Santa Cruz — SUPPR-501

Source: https://www.santacruz.courts.ca.gov/system/files/forms-and-filings/post-web-suppr-501-petition-first-and-final-report-personal-representative.pdf

SUPPR 501 ATTORNEY OR PARTY WITHOUT AN ATTORNEY (Name, State Bar number, and address): FOR COURT USE ONLY NAME: ADDRESS: CITY, STATE, ZIP:

TELEPHONE NO: FAX NO. (Optional): EMAIL ADDRESS: ATTORNEY FOR (Name): SUPERIOR COURT OF CALIFORNIA COUNTY OF SANTA CRUZ Santa Cruz Branch 701 Ocean Street, Room 110 Santa Cruz, CA 95060

ESTATE OF:

CASE NUMBER: FIRST AND FINAL REPORT OF PERSONAL REPRESENTATIVE AND

PETITION FOR FINAL DISTRIBUTION ON: WAIVER OF ACCOUNT or ACCOUNT; HEARING DATE: PAYMENT OF STATUTORY FEES TO PERSONAL REPRESENTATIVE ATTORNEY; PAYMENT OF EXTRAORDINARY FEES TO PERSONAL REPRESENTATIVE ATTORNEY; TIME: PAYMENT OF COSTS/REIMBURSEMENTS; RESERVE; DEPT: OTHER ORDERS

Petitioner(s) (name(s)): alleges:

1. Decedent (name): died testate OR intestate on date: at (place): being at the time of death a resident of the County of Santa Cruz, State of California OR County of State of .

2. Petitioner was appointed as Executor Administrator with Will Annexed Administrator Special Administrator with General Powers on (date) and Letters were issued on (date): .

3. Will dated and Codicil(s) dated was/were

   admitted to Probate by order of this court.

4. Petitioner was authorized to administer the estate with full OR limited authority. And without court supervision under the Independent Administration of Estate Act, or no authority.

5. Petitioner’s report covers the period of (date of death) through (date)

6. ACCOUNT: Summary of Account and accounting schedules are attached as Attachment 6.

WAIVER OF ACCOUNT: All beneficiaries or heirs waive the requirement of an accounting. Waivers of

Account signed by each beneficiary or heir are submitted herewith will be filed prior to the hearing.

Form Adopted for OPTIONAL Use FIRST AND FINAL REPORT OF Page 1 of 11 Superior Court of Santa Cruz County PERSONAL REPRESENTATIVE & Probate Code §§ 10831, 10951, 10954 & SUPPR 501 07/25/24 11640 et seq. PETITION FOR FINAL DISTRIBUTION

ESTATE OF: CASE NUMBER:

7. a. More than four (4) months have elapsed since the issuance of Letters and reasonable efforts were made to identify creditors of the estate. The time for filing and presenting creditor’s claims has expired.

   b. Notice of Administration was given to all known creditors of the estate within four months after the date Letters were first issued or within 30 days after the personal representative first has knowledge of the creditor was not required as there were no creditors.

8. a. Other than taxes or creditor claims addressed in this petition, petitioner has no reason to believe that any public entity listed in Probate Code §9201 has any basis for making a claim against the estate.

   b. Notice pursuant to Probate Code §9201 was sent as follows:

   Date Mailed Date Mailed
   Sales and Use Tax Motor Vehicle Fuel License Tax
   Use Fuel Tax Franchise and Income Tax
   Cigarette Tax Alcohol Beverage Tax
   Unemployment Insurance State Hospital for Mentally Disordered

9. The decedent did not receive and was not the surviving spouse or registered domestic partner of a person

   who received Medi-Cal benefits. Petitioner has no reason to believe the Department of Health Services (DHS) has a claim against the estate.

   OR

   Notice was served on the DHS on (date): with a copy of decedent’s death

   certificate and with a copy of the death certificate of the decedent’s pre-deceased spouse or registered partner (name): (Probate Code §9201(a)).

10. Petitioner knows of no heir who is or previously has been confined in a prison or facility under the

    jurisdiction of the Department of Corrections or the Department of Youth Authority or confined in any county jail, road camp, industrial farm or other local correctional facility. Therefore, notice is not required to be given to the Director of the California Victim Compensation and Government Claims Board (Probate Code §9201(b)).

OR

Notice was served on the California Victim Compensation and Government Claims Board on (date): .

11. Notice pursuant to Probate Code §9202(c) was given to the Franchise Tax Board on (date):

Form Adopted for OPTIONAL Use FIRST AND FINAL REPORT OF Page 2 of 11 Superior Court of Santa Cruz County PERSONAL REPRESENTATIVE & Probate Code §§ 10831, 10951, 10954 & SUPPR 501 07/25/24 11640 et seq. PETITION FOR FINAL DISTRIBUTION

ESTATE OF: CASE NUMBER:

12. The names and addresses of all parties entitle to notice, including parties who have submitted a Request for Special Notice are as follows:

    Name Address

    Continued in Attachment 12.

