Form De-101 (I) - County Probate Court - State Of Maine Page 3
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4DE-101 (I)
(Rev.June 2012)
Page 3 of 4
14. Did decedent die more than three years before the date of this petition? YES ____ NO ____. If yes, state here the
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circumstances which authorize commencing this proceeding.
15. Has the applicant received a demand for notice or is the applicant aware of any demand for notice of any probate or
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appointment proceeding concerning the decedent that may have been filed in this state or elsewhere?
YES ____ NO ____. If yes, include name and address of person demanding notice.
16. I request the Court to give notice of this filing to the heirs listed in item 10a and 10b and if the decedent was 55
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years of age or older, to the Department of Health and Human Services and to the following other persons:
17. Check if desired:
_____ Pursuant to Rule 80B(a), I request the register to publish notice to creditors.
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18. Check one:
____ No bond is required.
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____ A personal representative’s bond is required and is attached.
____ An estate tax bond is required and is attached.
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19. Check (a) or (b):
____ (a) I know of an unrevoked testamentary instrument relating to property in this estate, and I have attached a
statement setting forth why that instrument is not being probated.
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____ (b) After exercise of reasonable diligence, I am unaware of any unrevoked testamentary instrument relating to
property having a situs in this state.
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20. Verification:
Under penalty of perjury, I, the undersigned applicant, state as follows:
(a) All of the foregoing facts and statements are complete and accurate as far as I know or am informed.
(b) I understand that by executing this verification I submit personally to the jurisdiction of this court in any
proceeding for relief from fraud relating to this application or for perjury that may be instituted against me.
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