Document for In the matter of: Woodruff, Nathalie Anne

• 
• 
• 
• 

						
                                
Preview
                                i |

“ te Docket No. ‘:_.amonwealth of Massachusetts
DEVISEES The Trial Court
G.L. c. 190B, § 3-301 DU 22 Pp 01 5 1 EA Probate and Family Court
Original Form Amended Form
Estate of: .
ate o Dukes . Division
Nathalie Anne Woodruff
First Name Middle Name Tast Name
Date of Death: November 18, 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. 190B 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 October 25, 2022 _ CD 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 were living 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).

SO NAME OF DEVISEE = “|” ©. ADDRESS (omitifsince deceased) | RELATIONSHIP TO DECEDENT | A MINOR
- 18 Sengekontacket Road, Oak Bluffs, Yes
Laurel Anne Welch MA 02557 Daughter
Andrew Marshall Woodruff 10 Bourne bane, West Tisbury, MA Son 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, 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 (omtif since deceesec) | © RELATIONSHIP TO'DECEDENT | A MINOR
D Yes
FILED
DEC 3 0 2022
MPC 163 (4/15/16) DEV page 1 of 2 (5)
NUKES PROBATE COURT* ALL PETITIONERS MUST COMPLETE Liné 5 AND LINE 6, if applicable.

4

5. NONE of the devisees are under legal disability except for:

: NAME/ADDRESS OF
: Re eccpNditer. | _ REPRESENTATIVE
‘NAME OF DEVISEE LEGAL DISABILITY required unless waived. | (Provide docket number or proof of
. . See Instructions) "| appointment for any court appointed
~ fiduciary.)
Minor List age: Guardian
Incapacitated or protected person Conservator
(adjudicated or alleged) Unrepresented*
Unborn or unascertained
6. NONE of the devisees who survived the Decedent are deceased at the time of this filing except for:
. . oe 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.)

Unrepresented

Personal Representative
(Required for an informal proceeding)

(Formal proceeding required)

SIGNED UNDER THE PENALTIES OF PERJURY

| certify under the penalties of perjury that the foregoing statements are true to the best of my knowledge and belief.

|

Wa

Date: (u- Z 7h
Signature of Petitioner
Laurel Anne Welch
Print namey
Date: /L- X¥ ~ 2 InarghlB_ ley AG

MPC 163 (4/15/16) DEV

Signature of Petitioner

Andrew Marshall Woodruff

(Print namey

page 2 of 2