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Essex Probate and Family Court
Date Filed: 9/1/2021 12:04 PM
DocuSign Envelope ID: 13B41965-994A-4582-88B2-9DA4OB11 D415
Case Number:
PETITION FOR INFORMAL Docket No. Commonwealth of Massachusetts
The Trial Court
[8] PROBATE OF WILL Probate and Family Court
[8] APPOINTMENT OF PERSONAL
REPRESENTATIVE
PURSUANT TO G.L. c. 190B, $3-301
~ Original Form
â–¡ Amended Form
Estate of:
Elisabeth R Fifield ESSEX Division
First Name Middle Name Last Name
Date of Death: February 5, 2021
I. GENERAL INFORMATION
The Petitioner(s) (hereafter "Petitioner"), an interested person(s), makes the following statements:
1. Information about the Decedent:
Name: Elisabeth" Fifield Age at dea# 87
First Name Middle Name Last Name
Also known as:
------------------ Name
Brooksby
street Address: 302Brooks xxxxxx Unit 211 Peabody MA
Village 01960 D
(Address) (Apt, Unit, No., etc.) (City/Town) (State) (Zip)
The Decedent was domiciled in Peabody MA
(City/Town) (State)
FORM ALERT: A death certificate issued by a public officer is in the possession of the court or accompanies this
Petition.
2. Information about the Petitioner(s):
Name: Jayne F Knott
First Name M.I. Last Name
115 Glen Avenue Upton MA 01568
(Address) (Apt, Unit, No. etc.) (City/Town) (State) (Zip)
Mailing Address, if different: P.O. Box 515 Upton MA 01568
(Address) (Apt, Unit, No. etc.) (City/Town) (State) (Zip)
Primary Phone #: 508-344-2831
The Petitioner's interest in the estate is
as follows (e.g.,Personal Representative named in a will, surviving spouse, heir,.
devisee, etc. See G.L. c 190B § 1-201(24)): Personal Representative named in Will (Successor)
Name:
First Name M.I. Last Name
(Address) (Apt, Unit, No. etc.) (City/Town) (State) (Zip)
Mailing Address, if different:
(Address) (Apt, Unit, No. etc.) (City/Town) (State) (Zip)
Primary Phone #:
The Petitioner's interest in the estate is as follows
(e.g.,Personal Representative named in a will,
surviving spouse, heir,.
devisee, etc. See G.L. c 190B § 1-201(24)):
----------------------------
{Forms Library/TRU/ESTATES/MPC 150 (4-16) - Petition for Informal Probate of Will and-or Appointment of Personal Rep.doc; 1 }MPC
150
(4/15/16) page 1 of 3
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Essex Probate and Family Court
DocuSign Envelope ID: 13841965-9944-4582-882-9DA4DB11D415
Date Filed: 9/1/2021 12:04 PM
Case Number:
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):
FORM ALERT: Do not use this form to file a late probate proceeding pursuant to G. L. c. 190B, § 3-108(4). Use form
MPC161.
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:
(Address) (Apt, Unit, No., etc.) (City/Town) (State) (Zip)
5. ] The Petitioner gave written notice seven (7) days prior to petitioning for informal probate or appointment by sending a
copy of this Petition and death certificate by certified mail to Division of Medical Assistance, Estate Recovery Unit,
P.O. Box 15205, Worcester, MA 01615-0205.
II. PERSONS INTERESTED IN THE ESTATE
6. 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 MPC 162 Surviving Spouse, Children, Heirs at Law AND if
the Decedent died with a will, form MPC 163 Devisees incorporated herein.
[] There are additional heirs at law who are not known to the Petitioner (Formal proceeding required).
FORM ALERT: Failure to submit this information will result in a delay in processing your case.
Ill. TESTACY STATUS
7. The Decedent died (select one):
D Intestate (without a will)
After the exercise of reasonable diligence, the Petitioner is unaware of any unrevoked testamentary instrument relating
to property inMassachusetts, or LJ 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 December7.2010
D The dates of all codicils are
-----------------------
(select one of the following):
r8] The original will is in the possession of the court or accompanies this Petition.
D The original will has been probated in Massachusetts and the Petitioner adopts the statements in the
Petition for Probate.
D The original 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.
IV. APPOINTMENT OF PERSONAL REPRESENTATIVE
(if requested)
8. ] The Petitioner requests that the following qualified person, who is 18 years of age or older, be appointed Personal
Representative: [] Self only. [] Self and other(s): [] other(s):
Name of other(s): _
First Name M.I. Last Name
(Address) (Apt, Unit, No. etc.) (City/Town) (State) (Zip)
{Forms Library/TRU/ESTATES/MPC 150 (4-16) - Petition for Informal Probate of Will and-or Appointment of Personal Rep.doc; 1 }M PC
150
(4/15/16) page 2 of 3
TurboLaw - (800) 518-8726--c.g.f.