13. Petitioner alleges:

    a. The Probate Referee’s fee was paid on: .

    b. All costs of administration incurred to date have been paid, except closing expenses and statutory fees, and the estate is now in a condition to be closed.

    c. At all times during the period of administration, petitioner has kept all surplus cash in interest-bearing accounts. There was no cash to invest in interest-bearing accounts.

    d. No compensation has been paid from assets to the petitioner or attorney without court order.

    e. The estate is solvent insolvent

14. The following Inventory and Appraisal(s) have been filed with the court:

    Date Filed Type Amount Partial No: Final Supplemental Corrected/Amended Partial No: Final Supplemental Corrected/Amended Partial No: Final Supplemental Corrected/Amended Partial No: Final Supplemental Corrected/Amended Total Inventory and Appraisal Value: Continued on Attachment 14.

15. The estate consists of entirely a combination of decedent’s separate community quasi- community property.

Form Adopted for OPTIONAL Use FIRST AND FINAL REPORT OF Page 3 of 11 Superior Court of Santa Cruz County PERSONAL REPRESENTATIVE & Probate Code §§ 10831, 10951, 10954 & SUPPR 501 07/25/24 11640 et seq. PETITION FOR FINAL DISTRIBUTION

ESTATE OF: CASE NUMBER:

16. Petitioner alleges that no family or affiliate relationships exist between petitioner and any agent hired by

petitioner during the period of administration.

OR

The following family or affiliates were hired:

Name Capacity Retained Relationship

Continued on Attachment 16.

17. No Creditor’s Claim(s) has/have been filed with the court.

OR

The following Creditor’s Claim(s) was/were filed with the court:

Date Claim Claimant Amount of Amount Amount Date
Filed Claim Allowed Denied Allowed
/Denied

Continued on Attachment 17

18. The following written demands for payment were received within four months after Letters were first issued, and were treaded as filed claims and paid before the expiration of 30 days after the four-month period, and (1) the debts were justly due; (2) the debts were paid in good faith; (3) the amounts paid were the true amounts of the indebtedness over and above all payments and offsets; and (4) the estate is solvent.

    Date Paid Payee Description Amount

Continued on Attachment 18.

Form Adopted for OPTIONAL Use FIRST AND FINAL REPORT OF Page 4 of 11 Superior Court of Santa Cruz County PERSONAL REPRESENTATIVE & Probate Code §§ 10831, 10951, 10954 & SUPPR 501 07/25/24 11640 et seq. PETITION FOR FINAL DISTRIBUTION

ESTATE OF: CASE NUMBER:

19. Petitioner did not take any action without prior court approval under the Independent Administration of

Estates Act for which notice of proposed action was required.

OR

Petitioner took the following action(s) without prior court approval under the Independent Administration
of Estates Act for which notice of proposed action was required.

Name of Action Date Action When & to Whom Notice Notice Waived Objections
was Taken was Given (Name & Date) (Name & Date) Received (Name
& Date)

Continued on Attachment 19.

20. a. No federal or state estate taxes are due or payable by the estate. b. All taxes, if any, have been paid.

21. a. No personal property taxes are due or payable by the estate. b. All taxes, if any, have been paid.

22. a. No California or federal income taxes are due or payable by the estate. b. All taxes, if any, have been paid. c. A final income tax return will be filed and any taxes due will be paid by the reserve requested at item 26, below.

23. a. Statutory fee due to petitioner as personal representative is (amount) WAIVED.

    b. Statutory fee due to petitioner’s attorney is (amount) WAIVED.

Form Adopted for OPTIONAL Use FIRST AND FINAL REPORT OF Page 5 of 11 Superior Court of Santa Cruz County PERSONAL REPRESENTATIVE & Probate Code §§ 10831, 10951, 10954 & SUPPR 501 07/25/24 11640 et seq. PETITION FOR FINAL DISTRIBUTION

ESTATE OF: CASE NUMBER:

c. Statutory fees are calculated as follows:

(1) Total Inventory &
Appraisal Value 4% of the first $100,000
(2) Receipts* 3% of the next $100,000
(3) Gains on Sales* 2% of the next $800,000
(4) Losses on Sales** 1% of the next $9,000,000
½ of 1% of the next $15,000,000
Total Calculation of Estate
(1+2+3) - (4)
Total Statutory Compensation

*If including receipts or gains in fee calculation, schedules must be attached. (California Rule of Court 7.550(b)(6).
**Losses, if any, must be included in fee calculation and schedules attached, even if account herein is waived.

24. a. Petitioner requests payment of extraordinary fees in the amount of . A fee Declaration pursuant to Local Rule 4.2.15 is submitted herewith will be submitted prior to the hearing.

    b. Attorney requests payment of extraordinary fees in the amount of . A fee Declaration pursuant to Local Rule 4.2.15 is submitted herewith will be submitted prior to the hearing.

