATION The undersigned, being all the persons interested under the summary administration law, agree that further court supervision of the administration of the estate is no longer necessary; do not request a final accounting; and request that the motion for summary administration be granted. DATE PRINT NAME BELOW LINE ADDRESS WRITE SIGNATURE ON LINE

Motion for Summary Administration and Assent

NHJB-2150-P (05/01/2015) Page 1 of 2 THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH http://www.courts.state.nh.us Court Name: Case Name: Case Number: (if known) Estate of LEGATEES AND DEVISEES – ESTATE WITH WILL Original Form Amended Form LEGATEES and DEVISEES are persons and/or entities directed to receive the decedent’s personal or real property under the will. 1. List all legatees or devisees named in the will to inherit personal or real property that were living at the time of the decedent's death. If the legatee or devisee is a trust, list the name of the trust and trustees. (If more space is needed, attach additional pages.) Name Mailing Address Relationship Age 2. List any legatee/devisee named in the will to inherit personal or real property who was not living at the time of the decedent's death. (If there is more than one deceased legatee/devisee or if more space is needed, attach additional pages.) Name: Date of Death If the will requires the deceased legatee/devisee to survive the decedent, list the contingent legatees/devisees named in the will; or if the will does not require the deceased legatee/devisee to survive the decedent, list the heirs as defined under RSA 551:12. Name Mailing Address Relationship Age Case Name: Estate of Case Number: LEGATEES AND DEVISEES – ESTATE WITH WILL NHJB-2150-P (05/01/2015) Page 2 of 2 3. List the spouse and all known heirs at law of the decedent under RSA 561:1 if not named in the will as a beneficiary to inherit. Name Mailing Address Relationship Age Date Petitioner Date Petitioner

Legatees and Devisees - Estate with Will

NHJB-2151-P (08/01/2015) Page 1 of 2 THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH http://www.courts.state.nh.us Court Name: Case Name: Case Number: (if known) Estate of HEIRS-AT-LAW – ESTATE WITHOUT WILL Original Form Amended Form HEIR-AT-LAW is a person who is entitled to receive the decedent’s personal or real property under the intestacy succession laws if there is no will. 1. List the decedent's surviving spouse, if any. Name Mailing Address 2. List all the children born of or adopted by the decedent who were living at the time of the decedent's death. (If more space is needed, attach additional pages.) Child of Name Mailing Address Surviving Age Spouse? Yes No Yes No Yes No Yes No Yes No 3. List all children born of or adopted by the decedent who were not living at the time of the decedent's death. (If there is more than one deceased child or if more space is needed, attach additional pages.) Name: Date of Death List the deceased child's surviving issue (children, grandchildren, etc.). (If more space is needed, attach additional pages.) Name Mailing Address Relationship Age Case Name: Estate of Case Number: HEIRS-AT-LAW – ESTATE WITHOUT WILL NHJB-2151-P (08/01/2015) Page 2 of 2 4. If the decedent had no surviving issue (children, grandchildren, etc.), list the decedent’s parents if living. Name Mailing Address 5. If the decedent had no surviving spouse, parents or issue (children, grandchildren, etc.), list the heirs as defined under RSA 561:1. (If more space is needed, attach additional pages.) Name Mailing Address Relationship Age 6. Does the surviving spouse have children who are not children of the marriage to the decedent? See RSA 561:1, I (d) Yes No Date Petitioner Date Petitioner

Heirs-at-Law - Estate without Will

NHJB-2243-P (03/25/2013) Page 1 of 1 THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH http://www.courts.state.nh.us Court Name: Case Name: Case Number: (if known) MOTION TO RE-EXAMINE PROBATE WILL 1. Name Relationship to deceased Address Telephone Number 2. Executor of the will Address Telephone Number 3. The above-named executor offered a certain instrument, purporting to be the last will and testament of the above-named deceased, for probate; it was proved and allowed on , as the last will and testament of the deceased in common form and without notice. 4. The above-named party seeks proof in solemn form and re-examination of the will based on the following: Examination of the witnesses to the will only. Examination based on the allegations set forth in the attached statement. The party, having an interest in the will, requests that the probate of the will be re-examined, and proved in solemn form before the Probate Division, and that the former probate of the will be decreed void or affirmed in accordance with the laws of the State of New Hampshire. I certify that on this date I provided this document(s) to the parties who have filed an appearance for this case or who are otherwise interested parties by: Hand-delivery OR US Mail OR Email (E-mail only by prior agreement of the parties based on Circuit Court Administrative Order). Date Signature (must be signed in presence of notarial officer) State of , County of This instrument was acknowledged before me on by Date Name of Party filing motion My Commission Expires Affix Seal, if any Signature of Notarial Officer / Title