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Essex Probate and Family Court
DocuSign Envelope ID: 13B41965-994A-4582-882-9DA4DB11D415 Date Filed: 9/1/2021 12:04 PM
Case Number:
9. All nominees listed above have priority for appointment:
y statute. See G. L. c. 190B, § 3-203.
D by renunciation and/or nomination. Persons with higher or equal rights to appointment are:
FORM ALERT: All required renunciations/nominations using form MPC 455 must accompany this Petition.
10. Select one of the following:
[gl No court has appointed a Personal Representative and no such appointment proceeding is pending in
Massachusetts or elsewhere.
D A court has appointed 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:
11. Select one of the following:
D A bond with sureties with the penal sum amount of$
------------
has been filed.
[gl A bond without sureties has been filed and is permissible because:
[gl The will waives sureties on the bond and no interested person has demanded that a bond with sureties be filed.
D .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 the waivers are filed with this Petition or are in the possession of the xourt.
FORM ALERT: All persons seeking appointment must file a bond using form MPC 801.
V. RELIEF REQUESTED
Wherefore, the Petitioner requests that the court/magistrate:
[gl Admit the Decedent's will to informal probate.
[gl Appoint the nominee(s) with priority for appointment as Personal Representative of the estate in an
unsupervised administration to serve [gl without D with sureties on the bond and that Letters be issued.
SIGNED UNDER THE PENALTIES OF PERJURY
Icertify under the penalties of perjury that the foregoing stateme 34e4to the best of my knowledge and belief.
Date:
8/3/2021 val
Signature
Date:
------------------
Information on Attorney for Petitioner, if any
Signature of At
311Main Street, P.O. Box 15156
(Ad d ress} (Apt, Un it, No . etc}
Worcester MA 01615-0156
(C ity/T ow n ) (Stale ) (Zip }
Primary Phone #: 50
_8_-_9_
2_
6-_3_4_1_
5 _
B.B.O.# 691118
Email: adragga@bowditch.com
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(4/15/16) page 3 of 3
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Essex Probate and Family Court Date Filed: 9/1/2021 12:04 PM DocuSign Envelope ID: 13B41965-994A-4582-88B2-9DA4OB11 D415 Case Number: PETITION FOR INFORMAL Docket No. Commonwealth of Massachusetts The Trial Court [8] PROBATE OF WILL Probate and Family Court [8] APPOINTMENT OF PERSONAL REPRESENTATIVE PURSUANT TO G.L. c. 190B, $3-301 ~ Original Form □ Amended Form Estate of: Elisabeth R Fifield ESSEX Division First Name Middle Name Last Name Date of Death: February 5, 2021 I. GENERAL INFORMATION The Petitioner(s) (hereafter "Petitioner"), an interested person(s), makes the following statements: 1. Information about the Decedent: Name: Elisabeth" Fifield Age at dea# 87 First Name Middle Name Last Name Also known as: ------------------ Name Brooksby street Address: 302Brooks xxxxxx Unit 211 Peabody MA Village 01960 D (Address) (Apt, Unit, No., etc.) (City/Town) (State) (Zip) The Decedent was domiciled in Peabody MA (City/Town) (State) FORM ALERT: A death certificate issued by a public officer is in the possession of the court or accompanies this Petition. 2. Information about the Petitioner(s): Name: Jayne F Knott First Name M.I. Last Name 115 Glen Avenue Upton MA 01568 (Address) (Apt, Unit, No. etc.) (City/Town) (State) (Zip) Mailing Address, if different: P.O. Box 515 Upton MA 01568 (Address) (Apt, Unit, No. etc.) (City/Town) (State) (Zip) Primary Phone #: 508-344-2831 The Petitioner's interest in the estate is as follows (e.g.,Personal Representative named in a will, surviving spouse, heir,. devisee, etc. See G.L. c 190B § 1-201(24)): Personal Representative named in Will (Successor) Name: First Name M.I. Last Name (Address) (Apt, Unit, No. etc.) (City/Town) (State) (Zip) Mailing Address, if different: (Address) (Apt, Unit, No. etc.) (City/Town) (State) (Zip) Primary Phone #: The Petitioner's interest in the estate is as follows (e.g.,Personal Representative named in a will, surviving spouse, heir,. devisee, etc. See G.L. c 190B § 1-201(24)): ---------------------------- {Forms Library/TRU/ESTATES/MPC 150 (4-16) - Petition for Informal Probate of Will and-or Appointment of Personal Rep.doc; 1 }MPC 150 (4/15/16) page 1 of 3 TurboLaw - (800) 518-8726-c.g.f. 4823-9200-9715. I Essex Probate and Family Court DocuSign Envelope ID: 13841965-9944-4582-882-9DA4DB11D415 Date Filed: 9/1/2021 12:04 PM Case Number: 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): FORM ALERT: Do not use this form to file a late probate proceeding pursuant to G. L. c. 190B, § 3-108(4). Use form MPC161. 