Santa Clara — PB-4078*

Source: https://santaclara.courts.ca.gov/system/files/forms/pb-4078_rem.pdf

SUPERIOR COURT OF CALIFORNIA COUNTY OF SANTA CLARA

Probate Ex Parte Relief Checklist

Case Number: Date Submitted: ________________________

Case Name:

Party Seeking Ex Parte Relief:

Attorney or Party Contact Information:

Attorney/Party Name:

Email Address:

Telephone No.:

Petition type: □ Heggstad □ Modify Trust □ Approve Settlement Agreement □ Preliminary Distribution □ Other

Urgency: □ urgent □ not urgent

Party seeking ex parte relief is (check all that apply): □ Trustee □ Personal Representative □ Trust Beneficiary □ Estate Heir □ Surviving Spouse □ Guardian □ Conservator □ Creditor □ Other (explain): .

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Interested Parties - Competent Adults

List the full name(s) and relationship(s) of all interested persons who are both adults and competent (please attach an extra sheet if more space is required):

Name Relationship Consent? Y / N

Interested Parties - Minors or Persons Lacking Capacity

List the full name(s) and relationship(s) of all interested persons who are minors and/or otherwise lack capacity, and whether any guardian ad litem, conservator, or attorney in fact has been appointed (please attach an extra sheet if more space is required):

Name Relationship GAL/CNR/AIF

Qualification of Guardian Ad Litem

The Guardian Ad Litem is (check all that apply): □ An attorney licensed to practice in California; □ Represented by an attorney licensed to practice in California; □ Other (explain): .

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Parties who have objected or may object: (Note: if the petition is contested, it must be submitted in hard copy to the Probate Filing Office)

The following parties have indicated they object or may object to the proposed relief:

Name Relationship

Heggstad Petitions

Evidence of the settlor’s intent is based on (check all that apply):

□ Pour over will □ General assignment □ Assets listed on schedule A

□ Other:

Petition to Modify Trust

Purpose of Proposed Modification(s) (check all that apply) :

□ To eliminate a bypass trust in favor of a survivor’s trust

□ To create a special needs trust where one did not exist

□ To fill a vacancy in the office of trustee □ To modify the powers/duties of trustee(s)

□ To grant a power of appointment over an irrevocable trust

□ Other - briefly describe:

Authority for modification:

□ Probate Code 17200 □ Probate Code 15403 □ Probate Code 15404

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□ Probate Code 15409 □ Other

Petition for Preliminary Distribution from an Estate

The value of the estate as reflected in the I & A is:

Approximate amount owed to creditors, including lien holders:

Total dollar amount of assignments by beneficiaries:

Approximate costs of administration, including fees and reimbursements:

The amount of requested distribution and the person(s) to whom the distribution would be made:

months have passed since letters were issued

Petition □ requests □ does not request additional bond be set as a result of distribution.

There □ are □ are not currently unpaid creditors of the estate.

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