Free PC-212A - Connecticut


File Size: 179.9 kB
Pages: 1
File Format: PDF
State: Connecticut
Category: Court Forms - State
Word Count: 468 Words, 4,193 Characters
Page Size: 612 x 992.13 pts
URL

http://www.jud2.ct.gov/webforms/forms/pc-212aar.pdf

Download PC-212A ( 179.9 kB)


Preview PC-212A
REQUEST FOR ORDER OF DISTRIBUTION PC-212A REV. 10/99

STATE OF CONNECTICUT COURT OF PROBATE [Use only with Form PC-212 when distribution is necessary.] [Type or print in black ink. File in duplicate.] [Use Second Sheet, PC-180, for additional data.] DISTRICT NO.

RECORDED:

TO: COURT OF PROBATE, DISTRICT OF ESTATE OF [Include all names and initials under which any asset was held.] Hereinafter referred to as the decedent. DECEDENT'S RESIDENCE AT TIME OF DEATH [Include full address.]

SOCIAL SECURITY NO. DATE OF DEATH

PETITIONER [Name, address, zip code, and telephone number]

RELATIONSHIP TO DECEDENT, if any

The amount of personal property of said decedent exceeds the listed debts and claims, and the petitioner hereby applies for an order of distribution of the excess as follows: The heirs-at-law of said decedent are: [Give names, addresses, zip codes, and relationships. Indicate ancestor through whom heir takes. For all minors listed, give date of birth. Indicate any person who is under legal disability or in the military service.]

One or more of the issue of the decedent listed above or on Second Sheet, PC-180, is/are not also the issue of the surviving spouse. The decedent left no will, and the petitioner requests an order of distribution to said heirs-at-law in accordance with the laws of intestacy. that provides for distribution equivalent to that under the laws of intestacy, and the The decedent left a will dated petitioner therefore requests an order of distribution under the laws of intestacy. , and the distribution thereunder is different from that under the laws of intestacy, The decedent left a will dated AND the heirs-at-law listed above have signed a written waiver of their right to contest said will, and the petitioner requests an order of distribution stating that the excess may be paid in accordance with the terms of said will to the proposed distributees listed below, OR the distributees under said will listed below have signed a written consent to distribution in accordance with the laws of intestacy, and the petitioner requests an order of distribution under the laws of intestacy. The distributees under said will are: [Give names, addresses, and zip codes.]

The undersigned, being all of the heirs-at-law of said decedent, hereby waive their right to contest the will.
.............................................................................. .............................................................................. .............................................................................. .............................................................................. .............................................................................. ..............................................................................

The undersigned, being beneficiaries under the will of said decedent, hereby consent to distribution of the bequests in accordance with the laws of intestate succession.
.............................................................................. .............................................................................. ..............................................................................

..............................................................................

..............................................................................

..............................................................................

The undersigned payor(s) of the claims listed on form PC-212 waive reimbursement.
.............................................................................. .............................................................................. ..............................................................................

WHEREFORE, the undersigned petitions the court to issue an order of distribution of the excess personal property of the decedent to the heirs-at-law and/or distributees listed above. The representations contained herein are made under the penalties of false statement. Date: REQUEST FOR ORDER OF DISTRIBUTION PC-212A
RESET

................................................................................... Petitioner: