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PETITION FOR FORMAL Docket No. Commonwealth of Massachusetts
[{X] PROBATE OF A WILL The Trial Court
Probate and Family Court
[D ADJUDICATION OF INTESTACY
X APPOINTMENT OF A PERSONAL REPRESENTATIVE
Oo OTHER:
' PURSUANT TO G. L. c: 190B, § 3-402
OOP EA
m Original Form ( Amended Form
Estate of: Worcester Division
|| Paul
First Name
R.
Middle Name
Lapierre
Last Name
|
Date of Death: June 24, 2022
FILED ViDD
AUG 17 2022
| I. GENERAL INFORMATIO
The Petitioner(s) (hereafter "Petitioner"), an interested person, makes the following statements:
1 Information about the Decedent:
| Name: Paul Lapierre Ageatdeath 85
First Name Middle Name Last Name
| Also known as:
| Name
| Street Address: 116 South Quinsigamond Ave Shrewsbury MA 01545
G fares) pt, Unit, No- ete) (CityTowny Clatey (Zip)
! The Decedent was domiciled in Shrewsbury MA
(City/Town) ’
®tatey
XX] A death certificate issued by a public officer is in the possession of the court or accompanies this Petition.
C1 A death certificate issued by a public officer is not in the possession of the court and does not accompany this Petition
The circumstances which make it impossible for a death certificate to be provided are (See GL. c. 190B, §§ 3-402(b),
~107):
2. Information about the Petitioner:
Name: Paulette McKenzie
First Name MT. Last Name
87 Alvarado Avenue Worcester MA 01604
(Address) (Apt, Unit, No. etc.) (CityTowny Ctatey py
Mailing Address, if different:
(Address) (Apt, Unit, No. etc.) CyTTowy Ciatey ip)
Primary Phone #: 5087993939 Email:
The Petitioner's interest in the estate is as follows (e.g., Personal Representative named in a will, surviving spouse, heir,
, devisee, Public Administrator, creditor, etc. See G. L. c. 190B,-§ 1-201(24)): name in will
,
i
3. This Petition is filed within the time period permitted by law. See G. L. c. 190B, § 3-108. Three years or less have passed
| since the Decedent's death, or the following circumstances authorize tardy proceedings (include statutory reference):
1
‘ORM ALERT: Do not use this form to file a late probate proceeding pursuantto G. L. c. 190B, § 3-108(4). Use form
MPC 161.
Cc eo (12/11/20) page 1 of 4
Venue for this proceeding is proper in this county because on the date of death, the Decedent:
{X] was domiciled in this county. [_] was not domiciled in Massachusetts, put had property located in this county at:
(Address) (Apt, Unit, Nov etc.) (CityTowny tate) Zipy
5. [ The Petitioner shall give notice once by citation to the Division.of Medical Assistance. To do so, the Petitioner shall
send a copy of the citation when issued by the court together with a copy of this Petition and death certificate by
certified mail at least fourteen (14) days before the return day to the Division of Medical Assistance, Estate Recovery
Unit P.O. Box 15205, Worcester, MA 01615-0205. For specific details, see the citation's Order of Notice.
IRSONS IN ESTED IN ESTATE
The Decedent's surviving spouse, children, heirs at law and devisees (if any), so far as known or ascertainable with
reasonable diligence by the Petitioner are as stated in form IPC 162 Spouse, leirsat Li AND if
the Decedent died with a will, form MPC 163 Devisees incorporated herein.
XX There are additional heirs at law who are not known to the Petitioner.
FORM ALERT: Failure to submit this information will result in a delay in processing your case.
Ill. TESTACY STATU:
7.| The Decedent died (select one):
LJ Intestate (without a will)
After the exercise of reasonable diligence, the Petitioner is unaware of any unrevoked testamentary instrument relating
to property in Massachusetts, or [_] see attached Statement of why such an instrument is not being probated.
Testate (with a will)
The date of the Decedent's last will is May 13, 2014
LD The dates of ail codicils are
(select one of the following):
C1 The original will is in the possession of the court or accompanies this Petition.
XJ The original will is lost, destroyed or otherwise unavailable and
[XJ a copy of the original will accompanies this Petition OR
{1 a statement of its contents is attached and incorporated herein.
