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7 Commonwealth of Massachusetts
PETITION FOR FORMAL Docket No.
1' The Trial Court
[KX] PROBATE OF A WILL Probate and Family Court
[) ADJUDICATION OF INTESTACY
LD APPOINTMENT OF A PERSONAL REPRESENTATIVE}
[1] OTHER: ' \ SAY
PURSUANT TO G. L. c. 190B, § 3-402
&X Original Form ( Amended Form
Estate of: Worcester Division
Ruth Esther Knier
A rat Name Middle Name Last Name
ci nA my
Le mw
Date of Déath: February 15, 2021
SEP ~ J 2021
L_ GENERAL INFORMATION
The Petitioner(s) (hereafter Petitioner"), an interested person, makes the following statements:
1. Information about the Decedent:
Name: Ruth Esther Knier Age at death 89
First Name Middle Name Tast Name
Also known as: Ruth E. Knier
Name
Street Address: 140 South Laker Merced Hill 140 San Francisco CA 94132
(Address) Apt, Unil, No. eic.} (City/Town) Ctatey Tip)
The Decedent was domiciled in; San Francisco , CA
’ (CityTown) Ciatey
w A death certificate issued by a public officer is in the possession of the court or accompanies this Petition.
CD 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 G. L. c. 190B, §§ 3-402(b),
1-107): I
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Information about the Petitioner:
Name: Elizabeth Evans
First Name Last Name
(Peake lzabeth Dikeg Cm ifh
420 Bob Watson Truckee CA 96161
TAddress) Apt, Unit, No. ele.) (CiyTown) Crate) py
Mailing Address, if different:
' TAddress) pt, Unit, No. etc) (City/Town) (State) ip)
Primary Phone #: 650 823 5438 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)): personal rep. in will
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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, orthe following circumstances authorize tardy proceedings (include statutory reference):
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FORM ALERT: Do not use this form to file a Jate probate proceeding pursuant to G. L. c. 190B, § 3-108(4). Use form
MPC 161.
MPC 460 (12/11/20) page 1 of 4
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4. Venue for this proceeding is proper in this county because on the date of death, the Decedent:
(was domiciled in this county. [><] was not domiciled in Massachusetts, but had property located in this county at:
Carter Rd. Westminster MA 01473
Address) T TAPE, Unit, No. etc) (City Town) Clate) ip)
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5. [X] The Petitioner shall give notice once by citation to the Division of Medical Assistance. To do so, the Petitioner shall
send a capy of the citation when issued by the court tagether 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.
Il, PERSONS INTERESTED IN THE ESTATE
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6. The Decedent's surviving spouse, children, heirs at law and devisees (if any), so far as known or ascertainable with
teasonable diligence by the Petitioner are as stated in form MPC 162 Surviving Spouse, Children, Heirs at Law AND if
the Decedent died with a will, farm MPC 163 Devisees incorporated herein.
LD There are additional heirs at faw who are not known to the Petitioner.
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FORM ALERT: Failure to submit this information will result in a delay in processing your case.
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t Ill. TESTACY STATUS,
7. The Decedent died (select one):
LC Intestate (withouta will) |
After the exercise of reasorlable diligence, the Petitioner is unaware of any unrevoked testamentary instrument relating
to property in Massachusetts, or LJ see attached statement of why such an instrument is not being probated.
KK] Testate (with a will) ‘
The date of the Decedent's last willis January 8, 2010
CD The dates of all codicils!are
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(select one of the following).
EX The original will is in the possession of the court or accompanies this Petition
(J The criginal will is lost, destroyed or otherwise unavailable and
LC acopy of the oni will accompanies this Petition OR
OD astatement of is contents is attached and incorporated herein.
C2 The will has been probéted iin 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 thejexercise of reasonable diligence, the Petitioner is unaware of any instrument revoking the
will and believes that the will is the Decedent's last will.
IV. APPOINTMENT OF PERSONAL REPRESENTATIVE
(if requested)
8. [X) The Petitioner requests that the following qualified person, who is 18 years of age or older, be appointed Personal
Representative: XJ Self only. C1 Self and other(s): C1 Others):
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Name of other(s) .
' First Name MI. Last Name
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(Address) (Apt, Unit, No. etc.) (City/Town) Crates” ip)
Mailing Address, if different:
(Address) (Apt, Unit, No. ete.) (CityTown) iatey py
| Email
Primary Phone #:
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MPC 160 (12/1-1/20) ' page 2 of 4
9, Select all that apply:
All or some of the nominees have priority for appointment:
by statute. See G. Le, 190B, § 3-203.
(by renunciation and/or nomination. Persons with higher or equal rights to appointment are:
First Name MI TastName
FORM ALERT: Any required refunciationsinominations using form MPC 455 must accompany this Petition.
( The nominee(s) without Priority for appointment are:
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First Name MI Tast Name
C1 Persons with priority have failed to request appointment or to nominate the above nominee and administration is
necessary. '
10. Select one of the following: '
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
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address is: ‘'
First Name MI Cast Name
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(AdaTeSs) (Apt Unit, No. etc) TiyiTowny ®ialey Zip)
11, Select one of the following.’
( Abond with sureties in the penal sum amount of $ has been or will be filed.
i] A bond without sureties has been or will be filed and is permissible because:
The will waives suieties on the bond and no interested person has demanded that a bond with sureties be filed.
C0 All devisees (if a 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.
FORM ALERT: All persons seeking appointment must file a bond using form MPC 801.
12, The Petitioner requests (Selectione of the following):
Unsupervised administration
(] The Decedent died intestate (withaut a will).
KX] The will directs unsupervised adrinistration or is silent on the issue.
1 The will directs supervised administration, but circumstances have changed since the execution of the will
and there is no necessity for supervised administration because:
(1 Supervised administration '
LD The will directs supervised administration.
CD The will directs unsupervised administration, but it is necessary for protection of persons interested in the estate
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MPC 160 (12/11/20) | page 3 of 4
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because: '
(D No will directs supervised administration but it is necessary under the circumstances, specifically:
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13. (1 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).
1 V. RELIEF REQUESTED
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Wherefore the Petitioner requests that the court:
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{X] Admit the Decedent's will to formal probate and determine the heirs.
C] Determine that the Decedent died without a will and determine the heirs.
(CO Determine the heirs of the Decedent.
& Appoint the nominee(s) as Personal Representative of the estate in a(n) [x] unsupervised
C1 supervised administration to serve without [] with sureties on the bond and that Letters be issued.
The Petitioner also requests: '
1] A setting aside of prior informal fi indings as to testacy.
C1 A setting aside of prior informal appointment of Personal Representative.
(1 Other:
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SIGNED UNDER THE PENALTIES OF PERJURY
| certify under the penalties of perjury that the forey:sing + stements are true to the best of my knowledge and belief.
bate: _Ot//4/202/ 1
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Signa! i Petitioner
kL an
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Information on Attorney for Petitioner, if any ere
Bigdature of Attorney
Michael D. DellaMonaca
(rintname)
982 South St
Address) TApt, Unit, No. etc.)
Fitchburg MA 01420
—TciyiTowny (Zip)
Primary Phone #: (978) 342-1914
B.B.0.# 637851
Email: michael@dellamonaca.com
MPC 160 (12/11/20) page 4 of 4
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' 1 7 Commonwealth of Massachusetts PETITION FOR FORMAL Docket No. 1' The Trial Court [KX] PROBATE OF A WILL Probate and Family Court [) ADJUDICATION OF INTESTACY LD APPOINTMENT OF A PERSONAL REPRESENTATIVE} [1] OTHER: ' \ SAY PURSUANT TO G. L. c. 190B, § 3-402 &X Original Form ( Amended Form Estate of: Worcester Division Ruth Esther Knier A rat Name Middle Name Last Name ci nA my Le mw Date of Déath: February 15, 2021 SEP ~ J 2021 L_ GENERAL INFORMATION The Petitioner(s) (hereafter Petitioner"), an interested person, makes the following statements: 1. Information about the Decedent: Name: Ruth Esther Knier Age at death 89 First Name Middle Name Tast Name Also known as: Ruth E. Knier Name Street Address: 140 South Laker Merced Hill 140 San Francisco CA 94132 (Address) Apt, Unil, No. eic.} (City/Town) Ctatey Tip) The Decedent was domiciled in; San Francisco , CA ’ (CityTown) Ciatey w A death certificate issued by a public officer is in the possession of the court or accompanies this Petition. CD 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 G. L. c. 190B, §§ 3-402(b), 1-107): I ' Information about the Petitioner: Name: Elizabeth Evans First Name Last Name (Peake lzabeth Dikeg Cm ifh 420 Bob Watson Truckee CA 96161 TAddress) Apt, Unit, No. ele.) (CiyTown) Crate) py Mailing Address, if different: ' TAddress) pt, Unit, No. etc) (City/Town) (State) ip) Primary Phone #: 650 823 5438 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)): personal rep. in will ' 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, orthe following circumstances authorize tardy proceedings (include statutory reference): 1 FORM ALERT: Do not use this form to file a Jate probate proceeding pursuant to G. L. c. 190B, § 3-108(4). Use form MPC 161. MPC 460 (12/11/20) page 1 of 4 ' { . ‘ 1 4. Venue for this proceeding is proper in this county because on the date of death, the Decedent: (was domiciled in this county. [><] was not domiciled in Massachusetts, but had property located in this county at: Carter Rd. Westminster MA 01473 Address) T TAPE, Unit, No. etc) (City Town) Clate) ip) : 5. [X] The Petitioner shall give notice once by citation to the Division of Medical Assistance. To do so, the Petitioner shall send a capy of the citation when issued by the court tagether 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. Il, PERSONS INTERESTED IN THE ESTATE 1 6. The Decedent's surviving spouse, children, heirs at law and devisees (if any), so far as known or ascertainable with teasonable diligence by the Petitioner are as stated in form MPC 162 Surviving Spouse, Children, Heirs at Law AND if the Decedent died with a will, farm MPC 163 Devisees incorporated herein. LD There are additional heirs at faw who are not known to the Petitioner. 