Tennessee Probate Form

Small Estate Petition For Limited Letters Of Authority - Testate (Montgomery)

Everything you need to know about Tennessee Form Small Estate Petition For Limited Letters Of Authority - Testate (Montgomery), including helpful tips, fast facts & deadlines, how to fill it out, where to submit it and other related TN probate forms.

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About Small Estate Petition For Limited Letters Of Authority - Testate (Montgomery)

There are all sorts of forms executors, beneficiaries, and probate court clerks have to fill out and correspond with during probate and estate settlement, including affidavits, letters, petitions, summons, orders, and notices.

Small Estate Petition For Limited Letters Of Authority - Testate (Montgomery) is a commonly used form within Tennessee. Here’s an overview of what the form is and means, including a breakdown of the situations when (or why) you may need to use it:

Atticus Fast Facts About Small Estate Petition For Limited Letters Of Authority - Testate (Montgomery)

Sometimes it’s tough to find a quick summary— here’s the important details you should know about Small Estate Petition For Limited Letters Of Authority - Testate (Montgomery):

  • This form pertains to the State of Tennessee

Government forms are not typically updated often, though when they are, it often happens rather quietly. While Atticus works hard to keep this information about Tennessee’s Form Small Estate Petition For Limited Letters Of Authority - Testate (Montgomery) up to date, certain details can change from time-to-time with little or no communication.

How to file Form Small Estate Petition For Limited Letters Of Authority - Testate (Montgomery)

Step 1 - Download the correct Tennessee form based on the name and ID if applicable

Double check that you have both the correct form name and the correct form ID. Some Tennessee probate forms can look remarkably similar, so it’s best to double, even triple-check that you’re using the right one! Keep in mind that not all States have a standardized Form ID system for their probate forms.

Step 2 - Complete the Document

Fill out all relevant fields in Form Small Estate Petition For Limited Letters Of Authority - Testate (Montgomery), take a break, and then review. Probate and estate settlement processes in TN are long enough to begin with, and making a silly error can push your timeline even farther back. No thank you!

Note: If you don’t currently know all of the answers and are accessing Form Small Estate Petition For Limited Letters Of Authority - Testate (Montgomery) online, be sure to avoid closing the browser tab and potentially losing all your progress (or use a platform like Atticus to help avoid making mistakes).

Step 3 - Have Form witnessed or notarized (if required)

Some States and situations require particular forms to be notarized. If you have been instructed to get the document notarized or see it in writing on the document, then make sure to hire a local notary. There are max notary fees in the United States that are defined and set by local law. Take a look at our full guide to notary fees to make sure you aren’t overpaying or getting ripped off.

Step 4 - Submit Small Estate Petition For Limited Letters Of Authority - Testate (Montgomery) to the relevant office

This is most often the local probate court where the decedent (person who passed away) is domiciled (permanently resides) or the institution involved with this particular form (e.g. a bank). Some offices allow you to submit forms online, other’s don’t, and we while we generally recommend going in-person to expedite the process, sometimes that simply isn’t an option.

It’s also a generally good idea to establish a positive working relationship with any probate clerk (unfortunately there’s enough people & process out there making things more difficult and unnecessarily confusing for them), so a best practice is to simply ask the probate clerk proactively exactly how and where they’d prefer you to submit all forms.

Need help getting in touch with a local probate court or identifying a domicile probate jurisdiction?

👉 Find and Contact your Local Probate Court

👉 What is a Domicile Jurisdiction?

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When Small Estate Petition For Limited Letters Of Authority - Testate (Montgomery) is due

Different probate forms or processes can require different deadlines or response times for completing the appropriate form.

While some steps in the process are bound to specific deadlines (like petitioning for probate, having to submit an inventory of assets, or filing applicable notices to creditors and beneficiaries), many probate forms or processes are not tied to a specific deadline since the scope of work can vary based on situational factors or requirements involved.