25. a. Petitioner requests payment of costs/reimbursement for in the amount of .

    b. Attorney requests payment of costs/reimbursement for in the amount of . A declaration pursuant to Local Rule 4.2.15(g) as to calculation of costs is submitted herewith will be submitted prior to the hearing.

26. Petitioner requests (amount) to be reserved for taxes and tax preparation fees closing expenses county recorder fees other: .

27. The following preliminary distribution(s) has/have been made:

    Date of Order Receipts To Whom Made Amount/Asset Distributed Authorizing Filed (Date) Distribution

    Continued on attachment 27.

Form Adopted for OPTIONAL Use FIRST AND FINAL REPORT OF Page 6 of 11 Superior Court of Santa Cruz County PERSONAL REPRESENTATIVE & Probate Code §§ 10831, 10951, 10954 & SUPPR 501 07/25/24 11640 et seq. PETITION FOR FINAL DISTRIBUTION

ESTATE OF: CASE NUMBER:

28. Assets on hand at the end of report period:

    Total Value of Non-Cash Assets on Hand: Total Value of Cash Assets on Hand:

    Less:

    Statutory Personal Representative Fees: Statutory Attorney Fees:

    Extraordinary Personal Representative Fees: Extraordinary Attorney Fees: Reimbursement of Costs: Reserve: Remaining Cash Assets for Distribution:

29. a. Petitioner alleges distribution of the estate should be made by intestate succession. The names and relationship to decedent of all heirs are as follows:

    Continued on Attachment 29a

Form Adopted for OPTIONAL Use FIRST AND FINAL REPORT OF Page 7 of 11 Superior Court of Santa Cruz County PERSONAL REPRESENTATIVE & Probate Code §§ 10831, 10951, 10954 & SUPPR 501 07/25/24 11640 et seq. PETITION FOR FINAL DISTRIBUTION

ESTATE OF: CASE NUMBER:

b. Petitioner alleges distribution of the estate should be made pursuant to decedent’s Will/Codicil(s). The
dispositive provision are as follows (must be verbatim):

Continued on Attachment 29b

30. Other allegations:

    Continued on Attachment 30

Form Adopted for OPTIONAL Use FIRST AND FINAL REPORT OF Page 8 of 11 Superior Court of Santa Cruz County PERSONAL REPRESENTATIVE & Probate Code §§ 10831, 10951, 10954 & SUPPR 501 07/25/24 11640 et seq. PETITION FOR FINAL DISTRIBUTION

ESTATE OF: CASE NUMBER:

WHEREFORE, Petitioner prays for an order of this court as follows:

1. The report and account waiver of account of the personal representative is approved.

2. All acts of the petitioner as personal representative reported to the court are approved.

3. a. Payment to petitioner in the amount of , representing statutory fees.

   b. Payment to petitioner’s attorney (name) in the amount of , representing statutory fees.

4. a. Payment to petitioner in the amount of , representing extraordinary fees.

   b. Payment to petitioner’s attorney (name) in the amount of , representing extraordinary fees.

5. a. Reimbursement of costs to the petitioner in the amount of ..

   b. Reimbursement of costs to petitioner’s attorney (name) in the amount of .

6. A reserve in the amount of ..

7. Other orders:

   Continued on Attachment A

Form Adopted for OPTIONAL Use FIRST AND FINAL REPORT OF Page 9 of 11 Superior Court of Santa Cruz County PERSONAL REPRESENTATIVE & Probate Code §§ 10831, 10951, 10954 & SUPPR 501 07/25/24 11640 et seq. PETITION FOR FINAL DISTRIBUTION

ESTATE OF: CASE NUMBER:

8. Distribution of the assets of the estate is approved as follows: (Include name and relationship of each heir/beneficiary and description of each asset being distributed. If real property, include the address, legal description, and assessor’s parcel number.)

Continued on Attachment B.

Form Adopted for OPTIONAL Use FIRST AND FINAL REPORT OF Page 10 of 11 Superior Court of Santa Cruz County PERSONAL REPRESENTATIVE & Probate Code §§ 10831, 10951, 10954 & SUPPR 501 07/25/24 11640 et seq. PETITION FOR FINAL DISTRIBUTION

ESTATE OF: CASE NUMBER:

9. Distribution of any property of the estate acquired or discovered after the court order for final distribution is made, including any unused portion of the reserve, if any, is approved as follows:

Continued on Attachment C.

Date:

Type or Print Name of Attorney Signature of Attorney

I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

Date:

Type or Print Name of Petitioner Signature of Petitioner

Date:

Type or Print Name of Petitioner Signature of Petitioner

Form Adopted for OPTIONAL Use FIRST AND FINAL REPORT OF Page 11 of 11 Superior Court of Santa Cruz County PERSONAL REPRESENTATIVE & Probate Code §§ 10831, 10951, 10954 & SUPPR 501 07/25/24 11640 et seq. PETITION FOR FINAL DISTRIBUTION