1 FORM ALERT: Failure to submit this information will result in a delay in processing your case. ‘‘ t Ill. TESTACY STATUS, 7. The Decedent died (select one): LC Intestate (withouta will) | After the exercise of reasorlable diligence, the Petitioner is unaware of any unrevoked testamentary instrument relating to property in Massachusetts, or LJ see attached statement of why such an instrument is not being probated. KK] Testate (with a will) ‘ The date of the Decedent's last willis January 8, 2010 CD The dates of all codicils!are ‘ (select one of the following). EX The original will is in the possession of the court or accompanies this Petition (J The criginal will is lost, destroyed or otherwise unavailable and LC acopy of the oni will accompanies this Petition OR OD astatement of is contents is attached and incorporated herein. C2 The will has been probéted iin 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 thejexercise of reasonable diligence, the Petitioner is unaware of any instrument revoking the will and believes that the will is the Decedent's last will. IV. APPOINTMENT OF PERSONAL REPRESENTATIVE (if requested) 8. [X) The Petitioner requests that the following qualified person, who is 18 years of age or older, be appointed Personal Representative: XJ Self only. C1 Self and other(s): C1 Others): t Name of other(s) . ' First Name MI. Last Name 1 (Address) (Apt, Unit, No. etc.) (City/Town) Crates” ip) Mailing Address, if different: (Address) (Apt, Unit, No. ete.) (CityTown) iatey py | Email Primary Phone #: 1 MPC 160 (12/1-1/20) ' page 2 of 4 9, Select all that apply: All or some of the nominees have priority for appointment: by statute. See G. Le, 190B, § 3-203. (by renunciation and/or nomination. Persons with higher or equal rights to appointment are: First Name MI TastName FORM ALERT: Any required refunciationsinominations using form MPC 455 must accompany this Petition. ( The nominee(s) without Priority for appointment are: ‘ First Name MI Tast Name C1 Persons with priority have failed to request appointment or to nominate the above nominee and administration is necessary. ' 10. Select one of the following: ' 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 Cast Name ' ' (AdaTeSs) (Apt Unit, No. etc) TiyiTowny ®ialey Zip) 11, Select one of the following.’ ( Abond with sureties in the penal sum amount of $ has been or will be filed. i] A bond without sureties has been or will be filed and is permissible because: The will waives suieties on the bond and no interested person has demanded that a bond with sureties be filed. C0 All devisees (if a 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. FORM ALERT: All persons seeking appointment must file a bond using form MPC 801. 12, The Petitioner requests (Selectione of the following): Unsupervised administration (] The Decedent died intestate (withaut a will). KX] The will directs unsupervised adrinistration or is silent on the issue. 1 The will directs supervised administration, but circumstances have changed since the execution of the will and there is no necessity for supervised administration because: (1 Supervised administration ' LD The will directs supervised administration. CD The will directs unsupervised administration, but it is necessary for protection of persons interested in the estate t ' MPC 160 (12/11/20) | page 3 of 4 ' |1 | because: ' (D No will directs supervised administration but it is necessary under the circumstances, specifically: 7 13. (1 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). 1 V. RELIEF REQUESTED 1 Wherefore the Petitioner requests that the court: 1 {X] Admit the Decedent's will to formal probate and determine the heirs. C] Determine that the Decedent died without a will and determine the heirs. (CO Determine the heirs of the Decedent. & Appoint the nominee(s) as Personal Representative of the estate in a(n) [x] unsupervised C1 supervised administration to serve without [] with sureties on the bond and that Letters be issued. The Petitioner also requests: ' 1] A setting aside of prior informal fi indings as to testacy. C1 A setting aside of prior informal appointment of Personal Representative. (1 Other: ' SIGNED UNDER THE PENALTIES OF PERJURY | certify under the penalties of perjury that the forey:sing + stements are true to the best of my knowledge and belief. bate: _Ot//4/202/ 1 - Signa! i Petitioner kL an Lv / Information on Attorney for Petitioner, if any ere Bigdature of Attorney Michael D. DellaMonaca (rintname) 982 South St Address) TApt, Unit, No. etc.) Fitchburg MA 01420 —TciyiTowny (Zip) Primary Phone #: (978) 342-1914 B.B.0.# 637851 Email: michael@dellamonaca.com MPC 160 (12/11/20) page 4 of 4