Either way, there are a bunch of practical reasons why personal representatives should work to complete each step as thoroughly and quickly as possible when completing probate in Tennessee.

5 reasons you should submit this form as quickly as possible:

  1. The sooner you begin, the faster Tennessee can allow heirs and beneficiaries to get their share of assets subject to probate. Acting promptly can also decrease the costs & overall mental fatigue through an otherwise burdensome process.

    Helpful Context: What’s the Difference Between Probate and Non-Probate Assets?

  2. In general, creditors of an estate usually have around 3-6 months from the time you file notice to creditors to file any claims for debt against the deceased’s assets. If they don’t, then that debt is forfeited (and more importantly, the executor won’t be held personally responsible). So doing this sooner means you have a better idea of who is owed what and ensures you won’t get a surprise collector months later.

  3. Not filing a will within 30 days (on average) could mean that the probate process proceeds according to intestate laws (laws that govern what happens to someone's stuff without a will) or is subject to unnecessary supervision by the probate court. And if you aren't directly related to the deceased (a.k.a. next of kin), this could also mean you lose your inheritance.

  4. It’s important to file any necessary state tax returns on behalf of the deceased or estate by the following tax season in Tennessee. If you don’t, you could owe penalties and interest. This also includes any necessary federal tax returns such as Forms 1040, 1041, or even a Form 706 estate tax return.

  5. If a house in the State of Tennessee is left empty (or abandoned) for a while, insurance can get dicey. For example, if the house burns down and no one has been there for a year, an insurance company may get out of paying your claim.

If you’re not using Atticus to get specific forms, deadlines, and timelines for Tennessee probate, then try and stay as organized as possible, pay close attention to the dates mentioned in any correspondence you have with the State’s government officials, call the local Tennessee probate clerk or court for exact answers regarding Form Small Estate Petition For Limited Letters Of Authority - Testate (Montgomery), and when in doubt— consult a qualified trust & estates lawyer for that area.

How to Download, Open, and Edit this form Online

Small Estate Petition For Limited Letters Of Authority - Testate (Montgomery) is one of the many probate court forms available for download through Atticus.

It may also be available through some Tennessee probate court sites, such as . In order to access the latest version, be updated with any revisions, and get full instructions on how to complete each form, check out the Atticus Probate & Estate Settlement software or consider hiring a qualified legal expert locally within Tennessee.

While Atticus automatically provides the latest forms, be sure to choose the correct version of Form Small Estate Petition For Limited Letters Of Authority - Testate (Montgomery) f using any other site or resource in order to avoid having to re-complete the form process and/or make another trip to the Tennessee probate court office.

Small Estate Petition For Limited Letters Of Authority - Testate (Montgomery) is a .pdf, so opening it should be as simple as clicking “View Form” from within the Atticus app or by clicking the appropriate link found on any Tennessee-provided government platform. Once you’ve opened the form, you should be able to directly edit the form before saving or printing.

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Did you know?

  • Form Small Estate Petition For Limited Letters Of Authority - Testate (Montgomery) is a probate form in Tennessee.

  • Tennessee has multiple types of probate and the necessary forms depend on the unique aspects of each estate, such as type and value of assets, whether there was a valid will, who is serving as the personal representative or executor, and even whether or not they also live in Tennessee.

  • During probate, all personal representatives and executives in are required to submit a detailed inventory of assets that must separate non-probate assets from probate assets.

  • Probate in Tennessee, especially without guidance, can take years to finish and cost upwards of $14,000.

Frequently Asked Questions about Small Estate Petition For Limited Letters Of Authority - Testate (Montgomery)

Probate is the government’s way of making sure that when a person dies, the right stuff goes to the right people (including the taxes the government wants).

All of that stuff is collectively known as someone’s “estate”, and it’s the job of the executor or personal representative to fill out all the forms and complete all the required steps to formally dissolve the estate. 

To get instant clarity on the entire probate process and get an idea of the steps, timeline, and best practices, read the Atticus Beginner’s Guide to Probate

The best place? Create an account in Atticus to start getting estate-specific advice. 