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: (Address) (Apt, Unit, No., etc.) (City/Town) (State) (Zip) 5. ] The Petitioner gave written notice seven (7) days prior to petitioning for informal probate or appointment by sending a copy of this Petition and death certificate by certified mail to Division of Medical Assistance, Estate Recovery Unit, P.O. Box 15205, Worcester, MA 01615-0205. II. PERSONS INTERESTED IN THE ESTATE 6. 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 MPC 162 Surviving Spouse, Children, Heirs at Law AND if the Decedent died with a will, form MPC 163 Devisees incorporated herein. [] There are additional heirs at law who are not known to the Petitioner (Formal proceeding required). FORM ALERT: Failure to submit this information will result in a delay in processing your case. Ill. TESTACY STATUS 7. The Decedent died (select one): D Intestate (without a will) After the exercise of reasonable diligence, the Petitioner is unaware of any unrevoked testamentary instrument relating to property inMassachusetts, or LJ 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 December7.2010 D The dates of all codicils are ----------------------- (select one of the following): r8] The original will is in the possession of the court or accompanies this Petition. D The original will has been probated in Massachusetts and the Petitioner adopts the statements in the Petition for Probate. D The original 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. IV. APPOINTMENT OF PERSONAL REPRESENTATIVE (if requested) 8. ] The Petitioner requests that the following qualified person, who is 18 years of age or older, be appointed Personal Representative: [] Self only. [] Self and other(s): [] other(s): Name of other(s): _ First Name M.I. Last Name (Address) (Apt, Unit, No. etc.) (City/Town) (State) (Zip) {Forms Library/TRU/ESTATES/MPC 150 (4-16) - Petition for Informal Probate of Will and-or Appointment of Personal Rep.doc; 1 }M PC 150 (4/15/16) page 2 of 3 TurboLaw - (800) 518-8726--c.g.f. 4823-9200-9715. l Essex Probate and Family Court DocuSign Envelope ID: 13B41965-994A-4582-882-9DA4DB11D415 Date Filed: 9/1/2021 12:04 PM Case Number: 9. All nominees listed above have priority for appointment: y statute. See G. L. c. 190B, § 3-203. D by renunciation and/or nomination. Persons with higher or equal rights to appointment are: FORM ALERT: All required renunciations/nominations using form MPC 455 must accompany this Petition. 10. Select one of the following: [gl No court has appointed a Personal Representative and no such appointment proceeding is pending in Massachusetts or elsewhere. D A court has appointed 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: 11. Select one of the following: D A bond with sureties with the penal sum amount of$ ------------ has been filed. [gl A bond without sureties has been filed and is permissible because: [gl The will waives sureties on the bond and no interested person has demanded that a bond with sureties be filed. D .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 the waivers are filed with this Petition or are in the possession of the xourt. FORM ALERT: All persons seeking appointment must file a bond using form MPC 801. V. RELIEF REQUESTED Wherefore, the Petitioner requests that the court/magistrate: [gl Admit the Decedent's will to informal probate. [gl Appoint the nominee(s) with priority for appointment as Personal Representative of the estate in an unsupervised administration to serve [gl without D with sureties on the bond and that Letters be issued. SIGNED UNDER THE PENALTIES OF PERJURY Icertify under the penalties of perjury that the foregoing stateme 34e4to the best of my knowledge and belief. Date: 8/3/2021 val Signature Date: ------------------ Information on Attorney for Petitioner, if any Signature of At 311Main Street, P.O. Box 15156 (Ad d ress} (Apt, Un it, No . etc} Worcester MA 01615-0156 (C ity/T ow n ) (Stale ) (Zip } Primary Phone #: 50 _8_-_9_ 2_ 6-_3_4_1_ 5 _ B.B.O.# 691118 Email: adragga@bowditch.com {Forms library/TRU/ESTATES/MPC 150 (4-16)- Petition for Informal Probate of Will and-or Appointment of Personal Rep.doc;1}MPC 150 (4/15/16) page 3 of 3 TurboLaw - (800) 518-8726-c.g.f. 4823-9200-97I5.1