On August 17, 2022 a
Devisees
was filed
involving a dispute between
Tripi, Robert C,
and
for Estates and Administration
in the District Court of Worcester County.
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Worcester Probate and Family Court
Date Filed: 8/17/2022 1:08 PM
Docket No. Commonwealth of Massachusetts Case Number:
DEVISEES The Trial Court
G. L. c.190B, $3-301 Probate and Family Court
[] Original Form [] Amended Form
(
Estate of:
Worcester Division
Janet Eileen Fox
First Name Middle Name Last Name
Date of Death: May 13, 2022
Form Use: This form must be used to identify a Decedent's devisees. Devisees are persons, entities, charitable
organizations, or trusts designated in a will to receive the Decedent's personal or real property. In the case of a devise to an
existing trust or trustee, or to a trustee or trust established
by the will, the trust or trustee is the devisee and the beneficiaries
are not devisees. For additional information, the Massachusetts Uniform Probate Code, G. L. c.190 should be consulted.
Instructions: Complete ALL applicable sections of this form. For step by step instructions on how to complete this form,
click on the Instructions link above or see Instructions MPC 959.
ALL PETITIONERS MUST COMPLETE LINE 1 AND LINE 2.
1. The Decedent left a will dated November 7, 2005 . []The dates of all codicils are:
------------------
The will and any codicils are referred to as the will.
2. The following devisees named in the will to inherit personal or real property wereliving at the time of the Decedent's
death. (Note: If the devisee is a trust,
list the name of the trust and trustees. If any devisee is a charity, list the name of
the charity and provide notice to the Massachusetts Attorney General. See G. L. c.190B and Uniform Practice XXXIV).
NAME OF DEVISEE ADDRESS (omit if since deceased) RELATIONSHIP TO DECEDENT A MINOR
Kathleen Rose Fox
101116th Avenue, Coralville, Iowa,
52241
niece â–¡ Yes
Robert C. Tripi
23 Endicott Drive, Westborough,
01581
MA
friend â–¡ Yes
â–¡ Yes
3. ] The following devisees named in the will to inherit personal or real property were not living at the time of the
Decedent's death.
NAME OF PREDECEASED DEVISEE DATE OF DEATH RELATIONSHIP TO DECEDENT
4. D If the will names one or more persons to take in place of the pre-deceased devisee, or if the anti-lapse statute (G. L. c.
190B, $ 2-603) applies, list the contingent devisee(s).Do not include residuary devisees named elsewhere.
NAME OF CONTINGENT DEVISEE ADDRESS (omit if since deceased) RELATIONSHIP TO DECEDENT A MINOR
â–¡ Yes
â–¡ Yes
MPC 163 (4/15/16) DEV page of 2
Worcester Probate and Family Court
Date Filed: 8/17/2022 1:08 PM
ALL PETITIONERS MUST COMPLETE LINE 5 AND LINE 6, if applicable. Case Number:
5. NONE of the devisees are under legal disability except for:
NAME/ADDRESS OF
REPRESENTED BY
" (Guardian ad litem required
REPRESENTATIVE
NAME OF DEVISEE LEGAL DISABILITY (Provide docket number or proof of
unless waived.
See
Instructions) appointment for any court appointed
·ti fiduciary.)
[Minor List age: []Guardian
---
[]Incapacitated or protected person []Conservator
(adjudicated or alleged)
[]Unrepresented
D Unborn or unascertained
[ Minor List age: [ Guardian
---
[]Incapacitated or protected person []Conservator
(adjudicated or alleged)
D Unrepresented*
D Unborn or unascertained
6. NONE of the devisees who survived the Decedent are deceased at the time of this filing except for:
NAME/ADDRESS OF
NAME OF SINCE DATE OF REPRESENTATIVE
REPRESENTED BY (Provide docket number or proof of
DECEASED DEVISEE DEATH
appointment for any court appointed
fiduciary.)
[Personal Representative
(Required for an informal proceeding)
[Unrepresented
(Formal proceeding required)
[]Personal Representative
(Required for an informal proceeding)
[]Unrepresented
(Formal proceeding required)
SIGNED UNDER THE PENALTIES OF PERJURY
I certify under the penalties of perjury that the foregoing statements are true to the best of my knowledge and belief.