Motion to Re-examine Probate Will

NHJB-2303-P (03/25/2013) Page 1 of 1 THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH http://www.courts.state.nh.us Court Name: Case Name: Case Number: (if known) MOTION FOR APPRAISER 1. Petitioner Name Telephone Mailing Address 2. Petitioner Name Telephone Mailing Address 3. Previous Appraiser (if any) Telephone Mailing Address 4. If there was a previous appraiser, he or she cannot continue to serve as appraiser because 5. The petitioner requests that the following impartial appraiser be named to take an inventory and appraise the estate of the deceased or ward. Appraiser name Telephone Appraiser address Appraiser occupation I certify that on this date I provided this document(s) to the parties who have filed an appearance for this case or who are otherwise interested parties by: Hand-delivery OR US Mail OR Email (E-mail only by prior agreement of the parties based on Circuit Court Administrative Order). Date Petitioner signature Date Petitioner signature ORDER Motion for Appraiser is granted. Motion for Appraiser is denied. Date Judge

Motion for Appraiser

NHJB-2497-P (01/02/2014) Page 1 of 3 THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH http://www.courts.state.nh.us Court Name: Case Name: Case Number: (if known) Petition for Administration of Estate Of Person Presumed Dead (RSA 553:18 and 553:19) 1. Petitioner Name Telephone Mailing Address 2. Petitioner Name Telephone Mailing Address 3. Attorney Name Telephone Mailing Address 4. Person Presumed Dead Last known residence (street, city or town) Has person presumed dead lived in this county for at least one year? Yes No 5. This person: (select one) Is presumed to have been killed as a result of some catastrophic event, but his or her body could not be recovered. Left his or her home and has not been heard of or from directly or indirectly for 6 months. The petitioner believes he or she may be dead. 6. The legatees and heirs-at-law to the estate of the person presumed dead are as follows: 7. The value of the estate of the person presumed dead consists, as nearly as can be ascertained, of: Real Estate ......................................................................... $ Personal Estate .................................................................. $ Total amount of Estate ........................................................ $ 8. The petitioner requests that administration be granted to of and whose date of birth is Case Name: Case Number: PETITION FOR ADMINISTRATION OF ESTATE OF PERSON PRESUMED DEAD (RSA 553:18 AND 553:19) NHJB-2497-P (01/02/2014) Page 2 of 3 The petitioner has also filed with this petition a “Notice on Petition for Administration of Estate of Person Presumed Dead”, and requests that the information contained in that form be published and that if no information is received indicating that is alive, and that circumstances lead to a reasonable belief that he or she is dead, that administration of his or her estate be granted. Date Petitioner Signature ORDER FOR PUBLICATION It is ordered that the annexed notice be published in a newspaper with statewide distribution and which is also published on the Internet. (The petitioner is responsible for arranging publication.) In addition, the annexed notice shall be published in the county in which the person had last lived for one year. Such notice shall be published at least once per week for four consecutive weeks. A copy of the “Notice on Petition for Administration of Estate of Person Presumed Dead” shall be given to the following relatives: Date Signature of Judge Printed Name of Judge ORDER FOR ADMINISTRATION Petition for Administration of Estate of Person Presumed Dead is granted; letters of appointment to be issued. Prior to the issuance of said letters, the fiduciary is ordered to file with the court, within 30 days of this order, a fiduciary bond in the amount of $ , without sureties with corporate sureties. Failure to file the bond within 30 days may result in dismissal of the case. Further order Date Signature of Judge Printed Name of Judge NHJB-2497-P (01/02/2014) Page 3 of 3 THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH http://www.courts.state.nh.us Court Name: Case Name: Case Number: (if known) Notice on Petition for Administration of Estate Of Person Presumed Dead (RSA 553:18 and 553:19) Information is wanted regarding who left his or her home in , where he or she had resided for more than one year. This person left his or her home on or about , and has not been heard of, or from, since that date. was about years of age, with eyes, hair, about tall, and weighed about pounds. Occupation had been A petition to administer this person’s estate has been filed, and this notice is ordered by the Judge for County. This petition will be put before the court on at County Probate Division in . All persons interested in this matter may appear and be heard by the court. Any person having information about is requested to forward that information to the Judge in the above-named county, or to contact the court at the following telephone number: . BY ORDER OF THE COURT, Date Clerk of Court Return of Publication 1. Name of publication 2. Name of person authorized to sign below 3. Dates notice was published I certify that notices, of which the above is a true copy, were published once each week for four consecutive weeks as required by the order of notice above. Date Newspaper Representative