CJ The will has been probated in the state or country of
An authenticated copy of the will and proof of its probate are filed with this Petition.
The will and any codicils are referred to as the will. The Petitioner, to the best of his or her knowledge, believes the will
was validly executed. After the exercise of reasonable diligence, the Petitioner is unaware of any instrument revoking the
will and believes that the will is the Decedent's last will.
IENT OF PER: REPRESENTATIV!
(if requested)
|
8. | J] The Petitioner requests that the following qualified person, who is 18 years of age or older, be appointed Personal
|1 Representative: [] Self only. CO Self and other(s): Other(s):
Name of other(s):
|! Paulette
First Name MT.
McKenzie
Last Name
87 Alvarado Avenue Worcester MA 01604
Tess) Apt, Unit, No. etc) (CityTowny Crate) ip)
Mailing Address, if different:
Address) TApt, Unit, No. te) (CityTowny Cate) ipy
i
Primary Phone #: 5087993939 Email:
|
wecheo (12/11/20) page 2 of 4
s Select all that apply:
[XJ All or some of the nominees have priority for appointment:
1
1{ X] by statute. See G. L. c. 190B, § 3-203.
1 (1 by renunciation and/or nomination. Persons with higher or equal rights to appointment are:
First Name - MI Tast Name
FORM ALERT: Any required renunciations/nominations using form MPC 455 must accompany this Petition.
(1) The nominee(s) without priority for appointment are:
First Name MT. Last Name
C Persons with priority have failed to request appointment or to nominate the above nominee and administration is
necessary.
10, Select one of the following:
KX) No court has appointed a Personal Representative and no such appointment proceeding is pending in
|© Massachusetts or elsewhere.
Acourt has appointed a Personal Representative, whose appointment has not been terminated, or an appointment
proceeding is pending in the State of and the Personal Representative's name and
address is:
First Name MI Tast Name
(Address) Apt, Unit, No. et (CcityiTowny Gtatey (Zip)
11. Select one of the following:
A bond with sureties in the penal sum amount of $ has been or will be filed.
x A bond without sureties has been or will be filed and is permissible because:
[X] The will waives sureties on the bond-and no interested person has demanded that a bond with sureties be filed.
1 C All devisees (ifa will is filed) or heirs (if no will is filed) have waived sureties in writing using form MPC 455 and
all waivers are filed with this Petition or are in the possession of the court.
FORMIALERT: All persons seeking appointment must file a bond using form MPC 801.
12. The Petitioner requests (Select one of the following):
{Unsupervised administration
(J The Decedent died intestate (without a will).
The will directs unsupervised administration or is silent on the issue.
C The will directs supervised administration, but circumstances have changed since the execution of the will
and there is no necessity for supervised administration because:
|
Supervised administration
| LC The will directs supervised administration.
\ CH The will directs unsupervised administration, but it is necessary for protection of persons interested in the estate
MPC 160 (12/11/20) page 3 of 4
|
because:
2 No will directs supervised administration but it is necessary under the circumstances, specifically:
1
\
13. {XJ The appointment of a Special Personal Representative is necessary pursuant to G. L. c. 190B, § 3-614 (See Separate
|| motion and affidavit filed with this Petition).
|
Vv. JEF REQUESTED
lherefore the Petitioner requests that the court:
[IX] Admit the Decedent's will to formal probate and determine the heirs.
(i Determine that the Decedent died without a will and determine the heirs.
LJ Determine the heirs of the Decedent.
X] Appoint the nominee(s) as Personal Representative of the estate in a(n) [ unsupervised
L) supervised administration to serve [x] without [] with sureties on the bond and that Letters be issued
The Petitioner also requests:
| A setting aside of prior informal findings as to testacy.
[| A setting aside of prior informal appointment of Personal Representative.
[| Other:
SIGNED UNDER THE PENALTIES OF PERJURY
| certify under, the 1p: of perjury that the foregoing fements are to the best of my knowledge and belief.
Date: Ab: 202 Lin. Qe. Wen
ignature of Pétitbner
afe
Information on Attorney for Petitioner, if any
| Signature c=
of 7
| Robert Osol/Melia & Osol
Print name)
16 Harvard Street
TAdaress) Apr, Unit, No. etc:y
Worcester 01609
(City/Towny (State) Zip)
Primary Phone #: (508) 753-5552
B.B.O. # 380625
Email: rosol@melia-osol.com/cpleau@melia-osol.com !
