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PROBATE INFORMATION FORM

Clear All Data PROBATE INFORMATION form Court File No.: COMMONWEALTH OF VIRGINIA. (For appointment of executor, administrator, curator, and/or PROBATE of a will without qualification.). circuit Court of 1. Decedent's full name [ ] Married [ ] Single [ ] Divorced [ ] Widowed 2. Decedent's Residence address at death (street, city, state). 3. Date of birth Date and place of death 4. Proof of death: [ ] Death certificate [ ] Obituary [ ] Other (specify). 5. The decedent died: [ ] with a will [ ] without a will. Date of will (and codicils). 6. Requested action: appointment of [ ] administrator [ ] executor [ ] curator [ ] PROBATE of will 7. Name of person making request 8. Mailing address 9. Basis for request: [ ] executor named in will [ ] sole distributee [ ] other distributee [ ] creditor [ ] other 10.

Circuit Court of 1. Decedent's full name [ ]Ma r i edS ngl D v oc W w 2. Decedent's Residence address at death (street, city, state) ... D ATE PRINTED NAME OF REQUESTING PERSON SI G NTU RE OF Q P DATE PRINTED NAME OF REQUESTING PERSON SI G NA TU RE OF Q P FORM CC-1650 (PAGE ONE OF ONE) 7/03 PDF-Created Date: 6/16/2002 12:19:25 PM ...

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