Petition for Administration of Estate of Person Presumed Dead

NHJB-2498-P (02/01/2008) Page 1 of 1 THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH http://www.courts.state.nh.us Court Name: Case Name: Case Number: (if known) Waiver by Surviving Spouse RSA 560:10 1. Surviving Spouse Name Telephone 2. Attorney Name Telephone 3. Deceased Name Date of Death Residence (street, city or town) 4. Date of marriage of surviving spouse and deceased I am the surviving spouse of the above named deceased person. I hereby waive my homestead rights, if any, and the provisions of the will of the deceased in my favor, if any, for the purpose of receiving my statutory share of the deceased’s estate. Date Surviving Spouse Signature State of , County of This instrument was acknowledged before me on by My Commission Expires Affix Seal, if any Signature of Notarial Officer / Title

Waiver by Surviving Spouse

NHJB-2499-P (10/01/2018) THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH http://www.courts.state.nh.us Court Name: Case Name: Case Number: (if known) MOTION TO PAY STATE TREASURER FOR PROPERTY IN EXCESS OF $5,000 RSA 561:10 1. Petitioner Name Capacity Petitioner Name Capacity 2. Attorney Name Telephone 3. I have settled the account of the administration for this estate. 4. I have the following sum of money: It belongs to: 5. That person’s place of residence is unknown, and I have done everything I can to find that person or his or her heirs; or, the person entitled to the sum has refused it. The petitioner asks to be authorized by the court to pay the sum to the State Treasurer. Such payment would be a discharge of the administrator’s duties as they relate to this property. Date Petitioner Signature State of , County of This instrument was acknowledged before me on by My Commission Expires Affix Seal, if any Signature of Notarial Officer / Title ORDER Motion to pay the sum of to the New Hampshire State Treasurer is granted. Send to the Abandoned Property Division, State Treasury, 25 Capitol St Room 121 Concord NH 03301 A receipt must be filed within days of this order. Motion is denied. Date Signature of Judge Name of Judge

Motion to pay State Treasurer for Property in Excess of $5,000

NHJB-2558-P (12/01/2008) Page 1 of 1 THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH http://www.courts.state.nh.us Court Name: Case Name: Case Number: (if known) TEMPORARY ADMINISTRATION 60 DAY REPORT RSA 553:20-a 1. Temporary Administrator Name Telephone Mailing Address 2. Date Temporary Administrator was appointed 3. Check the appropriate boxes below to provide a status of this temporary administration. Assets have been found. Each asset and its value are listed on a separate sheet of paper attached to this report. No assets were located; no further action is required. I am waiting for further information on this case, and wish to extend this Temporary Administration. To do so, I have attached either a Motion for Extension of Time (NHJB-2132-P) or a Motion (NHJB-2201-DFP) for the court’s review and approval. Date Temporary Administrator Signature ORDER Read and Noted. No further action is needed. Read and Noted. The following further action is needed: Date Signature of Judge Name of Judge

Temporary Administration - 60 Day Report

NHJB-2634-P (02/14/2013) Page 1 of 1 THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH http://www.courts.state.nh.us Court Name: Case Name: Case Number: (if known) CERTIFICATION OF TRUST 1. The Name of Trust was executed on and is currently in existence. Date 2. The name of the settlor is 3. The current acting trustee(s) is: Trustee Name Telephone Mailing Address Trustee Name Telephone Mailing Address Trustee Name Telephone Mailing Address 4. The Trustee (s) has all necessary powers under the trust to receive bequests from the estate being probated pursuant to the terms of the will. 5. The trust has not been revoked, modified, or amended in any manner that would cause the representations contained herein to be incorrect. Date Signature of Trustee Date Signature of Trustee Date Signature of Trustee