You may need a lawyer, you may not, and paying for one when you didn’t need it really hurts. Atticus makes sure you make  the best decisions (plus you can write it off as an executor expense).

We’ve also created a list of other probate services. Be sure to check it out!

An executor is named in someone’s will, and if the deceased didn’t have a will, then the spouse or other close family relative usually steps up to fulfill the role. If no one wants to do it, then a judge will appoint someone. 

The executor is responsible for the complete management of the probate process, including major responsibilities such as:

  • Creating an inventory of all probate assets.

  • Filling out all necessary forms

  • Paying off all estate debts and taxes

  • Submitting reports to the court and beneficiaries as requested

And much more. This process often stretches longer than a year. 

For an idea of what separates executors who succeed from those who make this way harder than it should be, visit our article, Executors of an Estate:
What they do & secrets to succeeding
.

The Exact Text on Form Small Estate Petition For Limited Letters Of Authority - Testate (Montgomery)

Here’s the text, verbatim, that is found on Tennessee Form Small Estate Petition For Limited Letters Of Authority - Testate (Montgomery). You can use this to get an idea of the context of the form and what type of information is needed.

FILING FEES FORMS REQUIRED ADDRESS OF CLERK AND MASTER’S OFFICE CASH, CREDIT, DEBIT, CASHIER'S CHECK OR MONEY ORDER ONLY •Small Estate Petition •Consents to serve from ALL heirs and beneficiaries under the Will if you wish to waive bond •Original Will •Death Certificate Montgomery County Courthouse 2 Millennium Plaza Suite 101 Clarksville, TN 37040 Requirements: •VALUE: Total value of all personal property owned by the deceased at death must be $50,000 or less. Personal property does not include re al estate (such as house or land). •RESIDENCE: The deceased must have resided in Montgomery County when they died. •WAIT PERIOD: Forty-five (45) days must have passed since the deceased’s death. If you urgently need to a ccess property prior to the end of 45 days, file a request in writing with the Court describing the reasons why expedited access is needed. •LAST WILL AND TESTAMENT: You must file the original Last Will and Testament with the Clerk. •AUTHORITY TO FILE: In order to have authority to file this petition, you must be an heir-at-law, be named as the personal representative unde r the Last Will and Testament or have signed consents of all heirs-at-law and beneficiaries of the Will. •DEATH CERTIFICATE •NAME OF DECEASED: You must state the deceased's full LEGAL name, not nickname. CONSENTS REQUIRED TO BE FILED FOR ALL HEIRS OF THE DECEASED AND BENEFICIARIES UNDER WILL PLEASE NOTE THAT UNDER The Small Estates Act, T.C.A. §§ 30-4-101 et seq. (2023) , IT IS REQUIRED TO FILE CONSEN TS FROM ALL HEIRS AND BENEFICIARIES IN LIEU OF A BOND REQUIREMENT PRIOR TO LIMITED LETTERS OF AUTHORITY BEING ISSUED WITH WILL: $150.50 IN THE CHANCERY COURT FOR MONTGOMERY COUNTY, TENNESSEE AT CLARKSVILLE SMALL ESTATE PETITION FOR LIMITED LETTERS OF AUTHORITY FOR ESTATES WITH A WILL This petition is to be used to file for an alternative small estate administration of a deceased person's estate pursuant to The Small Estates Act, T.C.A. § 30-4-101 et seq. NOTICE OF FILING Notice must be given of this action to all heirs-at-law and all beneficiaries in the Will. Note that minors and incompetent (i.e., mentally disabled) adults cannot give consent (Consent may be possible through a custodial parent, guardian, conservator or agent under a power of attorney). It is the responsibility of the petitioner to provide a filed copy of the petition for limited letters of authority to each heir and beneficiary. PLEASE NOTE... The clerk’s office is authorized by