Form MPC 455 at a glance
What it is: Assent and Waiver of Notice, Renunciation, Nomination and Waiver of Sureties, of the Commonwealth of Massachusetts, The Trial Court, Probate and Family Court.
Who signs: The Interested Person signs on the Signature of Interested Person line.
As a person interested in the case, check all that apply.
A filled-in Form MPC 455 example: assent and waiver of sureties

How to fill out Form MPC 455, box by box
SECTION I. ASSENT AND WAIVER OF NOTICE

Under SECTION I. ASSENT AND WAIVER OF NOTICE, enter the Name of Pleading filed with the Court after "I hereby assent to the"; you assent to that pleading and waive your right to any statutory notice related to that specific pleading; you request that the relief requested in that pleading be allowed.
SECTION II. RENUNCIATION/NOMINATION

SECTION II. RENUNCIATION/NOMINATION is for estate and administration cases only; select ONE of the appropriate boxes.
(A) I renounce my right to appointment as Personal Representative and my right to nominate, if any.
(B) I renounce my right to appointment as Personal Representative and nominate the person whose Name you enter, to serve in my place.
(C) I assent to the nomination of the person whose Name you enter, to serve as Personal Representative with me or to apply for appointment.
SECTION III. WAIVER OF SURETIES
Signed under the penalties of perjury

SIGNED UNDER THE PENALTIES OF PERJURY: you certify under the penalties of perjury that the statements are true to the best of your knowledge and belief.
The Interested Person signs on the Signature of Interested Person line.
Enter the Date and your name in Print name.
Enter your Address with the Apt, Unit, No. etc., the City/Town, State and Zip, and the Primary Phone #.
Sources
[1] Form MPC 455 (10/23/12), Assent and Waiver of Notice, Renunciation, Nomination, Waiver of Sureties, Commonwealth of Massachusetts Trial Court (the Official source link on this page).