Certification of Trust

NHJB-2668-P (03/25/2013) Page 1 of 2 THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH http://www.courts.state.nh.us Court Name: Case Name: Case Number: (if known) Estate of MOTION FOR DISTRIBUTION OF INSOLVENT ESTATE 1. Administrator Name Telephone Mailing Address Administrator Name Telephone Mailing Address 2. Attorney Name Telephone Mailing Address Bar ID# 3. Value of estate assets Real estate value (as of the date of death) $ Personal estate value (as of the date of death) $ Additional value since date of death (ex. Interest on accounts, refund checks, gain or loss on sale) $ Trust value available to satisfy creditors and claims $ Total Value of Estate and Trust Assets $ 4. Payment of the claims will be made in accordance with the priorities outlined in RSA 554:19. No distribution shall be made without prior court approval. 5. Distribution is requested as follows: (Attach additional sheets of paper if necessary) NAME AMOUNT OF EXPENSE/ AMOUNT TO BE PAID AMOUNT CLAIMED $ $ $ $ $ $ $ $ $ $ $ $ $ $ TOTAL $ Case Name: Estate of Case Number: MOTION FOR DISTRIBUTION of INSOLVENT ESTATE NHJB-2668-P (03/25/2013) Page 2 of 2 The administrator requests that an order of distribution be made to those persons named in such sums as set forth above. I certify that on this date I provided this document(s) to the parties who have filed an appearance for this case or who are otherwise interested parties, including all known creditors, by: Hand-delivery OR US Mail OR Email (E-mail only by prior agreement of the parties based on Circuit Court Administrative Order) . Date Administrator Signature Date Administrator Signature IMPORTANT NOTICE To Beneficially Interested Persons This motion may be approved by the Probate Division unless a written objection, containing the specific factual or legal basis for the objection, is filed within 30 days after the date the motion is filed in the Probate Division. Failure to file an objection may forfeit your right to a hearing concerning the motion or your objection, and the Probate Division may then act without a hearing or any further notice to you. ORDER Motion is granted and the court orders that distribution be made as specified in the foregoing motion no sooner than 30 days; the Administrator shall thereafter file an Affidavit of Administrator with the court. Motion is denied. Date Judge

Motion for Distribution of Insolvent Estate

NHJB-2669-P (01/01/2011) Page 1 of 1 THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH http://www.courts.state.nh.us Court Name: Case Name: Case Number: (if known) AFFIDAVIT OF ADMINISTRATOR Regarding Distribution of Insolvent Estate The administrator certifies that distribution was made in accordance with the Order on the Motion for Distribution of Insolvent Estate issued by this court. Date Administrator Signature (must be signed in presence of Notarial officer) Date Administrator Signature (must be signed in presence of Notarial officer) State of County of This instrument was acknowledged before me on by Date Administrator My Commission Expires Affix Seal, if any Signature of Notarial Officer / Title ORDER The administrator is discharged from all claims of creditors against the estate, with the exception of those claims covered by insurance for which the decedent was insured at the time of death. In such cases, recovery shall be limited to the coverage of the insurance policy or policies. Date Judge

Affidavit of Administrator Regarding Distribution of Insolvent Estate

NHJB-2864-P (01/02/2014) Page 1 of 1 THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH http://www.courts.state.nh.us Court Name: Case Name: Case Number: (if known) ASSENT FOR PROOF OF WILL IN COMMON FORM The undersigned, being persons interested in the Will of , assent to the proving of the will in common form without the need for a witness to appear in court and request that the will be allowed. Check off the applicable box that applies to each person signing. Surviving Spouse Legatees/Devisees Heirs at Law Charity Named in Will Director of Charitable Trusts (only if charitable interest is unnamed) DATE PRINT NAME BELOW LINE ADDRESS WRITE SIGNATURE ON LINE