T.C.A. § 30-4-103(1)(B) to assist you in completing this form but is prohibited from giving you legal advice. If you have any legal questions, we urge you to consult an attorney. BEFORE YOU FILE Please check with whoever is holding the decedent's property (e.g. bank, insurance company, etc) to make sure that they will accept Limited Letters to release the property. Once you file, you cannot obtain a refund of your filing fee if the holder does not release the property to you. IN THE CHANCERY COURT FOR MONTGOMERY COUNTY, TENNESSEE AT CLARKSVILLE IN RE: ESTATE OF ________________________________ DOCKET NO: MC-CH-CV-PB-___________ SMALL ESTATE PETITION FOR LIMITED LETTERS OF AUTHORITY FOR A DECEASED’S ESTATE WITH A WILL (under authority of T.C.A. § 30-4-101 et. seq.) I, the u ndersigned Peti tioner, d o he reby certify and declare the fo llowing is tr ue and correct to t he best of my belief, knowledge, and information: 1.My full legal name is _________________________________________________________________ . 2.My mailing address is (include complete address with city/state/zip) : __________________________________________________ ________________________________. 3.I __ have __ have not (check one) been convicted of any misdemeanors, felonies or served a sentence in a penitentiary. /f so, please edžplain͗ ______________________________________________________________ 4.My authority to file this Petition for Limited Letters of Authority is: a. I am an heir-at-law to the deceased. Relationship: _________________________  b. All those eligible as an heir-at-law or beneficiary under the Will have consented in writing for me to serve and I am filing those consents with the clerk. c. I am named in the de ceased’s will as the personal representative. d. I am filing on behalf of someone (you must attach the letter of authority that gives you that authority, such as a power of attorney). Please also check the box indicating why the person you are representing would have authority to serve. 5.The deceased’s full legal name was ____________________________________________________ . 6.The deceased’s primary address was: __________________________________________________________________________________ Page 1 of 7 a.The Deceased left a will dated _____________________________________________ b.The deceased left a codicil (amendment to Will) dated _____________________________ or other testamentary documents. If so, explain:_________________________________________________________________. PLEASE NOTE YOU WILL NEED TO FILE THE ORIGINAL WILL WITH THE CLERK BEFORE LIMITED LETTERS WILL BE G RANTED. Page 2 of 9 CAUTION PLEASE NOTE IF THE SPECIAL MASTER BELIEVES IT APPROPRIATE, THIS MATTER MAY BE SET FOR HEARING TO RESOLVE ANY ISSUES RELATED TO THE WILL’S EXECUTION OR VALIDITY. WE STRONGLY ENCOURAGE YOU TO CONSULT WITH AN ATTORNEY BEFORE FILING A SMALL ESTATE PETI TION FOR LIMITED LETTERS WHEN A WILL IS INVOLVED. 7.The deceased died on the ________ day of ____________________, 20_____, at age _______. 8.The deceased died in the county of ___________________ in the state of ___________________ (If outside the U.S., death wa s in _____________________________________). 9.Forty-five (45) days have passed since the date of the Decedent's death. OR Due t o extenuating circumstances, I hereby request that the Court waive the 45-day waiting period for the following reason(s): ___________________________________________________________________________ 10.The Will: 11.DEBTS OF THIS ESTATE  The deceased did NOT have any unpaid debts at the time of death.  