PETITION FOR LETTERS OF SPECIAL ADMINISTRATION PR-4

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PETITION FOR LETTERS OF SPECIAL ADMINISTRATION PR-4 The District Court Filing Office is located on the first floor at: 75 Court Street Reno, NV 89501 www.washoecourts.com

PETITION FOR LETTERS OF SPECIAL ADMINISTRATION PACKET PR-4 Special Administrations are temporary. A formal Petition to Administer the Estate will be required at a future date. USE THIS PETITION FOR LETTERS OF ADMINISTRATION ONLY IF ALL OF THE FOLLOWING STATEMENTS ARE TRUE: There is an urgent need to protect the assets of an estate. You are 18 years of age or older. You have never been convicted of a felony. You are a resident of the State of Nevada. If you are not a resident of the State of Nevada, you may still qualify to serve as a Special Administrator. ONE of the following conditions must be met: You are named in the Will of the estate as an Executor; - OR - There is a co-administrator that is a resident of the State of Nevada Additionally, ONE of the following requirements must be met. Decedent was a resident of Washoe County; - OR - Decedent was not a resident of Washoe County, but died with an estate located in Washoe County; - OR - Decedent was not a resident of Washoe County, but died in Washoe County AND the death was the result of a wrongful death action in Washoe County. Do Not Copy Or File This Page The penalty for willfully making a false statement under penalty of perjury is a minimum of 1 year, and a maximum of 4 years in prison, in addition to a fine of not more than $5,000.00. N.R.S. 199.145. REV KV 11/16 PR-4 VISUAL INSTRUCTIONS

INSTRUCTIONS FOR COMPLETING FORMS CAREFULLY READ ALL INSTRUCTIONS BEFORE STARTING TO FILL OUT ANY OF THE FORMS Use black or blue ink only. Neatly print the information requested. Do not use correction fluid/tape on the forms. This packet contains the following forms: 1. Special Administrator Instructions 2. Petition for Letters of Special Administration 3. Index of Exhibits and Exhibit Cover Page 4. Request for Submission 5. Letters of Special Administration Do Not Copy Or File This Page The penalty for willfully making a false statement under penalty of perjury is a minimum of 1 year, and a maximum of 4 years in prison, in addition to a fine of not more than $5,000.00. N.R.S. 199.145. REV KV 11/16 PR-4 VISUAL INSTRUCTIONS

INSTRUCTIONS: STEP 1 Do Not Copy Or File This Page Complete the Petition for Letters of Special Administration as Shown: A certified copy of the decedent s death certificate - OR - other proof of death must be attached as Exhibit 1. 1) Print your name, address, telephone number, and email address. You will be assigned a case number when you file the Petition with the Court. 2) Print the Decedent s name. 3) Complete pages 1-3, following the instructions on each page. REV KV 11/16 PR-4 VISUAL INSTRUCTIONS

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 Code: 3595 Name: Address: Telephone: E-mail Address: Self-Represented IN THE SECOND JUDICIAL DISTRICT COURT OF THE STATE OF NEVADA IN THE MATTER OF THE ESTATE OF: IN AND FOR THE COUNTY OF WASHOE, Case No. Deceased. / Dept. No. PR PETITION FOR LETTERS OF SPECIAL ADMINISTRATION I respectfully represent as follows: 1. That the Decedent,, died on or about the day of,. A certified copy of Decedent s Death Certificate, or other proof of death, is attached hereto as Exhibit 1. 2. The Decedent was, at the time of his/her death, a resident of the County of Washoe, State of Nevada, and that his/her Estate consists of real and/or personal property and that the exact value and character of said property has not been determined, but it is believed to be of an estimated total value of [check one]: More than $200,000.00 Between $100,000.00 and $200,000.00 Less than $100,000.00 3. There is no person authorized to care for the property belonging to the Estate and there is 28 REVISED 8/2015 1 LETTERS OF SPECIAL ADMINISTRATION

1 2 3 danger of the same being neglected and greatly damaged thereby, and someone should be authorized to take charge of and care of the property of the Estate. In addition, Special Administration is needed for the following reason(s): 4 5 6 7 8 9 10 11 12 13 14 15. 4. Decedent died [check one]: without a Last Will and Testament. Petitioner is a Nevada resident [see NRS 139.010]. OR with a Last Will and Testament. The Will has OR has not been lodged with this Court pursuant to NRS 136.050. Petitioner is the person named in the Will to serve as Executor, with OR without bond. [If necessary, please provide additional explanation]: 16 17 18 19 20 21. 5. Petitioner is willing to act as Special Administrator of the Estate to ascertain the assets and protect the same and for the reasons stated in 3, above. Petitioner is over the age of 18 years and has never been convicted of a felony. Petitioner s address is: 22 23 24 25 26 27. 6. The following are all of the relatives, heirs, next of kin, and persons named in the Will of the Decedent within the second degree of consanguinity: (IMPORTANT: Must include: legally married spouse, all living parents, siblings, and all children, even if estranged, out of state, or 28 REVISED 8/2015 2 LETTERS OF SPECIAL ADMINISTRATION