MPC 160 (12/11/20) page 4 of 4
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PETITION FOR FORMAL Docket No. Commonwealth of Massachusetts [{X] PROBATE OF A WILL The Trial Court Probate and Family Court [D ADJUDICATION OF INTESTACY X APPOINTMENT OF A PERSONAL REPRESENTATIVE Oo OTHER: ' PURSUANT TO G. L. c: 190B, § 3-402 OOP EA m Original Form ( Amended Form Estate of: Worcester Division || Paul First Name R. Middle Name Lapierre Last Name | Date of Death: June 24, 2022 FILED ViDD AUG 17 2022 | I. GENERAL INFORMATIO The Petitioner(s) (hereafter "Petitioner"), an interested person, makes the following statements: 1 Information about the Decedent: | Name: Paul Lapierre Ageatdeath 85 First Name Middle Name Last Name | Also known as: | Name | Street Address: 116 South Quinsigamond Ave Shrewsbury MA 01545 G fares) pt, Unit, No- ete) (CityTowny Clatey (Zip) ! The Decedent was domiciled in Shrewsbury MA (City/Town) ’ ®tatey XX] A death certificate issued by a public officer is in the possession of the court or accompanies this Petition. C1 A death certificate issued by a public officer is not in the possession of the court and does not accompany this Petition The circumstances which make it impossible for a death certificate to be provided are (See GL. c. 190B, §§ 3-402(b), ~107): 2. Information about the Petitioner: Name: Paulette McKenzie First Name MT. Last Name 87 Alvarado Avenue Worcester MA 01604 (Address) (Apt, Unit, No. etc.) (CityTowny Ctatey py Mailing Address, if different: (Address) (Apt, Unit, No. etc.) CyTTowy Ciatey ip) Primary Phone #: 5087993939 Email: The Petitioner's interest in the estate is as follows (e.g., Personal Representative named in a will, surviving spouse, heir, , devisee, Public Administrator, creditor, etc. See G. L. c. 190B,-§ 1-201(24)): name in will , i 3. This Petition is filed within the time period permitted by law. See G. L. c. 190B, § 3-108. Three years or less have passed | since the Decedent's death, or the following circumstances authorize tardy proceedings (include statutory reference): 1 ‘ORM ALERT: Do not use this form to file a late probate proceeding pursuantto G. L. c. 190B, § 3-108(4). Use form MPC 161. Cc eo (12/11/20) page 1 of 4 Venue for this proceeding is proper in this county because on the date of death, the Decedent: {X] was domiciled in this county. [_] was not domiciled in Massachusetts, put had property located in this county at: (Address) (Apt, Unit, Nov etc.) (CityTowny tate) Zipy 5. [ The Petitioner shall give notice once by citation to the Division.of Medical Assistance. To do so, the Petitioner shall send a copy of the citation when issued by the court together with a copy of this Petition and death certificate by certified mail at least fourteen (14) days before the return day to the Division of Medical Assistance, Estate Recovery Unit P.O. Box 15205, Worcester, MA 01615-0205. For specific details, see the citation's Order of Notice. IRSONS IN ESTED IN ESTATE The Decedent's surviving spouse, children, heirs at law and devisees (if any), so far as known or ascertainable with reasonable diligence by the Petitioner are as stated in form IPC 162 Spouse, leirsat Li AND if the Decedent died with a will, form MPC 163 Devisees incorporated herein. XX There are additional heirs at law who are not known to the Petitioner. FORM ALERT: Failure to submit this information will result in a delay in processing your case. Ill. TESTACY STATU: 7.| The Decedent died (select one): LJ Intestate (without a will) After the exercise of reasonable diligence, the Petitioner is unaware of any unrevoked testamentary instrument relating to property in Massachusetts, or [_] see attached Statement of why such an instrument is not being probated. Testate (with a will) The date of the Decedent's last will is May 13, 2014 LD The dates of ail codicils are (select one of the following): C1 The original will is in the possession of the court or accompanies this Petition. XJ The original will is lost, destroyed or otherwise unavailable and [XJ a copy of the original will accompanies this Petition OR {1 a statement of its contents is attached and incorporated herein. CJ The will has been probated in the state or country of An authenticated copy of the will and proof of its probate are filed with this Petition. The will and any codicils are referred to as the will. The Petitioner, to the best of his or her