The deceased left the following known debts that were unpaid at time of death (you may also include the funeral and burial debts): Creditor Name and Account Number Creditor’s Mailing Address Including City, State and Zip Code Amount of Debt $ NOW PAID $ NOW PAID $ NOW PAID $ NOW PAID $ NOW PAID $ NOW PAID $ NOW PAID $ NOW PAID $ NOW PAID This list is continued o n a second sheet I’ve attached. Pa ge 3 of 9 1Ϯ. ASSETS OF THIS ESTATE The deceased owned real estate (house, land, etc)  The deceased did not own real estate. ____________ By placing my initials here, I certify that the total value of the deceased’s personal property (not real estate), as I ’ve specifically listed on the next page, amounts to $50,000 or less. If I discover that the deceased’s assets were more than $50,000, I will file a petition with the Court to convert this small estate administration to a full estate administration. ____________ By placin g my initials here, I confirm that I understand that as Petitioner of l imited letters of this Small Estate, I have no authority to claim, transfer, or distribute any assets owned by the deceased that are not listed on the next page. I understand I may amend this Petition if needed but will need a separate court order for it to be effective. The deceased owned the following items of personal property (Do not list jointly owned property or assets that passed outside of the estate. Also include any life insurance policies payable to the deceased or his/her estate.) : # Type of Asset Description Amount Please list general category, such as Ch ecking Account, Car, Household furnishings, etc. Please give as much information as you have... inc lu de company name; account numbers; year, Make, Model and VIN numbers for v ehicles; numbers identifying the i nstrument, che ck, o r po licy, date of note. Please also not e l ocat ion of a sset . If unknown, give best est imate. When estimated, write “Est. ” before amount. 1 $ 2 $ 3 $ 4 $ 5 $ 6 $ This list is continued on a second sheet I’ve attached. TOTAL ASSETS (Fair Market Estate): PLEASE NOTE THE FILING OF A SMALL ESTATE PETITION IS NOT VALID FOR THE TRANSFER OF REAL ESTATE. Page 4 of 9 1ϯ. HEIRS-AT-LAW CERTIFICATION a) Did the deceased have a SPOUSE that was living at the time of deceased’s death? i.e. deceased got married and they never got a legal divorce YESNO b)Did the deceased have a CHILD, GRANDCHILD, GREAT GRANDCHILD, or GREAT-GREAT GRANDCHILD living at the time of deceased’s d eath? include adopted children but do NOT include step-children YESNO IF YOU CHECKED YES , WRITE THESE NAMES IN THE BOX ON THE NEXT PAGE: WRITE THE SPOUSE’S NAME IF Y OU CHECKED YES TO (a) ABOVE, AND IF YOU CHECKED YES FOR (b) WRITE THESE NAMES: CHILDREN: list only if alive when deceased died. GRANDCHILDREN: list only if alive when deceased died AND that grandchild’s parent was a child of deceased who died before deceased. GREAT-GRANDCHILDREN: list only if alive when deceased died, AND 1) that great-grandchild’s parent was a grandchild of the deceased but died before deceased AND 2) that great -grandchild’s grandparent was a child of deceased but died before deceased (if a great-grandchild would have been an heir but died before deceased, that person’s children would be heirs if living when deceased died, and so-on.) THESE WILL BE THE ONLY HEIRS AT LAW - DO NOT CONTINUE ON THIS PAGE. IF YOU CHECKED NO IN BOTH BOXES ABOVE: c) Did the deceased have a PARENT living at the time of his/her death?YESNO IF YOU CHECKED YES, WRITE THE NAMES OF THE PARENTS LIVING AT THE TIME OF THE DECEASED’S DEATH IN THE BOX ON THE NEXT PAGE. THESE WILL BE THE ONLY HEIRS AT LAW - DO NOT CONTINUE ON THIS PAGE. IF YOU CHECKED NO IN ALL BOXES ABOVE: d) Did the deceased have a SIBLING (BROTHER/SISTER), or a descendant of the sibling (NIECES/NEPHEWS, GREAT-NIECES/GREAT-NEPHEWS, etc. ) living at the time of his/her death? YESNO IF YOU CHECKED YES, WRITE THESE NAMES IN THE BOX ON THE NEXT PAGE: BROTHER OR SISTER: list only if alive when deceased died. A NIECE OR NEPHEW: list only if alive when deceased died AND that niece/nephew’s parent was a brother or sister of deceased a nd died before deceased. GREAT-N