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 disinherited in Will. Relationship to Decedent must be listed, as well as whether adult or minor (with age of minors listed) and address of each (if unknown put last address or unknown ). Name Relationship/Age Address (1) (2) (3) (4) (5) (6) 7. I understand that, if the Court appoints me as Special Administrator, I will be required to file Reports, Accounts and Inventories, and to follow up with a Petition for Administration of the entire Estate, and/or for Discharge, as the Court may order. 8. I understand that I am obligated to serve by mail all papers, including this Order, on all parties who are interested in the Estate. WHEREFORE, Petitioner prays that he/she be appointed Special Administrator of the above Estate; that he/she be authorized to deposit all liquid assets in a separate Estate account; to take possession of or to secure all real and personal property, and to communicate with lenders and institutions as may become necessary to protect and preserve the Estate assets. Petitioner further requests that he/she be specifically authorized to: 23 24 25 26 27 28 I declare, under penalties of perjury, that I am the Petitioner in the foregoing action; that I have read the above and foregoing Petition for Special Letters of Administration, and that the same. REVISED 8/2015 3 LETTERS OF SPECIAL ADMINISTRATION

1 2 3 is true of my own knowledge, except for matters stated therein on information and belief, and as for those matters, I believe it to be true. This document does not contain the Social Security number of any person. 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 Date: Signature: Printed Name: REVISED 8/2015 4 LETTERS OF SPECIAL ADMINISTRATION

INSTRUCTIONS: STEP 2 Do Not Copy Or File This Page Complete the Index of Exhibits and Exhibit Cover Sheet(s) as Shown: 1) Write the exhibit number, number of pages (not including the Exhibit Cover Page), and a description for each exhibit. If more space is needed, attach additional sheets. 2) Attach the Index of Exhibits to the document after the last page of the document, before any exhibits. 3) For each exhibit, create a numbered Exhibit Cover Page. 4) Write the exhibit number on the Exhibit Cover Page. 5) Attach the correct Exhibit Cover Page to the front of each exhibit. 6) Attach your exhibits in the order listed on the Index of Exhibits. REV KV 11/16 PR-4 VISUAL INSTRUCTIONS

INDEX OF EXHIBITS Exhibit Number Number of Pages Exhibit Description Exhibit Number Number of Pages Exhibit Description Exhibit Number Number of Pages Exhibit Description Exhibit Number Number of Pages Exhibit Description Exhibit Number Number of Pages Exhibit Description Exhibit Number Number of Pages Exhibit Description Exhibit Number Number of Pages Exhibit Description Exhibit Number Number of Pages Exhibit Description Exhibit Number Number of Pages Exhibit Description

EXHIBIT EXHIBIT EXHIBIT

INSTRUCTIONS: STEP 3 Do Not Copy Or File This Page Complete the Request for Submission as Shown: 1) Print your name, address, telephone number, and email address. You will be assigned a case number when you file the Petition with the Court. 2) Print the Decedent s name. 4) Print the date the Petition was filed. 5) Date, sign, and print your name. REV KV 11/16 PR-4 VISUAL INSTRUCTIONS

1 2 3 4 5 Code: 3860 Name: Address: Telephone: Email: Self-Represented Litigant 6 7 8 9 10 IN THE SECOND JUDICIAL DISTRICT COURT OF THE STATE OF NEVADA IN THE MATTER OF THE ESTATE OF: IN AND FOR THE COUNTY OF WASHOE 11 12 13 14, Deceased. / Case No. Dept. No. PR 15 16 17 18 19 20 REQUEST FOR SUBMISSION I request that the Petition for Letters of Special Administration that was filed on be submitted to the court for decision. (Date the document was filed with the Court) 21 22 23 24 25 26 This document does not contain the Social Security Number of any person. Date: Signature: Print Your Name: 27 28 REV 11/2016 KV 1 REQUEST FOR SUBMISSION

INSTRUCTIONS: STEP 4 Filing Documents You must electronically file (E-file) the completed forms. You can do this by signing up for an E-Flex account at https://wceflex.washoecourts.com/. You will need to upload the original documents to E-Flex. E-Flex is available online, in the Filing Office, Law Library, or Self Help Center. There may be a filing fee charged when the documents are filed. Fee information is available at the Filing Office, Family Division Self Help Center, and online at: www.washoecourts.com. You can call the Filling Office at (775) 328-3110 to confirm the amount of the fee. When e-filing, please make sure to keep the original copies of all the documents for your personal records. STOP Once you receive the Court Order, proceed to Step 5. Any additional documents regarding this decedent shall be filed with this case number. Do Not Copy Or File This Page REV KV 11/16 PR-4 VISUAL INSTRUCTIONS

