Probate Intake Form

124 Lake Street South
Long Prairie, MN 56347
Phone: 1-320-732-6112 Fax: 1-320-732-6023

Decedent's Name_____________________________________________________

Petitioner___________________________________________________________

Petitioner's Address____________________________________________________________________

Petitioner's Home Phone______________________Work Phone_______________________________

Petitioner's Home phone_______________________Work Phone____________________________

Decedent's Birthdate_______________Age____Place of Birth___________________________________

Date of Death_________Place of Death____________________________________________________

Residence at Death____________________________________________________________________

Occupation___________________________________Social Security #__________________________

If no, will all heirs sign a Declination to Act indicating that they do not wish to be appointed and requesting that the
Court appoint your choice of personal representative?______________

If decedent left no will, will all heirs sign a Request for Waiver of Bond?________________

Did decedent or decedent's spouse receive any Medical Assistance during their lifetime___. If the answer is "yes",
indicate approximately how much was received by decedent____________decedent's spouse_____________

Personal Property	Value
Household Goods & Furnishings	$___________
Stocks	$___________
Notes, Bonds, CD's	$___________
Checking, Savings & Cash	$___________
List account number(s) if known
Automobile(s)	$___________
Other: Farm equipment, livestock, etc.	$___________
Total

Is there a Mortgage, lien or other encumbrance against this property?____Approx. Amount $_______________

Legal Description:_____________________________________________________________________

___________________________________________________________________________________

Do you intend to sell the real estate or have it distributed out to one or more of the heirs?____________________

Has a purchaser been found for this real estate?_______ If so, Purchaser's names & address:_______________

______________________________________________________________________________________

Is there a Mortgage, lien or other encumbrance against this property?____Appox. Amount $_______________

Legal Description_______________________________________________________________________

____________________________________________________________________________________

Do you intend to sell the real estate or have it distributed out to one or more of the heirs?___________________

Has a purchaser been found for this real estate______ If so, Purchaser's names & address__________________

______________________________________________________________________________________

Sale price $________________Has a purchase agreement been signed?_________________

(Heirs-at-law are first the Spouse and children & issue of any deceased children. If the decedent was not married or never had any children, then the heirs-at-law would be his parents, if they are still living. If they are not living, the heirs-at-law would be the decedent's brothers and sisters and if any of the decedent's brothers and sisters predeceased decedent, you must also list the issue of any deceased brothers and sisters, i.e. the nieces and nephews from that deceased brother or sister.)

Name	Birthday (if under 18)	Relationship	Address
1.	*	*	*
2.	*	*	*
3.	*	*	*
4.	*	*	*
5.	*	*	*

Who do you wish to be appointed administrator?__________________________________________________

Whose address is:_________________________________________________________________________

What newspaper do you want the notice published in"
Long Prairie Leader__Browerville Blade__Eagle Bend/Clarissa__Staples World

If probate will be filed outside of Todd County, notice must be published in the appropriate county.

Before the estate can be closed it will be necessary to file with the Court a Final Account which must balance to the penny. Although all checks will have to be signed by the personal representative, in some instances, the personal representatives prefer to have the attorney's office handle the bookkeeping and actually prepare all checks, balance the checkbook monthly, etc. (See letter to prospective personal representative.)