IECE/GREAT NEPHEW: list only if alive when deceased died, AND 1) that great-niece/great nephew’s parent was a niece or nephew of the deceased but died before deceased AND 2) that great-niece/nephew’s grandparent was a brother or sister of deceased but died before dece ased (if a great-niece/nephew would have been an heir but died before deceased, that person’s children would be heirs if living when deceased die d, and so-on.) THESE WILL BE THE ONLY HEIRS AT LAW. Page 5 of 9 IF YOU CHECKED NO IN ALL BOXES ON THE LAST PAGE: e) Did the deceased have a MATERNAL GRANDPARENT (mother’s side of the family) living at the time of his/her death? YESNO f) Did the deceased have a PATERNAL GRANDPARENT (father’s side of the family) living at the time of his/her death?  YES NO STEP ONE: IF YOU CHECKED YES TO BOTH: WRITE THE GRANDPARENTS’ NAMES LIVING WHEN DECEASED DIED IN THE BOX BELOW. THOSE ARE THE ONLY HEIRS AT LAW. GO TO NEXT PAGE. IF YOU CHECKED YES TO ONE AND NO IN THE OTHER ONE: WRITE THE NAME(S) O F THE LIVING GRANDPARENT(S) AT DECEASED DEATH IN THE BOX BELOW AND PROCEED TO STEP TWO BELOW. IF YOU CHECKED NO TO BOTH, PROCEED TO STEP TWO BELOW. STEP TWO: WRITE THESE NAMES IN THE BOX BELOW ONLY IF ALL BOXES ON PRECEDING PAGE WHERE CHECKED “NO” AND A T LEAST ONE BOX ABOVE IS CHECKED “NO”: AUNT OR UNCLE: list only if alive when deceased died AND both parents of that aunt or uncle died before deceased. COUSIN: list only if alive when deceased died AND 1)that cousin’s parent was an aunt or uncle of the deceased but died before deceased & 2) that cousin’s grandparents were also grandparents of the deceased and BOTH died before deceased (if a cousin would have been an heir but died before deceased, that person’s children would be heirs if living when deceased died, and so- on.) Page ς of 9 14. HEIRS-AT-LAW Name Complete Mailing Address Including City, State and Zip Code Relationship to Deceased Current Status UNDER 18 NOW DECEASED Consent filed for Waiver of Bond UNDER 18 NOW DECEASED Consent filed for Waiver of Bond UNDER 18 NOW DECEASED Consent filed for Waiver of Bond UNDER 18 NOW DECEASED Consent filed for Waiver of Bond UNDER 18 NOW DECEASED Consent filed for Waiver of Bond UNDER 18 NOW DECEASED Consent filed for Waiver of Bond UNDER 18 NOW DECEASED Consent filed for Waiver of Bond This list is continued on a second sheet I’ve attached. Page ϳ of 9 15. BENEFICIARIES OF THE WILL List those names that were left prope rty in the Will. Name Comp lete Mailing Address Incuding City State and Zip Code Relationship to Deceased Current Status UNDER 18 NOW DECEASED Consent filed for Waiver of Bond UNDER 18 NOW DECEASED Consent filed for Waiver of Bond UNDER 18 NOW DECEASED Consent filed for Waiver of Bond UNDER 18 NOW DECEASED Consent filed for Waiver of Bond UNDER 18 NOW DECEASED Consent filed for Waiver of Bond UNDER 18 NO W DECEASED Consent filed for Waiver of Bond UNDER 18 NOW DECEASED Consent filed for Waiver of Bond This list is continued on a second sheet I’ve attached. ________ By placing my initials here, I confirm that to the Court that as Petitioner of this Small Estate, I h ave provided a copy of this Small Estate Petition to all heirs of the deceased and beneficiaries of the deceased’s Will in accordance with the Montgomery County Probate practice. Page 8 of 9 ACKNOWLEDGMENTS/PRAYERS: I, Petitioner, acknowledge: 1.I am willing to collect and preserve all assets of the estate, pay all creditors and distribute the remainder in accordance with the terms of the Last Will and Testament or according to the laws of descent and distribution of the State of Tennessee. 2.I, and any sureties, will be automatically discharged on the first anniversary of the issuance of limited letters and the small estate proceeding will automatically close without further notice to any party. 