Instructions
Clear Form
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. 2. 3.
Surviving Spouse Name Attorney Name Deceased Name Residence (street, city or town)
Telephone Telephone Date of Death
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 This instrument was acknowledged before me on My Commission Expires Affix Seal, if any
, County of by
Signature of Notarial Officer / Title
NHJB-2498-P (02/01/2008)
(formerly AOC 137-003)
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