knowledge, believes the will was validly executed. After the exercise of reasonable diligence, the Petitioner is unaware of any instrument revoking the will and believes that the will is the Decedent's last will. IENT OF PER: REPRESENTATIV! (if requested) | 8. | J] The Petitioner requests that the following qualified person, who is 18 years of age or older, be appointed Personal |1 Representative: [] Self only. CO Self and other(s): Other(s): Name of other(s): |! Paulette First Name MT. McKenzie Last Name 87 Alvarado Avenue Worcester MA 01604 Tess) Apt, Unit, No. etc) (CityTowny Crate) ip) Mailing Address, if different: Address) TApt, Unit, No. te) (CityTowny Cate) ipy i Primary Phone #: 5087993939 Email: | wecheo (12/11/20) page 2 of 4 s Select all that apply: [XJ All or some of the nominees have priority for appointment: 1 1{ X] by statute. See G. L. c. 190B, § 3-203. 1 (1 by renunciation and/or nomination. Persons with higher or equal rights to appointment are: First Name - MI Tast Name FORM ALERT: Any required renunciations/nominations using form MPC 455 must accompany this Petition. (1) The nominee(s) without priority for appointment are: First Name MT. Last Name C Persons with priority have failed to request appointment or to nominate the above nominee and administration is necessary. 10, Select one of the following: KX) No court has appointed a Personal Representative and no such appointment proceeding is pending in |© Massachusetts or elsewhere. Acourt has appointed a Personal Representative, whose appointment has not been terminated, or an appointment proceeding is pending in the State of and the Personal Representative's name and address is: First Name MI Tast Name (Address) Apt, Unit, No. et (CcityiTowny Gtatey (Zip) 11. Select one of the following: A bond with sureties in the penal sum amount of $ has been or will be filed. x A bond without sureties has been or will be filed and is permissible because: [X] The will waives sureties on the bond-and no interested person has demanded that a bond with sureties be filed. 1 C All devisees (ifa will is filed) or heirs (if no will is filed) have waived sureties in writing using form MPC 455 and all waivers are filed with this Petition or are in the possession of the court. FORMIALERT: All persons seeking appointment must file a bond using form MPC 801. 12. The Petitioner requests (Select one of the following): {Unsupervised administration (J The Decedent died intestate (without a will). The will directs unsupervised administration or is silent on the issue. C The will directs supervised administration, but circumstances have changed since the execution of the will and there is no necessity for supervised administration because: | Supervised administration | LC The will directs supervised administration. \ CH The will directs unsupervised administration, but it is necessary for protection of persons interested in the estate MPC 160 (12/11/20) page 3 of 4 | because: 2 No will directs supervised administration but it is necessary under the circumstances, specifically: 1 \ 13. {XJ The appointment of a Special Personal Representative is necessary pursuant to G. L. c. 190B, § 3-614 (See Separate || motion and affidavit filed with this Petition). | Vv. JEF REQUESTED lherefore the Petitioner requests that the court: [IX] Admit the Decedent's will to formal probate and determine the heirs. (i Determine that the Decedent died without a will and determine the heirs. LJ Determine the heirs of the Decedent. X] Appoint the nominee(s) as Personal Representative of the estate in a(n) [ unsupervised L) supervised administration to serve [x] without [] with sureties on the bond and that Letters be issued The Petitioner also requests: | A setting aside of prior informal findings as to testacy. [| A setting aside of prior informal appointment of Personal Representative. [| Other: SIGNED UNDER THE PENALTIES OF PERJURY | certify under, the 1p: of perjury that the foregoing fements are to the best of my knowledge and belief. Date: Ab: 202 Lin. Qe. Wen ignature of Pétitbner afe Information on Attorney for Petitioner, if any | Signature c= of 7 | Robert Osol/Melia & Osol Print name) 16 Harvard Street TAdaress) Apr, Unit, No. etc:y Worcester 01609 (City/Towny (State) Zip) Primary Phone #: (508) 753-5552 B.B.O. # 380625 Email: rosol@melia-osol.com/cpleau@melia-osol.com ! MPC 160 (12/11/20) page 4 of 4 {