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Petition for Formal Administration
Petition for Formal Administration
PR-1901, 10/10 Petition for Formal Administration §§856.07, 856.09, and 879.01, Wisconsin Statutes
This form shall not be modified. It may be supplemented with additional material.
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STATE OF WISCONSIN, CIRCUIT COURT,
COUNTY
For Official Use
IN THE MATTER OF THE ESTATE OF
Amended
Petition for
Formal Administration
Case No.
UNDER OATH, I STATE:
1. The decedent, with date of birth
and date of death
,
was domiciled in
County, State of
, with a mailing
address of
.
2. I am interested as
.
3. The estimated net value of decedent's property requiring administration is $
.
4. The decedent
did did not receive Medical Assistance/Medicaid.
did did not receive Family Care and/or Partnership benefits (through a Managed Care Organization
MCO/CMO).
did did not receive benefits from the Community Options Program (COP).
did did not receive benefits from the Wisconsin Chronic Disease Program.
was was not a patient or inmate of a state or county hospital or institution, or
responsible for any person owing an obligation to the state or county.
Explain:
The affiant lacks information to complete this section.
5. If the decedent was ever married, complete the following: (If more than one spouse, See attached.)
Name of spouse ( living or deceased)
.
Married to decedent Divorced from decedent at time of decedent’s death.
The spouse did did not receive benefits from the Community Options Program (COP).
The spouse did did not receive benefits from the Wisconsin Chronic Disease Program.
The affiant lacks information to complete this section.
(Complete question 6 OR 7 below, whichever is applicable.)
6. The decedent died leaving a
will, dated
. codicil(s) (if any), dated
.
I believe these documents were executed properly and are valid. I made diligent inquiry and am unaware of any
revocation by decedent.
The original will, including any codicil(s),
is in the possession of the court.
accompanies this application.
was probated elsewhere and an authenticated copy accompanies this application.
The personal representative(s) named by the decedent in the will or any codicil(s) is
(Name)
.
I nominate
to serve as personal representative(s).
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