INSTRUCTIONS: STEP 5 Once you are appointed as the Special Administrator you must: Go to the courthouse and take your oath as the Special Administrator with the Deputy Clerk. You can then have your Letters of Special Administration issued. Letters and instructions are included in this packet. Complete and file your Letters of Special Administration within 10 judicial days of the date of the Court s Order. Serve a copy of the Order appointing Special Administrator on all possible heirs of the estate. * Carefully read your Order for anything that may be specific to your case * Then, you are required by law to: File with the Court an Inventory of the Estate of the Decedent. The Inventory is due no later than 60 calendar days from the date the Order Appointing you as Special Administrator was filed. File with the Court an Account/Report of the Special Administrator. This is due no later than 60 calendar days from the date the Order Appointing you as Special Administrator was filed. If the Special Administrator determines that there are no assets of the estate to probate, a Request to Discharge the Special Administrator may be filed. File with the Court a Petition to Set Aside the Estate, Petition for Summary Administration, or Petition for General Administration. This is due no later than 180 calendar days from the date the Order Appointing you as Special Administrator was filed. The type of Petition is determined by the value of the estate at the date of death. Do Not Copy Or File This Page REV KV 11/16 PR-4 VISUAL INSTRUCTIONS

INSTRUCTIONS: STEP 6 Complete the Letters of Special Administration as Shown: PAGE 1 1) Print your name, address, telephone number, and email address. 2) Print the Decedent s name and the case number just as they appear on all other documents in this case. 3) Print the date you were appointed as the Special Administrator (date the Order was filed). 4) The Deputy Clerk of the Court will fill out this section. REV KV 11/16 PR-4 VISUAL INSTRUCTIONS

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 1915 Name: Address: City, State, ZIP Phone/E-mail IN THE SECOND JUDICIAL COURT OF THE STATE OF NEVADA In the Matter of the Estate of deceased. / IN AND FOR THE COUNTY OF WASHOE Case No.: Dept. No.: PR LETTERS OF SPECIAL ADMINISTRATION On the day of, the Court entered an Order appointing as Special Administrator of the Estate of. The order includes: [ ] a directive for the establishment of a blocked account for sums in excess of $ ; [ ] a directive for the posting of a bond in the sum of $ ; or [ ] a directive for both the establishment of a blocked account for sums in excess of $ and the posting of a bond in the sum of $. The Special Administrator, after being duly qualified, may act and has the authority and duties of a Special Administrator as conferred by NRS 140.040. In testimony of which, I have this date signed these Letters and affixed the seal of the court. CLERK OF THE COURT By Deputy Clerk

INSTRUCTIONS: STEP 7 Complete the Oath as Shown: PAGE 2 1) Print your name and address. 2) COMPLETE THE REST OF THE FORM IN THE PRESENCE OF A NOTARY OR A DEPUTY CLERK OF THE COURT 3) IF your oath is administered by a Deputy Clerk of the Court, he/she will complete this section - OR - 3) IF your oath is administered before a notary, have the notary complete this section THE ORIGINAL LETTERS MUST BE BROUGHT TO THE FILING OFFICE FOR ISSUANCE BY A DEPUTY CLERK. THEY CANNOT BE efiled. Do Not Copy Or File This Page REV KV 11/16 PR-4 VISUAL INSTRUCTIONS

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 OATH I,, whose mailing address is, solemnly affirm that I will faithfully perform according to law the duties of Special Administrator, and that all matters stated in any petition or paper filed with the court by me are true of my own knowledge or, if any matters are stated on information and belief, I believe them to be true. Special Administrator SUBSCRIBED AND AFFIRMED before me this day of,. State of Nevada County of OR, NOTARY PUBLIC CLERK OF COURT By Deputy Clerk This instrument was acknowledged before me on by. (Notary stamp) (Signature of notarial officer) 24 25 26 27 28

Legal Assistance The information in this packet is provided as a courtesy only. This packet is not a substitute for the advice of an attorney. Counsel is always recommended for legal matters. If you do not have an attorney, you are encouraged to seek the advice of a licensed attorney or visit the Family Court Self Help Center, which is located at One South Sierra Street, Reno, NV. The Family Court Self Help Center cannot give legal advice but can give information regarding court procedures. You may also wish to speak with a lawyer at no cost through the Law Library s Lawyer in the Library program, or to seek assistance from other free or reduced-cost legal resources in the area, to include: LAWYER IN THE LIBRARY First Floor (to the left of the filing office) of the courthouse located at: 75 Court Street, Reno, NV. (775) 328-3250 www.washoecourts.com/lawlib 3 rd Wednesday Evening of the Month Arrive by 4:25 p.m. NEVADA LEGAL SERVICES 204 Marsh Avenue Reno, NV 89509 (775) 284-3491 x 237 leave message if necessary http://www.nlslaw.net WASHOE LEGAL SERVICES 299 S. Arlington Avenue Reno, NV 89501 (775) 329-2727 leave message if necessary http://www.washoelegalservices.org REV KV 11/16 PR-4 VISUAL INSTRUCTIONS