3.If distribution is made prior to payment of all medical assistance owed to TennCare under T.C.A. §71-5-116, I, and any person who receives property from the Estate, shall be liable to the extent of the value of the property received. 4.I am aware of all duties imposed upon the personal representative of a small estate proceeding as provided in The Small Estate Probate Act and any other relevant provisions of Title 30 of the Tennessee Code. WHEREFORE, the Petitioner prays: 1.That Petitioner be allowed to file this Petition pursuant to T.C.A. §30-4-101, et seq. 2.That Petitioner be the appointed Personal Representative of the above estate and that Limited Letters of Administration/Limited Letters Testamentary be issued. 3.For any such further relief that the law may allow. I, the undersigned Petitioner, swear and/or affirm under the penalty of perjury, that the foregoing information is true and correct to the best of my knowledge and belief. This ____________ day of _______________________________, 20 _________. YOUR SIGNATURE: X PHONE #: ________________________ EMAIL ADDRESS: _________________________ STATE OF _______________ COUNTY OF ______________ SWORN AND SUBSCRIBED BEFORE ME, THIS _________DAY OF _____________________,20_____. NOTARY PUBLIC : COMMISSION EXPIRES: Page 9 of 9 X IN RE: THE ESTATE OF __________________________________ DECEDENT ) ) ) ) DOCKET NO: MC-C H-C V-PB -________ In accordance with T.C.A. §30-4-101 et seq., I, _________________________________, do hereby solemnly swear or affirm that I will honestly and faithfully perform the duties as Personal Representative in the above referenced estate to the best of my ability and knowledge, and I do hereby solemnly swear or affirm that all statements in the Petition about me are true and accurate. I have no felony or misdemeanor convictions, and I am not disqualified from serving as Personal Representative because of having been sentenced to imprisonment in a penitentiary as set forth in T.C.A. § 40-20-115 or otherwise. SO HELP ME GOD. This ____________ day of _______________________________, 20 _________. PRINT NAME: ADDRESS: Signature State of County of Sworn to and subscribed before me, this _______ day of _______________, 20_____. Notary Public / Deputy Clerk My Commission Expires: ________________ OR I certify under penalty of perjury that the foregoing is true and correct. Signature IN THE CHANCERY COURT FOR MONTGOMERY COUNTY, TENNESSEE AT CLARKSVILLE PERSONAL REPRESENTATIVE OATH IN THE CHANCERY COURT FOR MONTGOMERY COUNTY, TENNESSEE AT CLARKSVILLE CONSENT TO APPOINTMENT OF PERSONAL REPRESENTATIVE WITHOUT BOND IN RE: THE ESTATE OF DOCKET NO: MC-CH-CV-PB_____________ Deceased I am one or m ore of the following [select all that apply]: Adult beneficiary of the above described estate. Power of attorney for an a dult beneficiary of this estate whose name is [attach copy of power of attorney]. Conservator of an adult beneficiary of this estate whose name is [attach conservatorship order or letters of conservatorship]. Guardian of a minor beneficiary of this estate whose name is [attach guardianship order or letters of guardianship]. Custodian of a minor beneficiary of this estate whose name is [attach court order]. Parent of a minor beneficiary of this estate whose name is [attach copy of birth certificate]. I consent to the appointment of _______________________________________________ as the Personal Representative of this estate. OR I do not consent for the following reason(s): _________________________________________ ADDRESS: Signature State of County of Sworn to and subscribed before me, this _______ day of _______________, 20_____. Notary Public / Deputy Clerk My Commission Expires: ________________ OR I certify under penalty of perjury that the foregoing is true and correct. Signature This the _____ day of ______________________, 20 ____. P RINT NAME:

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