Assent for Proof of Will

NHJB-2883-P (12/12/2019) THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH http://www.courts.state.nh.us Court Name: Case Name: Case Number: (if known) REQUEST FOR REASSIGNMENT Pursuant to Administrative Order 2014-04 This form shall be used to request reassignment of a matter to the Trust Docket pursuant to Administrative Order 2014-04. See RSA 490-F:2; New Hampshire Supreme Court Rule 54. Parties requesting reassignment shall contemporaneously file copies of this form with: (1) the Circuit Court Administrative Judge; (2) the Circuit Court Probate Division where the matter is currently being adjudicated; and (3) all parties of record. The Request shall be sent to the Circuit Court Administrative Judge at the following address: Circuit Court Administrative Judge Attention: Trust Docket/6 th Circuit Court Probate Division 2 Charles Doe Drive, Suite 1 Concord, New Hampshire 03301 Parties are also instructed to forward a copy of this request to all parties of record with a cover letter or memorandum conspicuously containing the following notice: In accordance with Circuit Court Administrative Order 2014-13, any party wishing to file a response asserting grounds for denial of this Request for Reassignment shall do so within ten (10) calendar days of the filing date of the Request with the Circuit Court Administrative Judge. Copies of the response shall be contemporaneously sent to the Circuit Court Administrative Judge, the Circuit Court Probate Division where the matter is currently being adjudicated, and all parties of record. 1. Name of Presiding Judge in Circuit Court Probate Division: 2A. Requesting party information: Name: Mailing address: If representing self, provide email address and telephone number: 2B. Requesting party’s counsel information: Name: Firm name: Mailing address: Email address and telephone number of requesting party’s counsel. Case Name: Case Number: REQUEST FOR REASSIGNMENT NHJB-2883-P (12/12/2019) 3A. Other party information: Name: Mailing address of other party of record: If other party of record is representing self, provide email address and telephone number. 3B. Other party’s counsel information: Name: Firm name: Mailing address: Email address and telephone number of other party’s counsel. The name and contact information of all other parties of record and their counsel, if applicable, shall be attached on a separate page and shall include the information requested in Part 3A and 3B. 4. Is any part of the case confidential? Yes No If your answer is yes, please identify which part and cite authority for confidentiality. 5. Please list if applicable: the complete case title, case number(s), name of court and location, name and address of all parties and their counsel, and the Presiding Judge, of any case related to this matter or involving the same parties. Please briefly describe the nature of each case. 6. Have the parties attempted or utilized formal mediation or other form of alternative dispute resolution with a neutral third party? Yes No. If yes, indicate the type of alternative dispute resolution attempted, date(s) of participation, and the result of the mediation or other form of alternative dispute resolution. Case Name: Case Number: REQUEST FOR REASSIGNMENT NHJB-2883-P (12/12/2019) 7. Do you know of any reason why any judge sitting on the Trust Docket would be disqualified from this case? Yes No. If yes, explain why. 8. Nature of case (Limit one page double-spaced; please attach). 9. Nature of complexity (Limit five pages double spaced; please attach). Each request for reassignment will be administratively reviewed for purposes of determining whether reassignment to the Trust Docket is appropriate based on the unique complexities of each case. Please describe the complexities present in this case making it appropriate for transfer. The following criteria, although not intended to be either controlling or fully describing the nature of cases appropriate for reassignment, indicate certain factors that might make a case complex and appropriate for reassignment to the Trust Docket. a. Multiple Issues and Complexity – Do the issues raised involve multiple layers of complexity? Does the instrument at issue include novel, ambiguous, or complicated provisions? Is the law unclear, complicated, or is there a choice of law controversy? b. Multitude of Instruments at Issue – Does the case involve interpretation of multiple types of probate documents? c. Number of Parties – Does the case involve multiple parties or parties with competing or differing interests? Are there a number of creditors with competing preferences for estate assets? d. Potential Tax Implications – Does the case involve complicated tax questions or does the outcome implicate various tax consequences? e. Projected Length of Trial – Do the parties project a multi-day trial as opposed to only a few hours? f. Multiple Forums – Are the parties involved in related litigation in other Circuit Court divisions that are best consolidated into one matter? Will the outcome of the case affect litigation pending in the Superior Court or in the Federal Court? Conversely, will the outcome of litigation pending in the Superior Court or in the Federal Court affect the case? g. Urgency of Adjudication – Is there a critical need for fast resolution? h. Efficiency – Are there any other circumstances which would cause the case to be more efficiently resolved in a specialized docket? Separately number each factor you believe qualifies this case for reassignment to the Trust Docket. For each factor, explain why the criteria above or other applicable criteria support reassignment. Case Name: Case Number: REQUEST FOR REASSIGNMENT NHJB-2883-P (12/12/2019) Do not attach any other document to this Request for Reassignment. If you want specific pleadings or documents considered in the administrative review, refer to them by name, date of submission to the current court, and docket entry number. Parties are prohibited from submitting with this Request for Reassignment any new evidence, motions, or other pleadings that have not been previously filed with the current court. Parties are cautioned to limit the scope of this Request for Reassignment to only information necessary for the Circuit Court’s determination whether reassignment to the Trust Docket is warranted. 10. Certification I certify that on this date I provided this document(s) to the parties who have filed an appearance for this case or who are otherwise interested parties by: Hand-delivery OR US Mail OR Email (E-mail only by prior agreement of the parties based on Circuit Court Administrative Order). Date Signature of Party or Counsel

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