Date: 6£.fc,
Signature of Petitioner ~
Robert C. Tripi
rint name
MPC 163 (4/15/16) DEV page 2 of 2
Document Filed Date
August 17, 2022
Case Filing Date
August 17, 2022
Category
Estates and Administration
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Worcester Probate and Family Court Date Filed: 8/17/2022 1:08 PM Docket No. Commonwealth of Massachusetts Case Number: DEVISEES The Trial Court G. L. c.190B, $3-301 Probate and Family Court [] Original Form [] Amended Form ( Estate of: Worcester Division Janet Eileen Fox First Name Middle Name Last Name Date of Death: May 13, 2022 Form Use: This form must be used to identify a Decedent's devisees. Devisees are persons, entities, charitable organizations, or trusts designated in a will to receive the Decedent's personal or real property. In the case of a devise to an existing trust or trustee, or to a trustee or trust established by the will, the trust or trustee is the devisee and the beneficiaries are not devisees. For additional information, the Massachusetts Uniform Probate Code, G. L. c.190 should be consulted. Instructions: Complete ALL applicable sections of this form. For step by step instructions on how to complete this form, click on the Instructions link above or see Instructions MPC 959. ALL PETITIONERS MUST COMPLETE LINE 1 AND LINE 2. 1. The Decedent left a will dated November 7, 2005 . []The dates of all codicils are: ------------------ The will and any codicils are referred to as the will. 2. The following devisees named in the will to inherit personal or real property wereliving at the time of the Decedent's death. (Note: If the devisee is a trust, list the name of the trust and trustees. If any devisee is a charity, list the name of the charity and provide notice to the Massachusetts Attorney General. See G. L. c.190B and Uniform Practice XXXIV). NAME OF DEVISEE ADDRESS (omit if since deceased) RELATIONSHIP TO DECEDENT A MINOR Kathleen Rose Fox 101116th Avenue, Coralville, Iowa, 52241 niece □ Yes Robert C. Tripi 23 Endicott Drive, Westborough, 01581 MA friend □ Yes □ Yes 3. ] The following devisees named in the will to inherit personal or real property were not living at the time of the Decedent's death. NAME OF PREDECEASED DEVISEE DATE OF DEATH RELATIONSHIP TO DECEDENT 4. D If the will names one or more persons to take in place of the pre-deceased devisee, or if the anti-lapse statute (G. L. c. 190B, $ 2-603) applies, list the contingent devisee(s).Do not include residuary devisees named elsewhere. NAME OF CONTINGENT DEVISEE ADDRESS (omit if since deceased) RELATIONSHIP TO DECEDENT A MINOR □ Yes □ Yes MPC 163 (4/15/16) DEV page of 2 Worcester Probate and Family Court Date Filed: 8/17/2022 1:08 PM ALL PETITIONERS MUST COMPLETE LINE 5 AND LINE 6, if applicable. Case Number: 5. NONE of the devisees are under legal disability except for: NAME/ADDRESS OF REPRESENTED BY " (Guardian ad litem required REPRESENTATIVE NAME OF DEVISEE LEGAL DISABILITY (Provide docket number or proof of unless waived. See Instructions) appointment for any court appointed ·ti fiduciary.) [Minor List age: []Guardian --- []Incapacitated or protected person []Conservator (adjudicated or alleged) []Unrepresented D Unborn or unascertained [ Minor List age: [ Guardian --- []Incapacitated or protected person []Conservator (adjudicated or alleged) D Unrepresented* D Unborn or unascertained 6. NONE of the devisees who survived the Decedent are deceased at the time of this filing except for: NAME/ADDRESS OF NAME OF SINCE DATE OF REPRESENTATIVE REPRESENTED BY (Provide docket number or proof of DECEASED DEVISEE DEATH appointment for any court appointed fiduciary.) [Personal Representative (Required for an informal proceeding) [Unrepresented (Formal proceeding required) []Personal Representative (Required for an informal proceeding) []Unrepresented (Formal proceeding required) SIGNED UNDER THE PENALTIES OF PERJURY I certify under the penalties of perjury that the foregoing statements are true to the best of my knowledge and belief. Date: 6£.fc, Signature of Petitioner ~ Robert C. Tripi rint name MPC 163 (4/15/16) DEV page 2 of 2