Form Nhjb 2141 P – Fill Out and Use This PDF

THE STATE OF NEW HAMPSHIRE

JUDICIAL BRANCH

http://www.courts.state.nh.us

Court Name:

Case Name: Estate of

Case Number:

(if known)

PETITION FOR SMALL ESTATE ADMINISTRATION

1.

Petitioner Name

Telephone

Mailing Address

2.

Petitioner Name

Telephone

Mailing Address

3.

Attorney Name

Telephone

Firm name

Mailing Address

Bar ID#

4.

Deceased Name

Date of Death

Residence (city or town)

5.

Deceased died:

with will

without will

6.

Petitioner was:

named

not named

in will of the deceased.

7.Petitioner’s relationship to deceased:

Instructions for completing this section of the form. List only personal property such as cash, bank accounts, stocks, bonds, vehicles; no real estate is allowed on a small estate administration (aka voluntary administration).

In the description of assets section, include specific identifying information such as: model, vehicle identification number, serial numbers, name of bank and account numbers, certificate of deposit numbers, etc.

If this is an amended petition, list the new assets followed by the total value of the estate reported on the original petition.

					$
					$
					$
					$
					$
					$
					$
		Total value of personal estate reported on	Descriptions listed on previous petition(s).		$
		original petition (if this is amended petition)
		TOTAL PERSONAL ESTATE – NOT TO EXCEED $10,000		$
NHJB-2141-P (06/04/2008)			Page 1 of 2
(formerly AOC 148-003)

Case Name: Estate of

Case Number:

PETITION FOR SMALL ESTATE ADMINISTRATION

Petitioner asks to serve as voluntary administrator of such estate and will administer the same according to law. I certify that a copy of this document has been provided to the parties who have filed an appearance for this case or who are otherwise interested parties.

Date		Petitioner Signature (must be signed in presence of notarial officer)
Date		Petitioner Signature (must be signed in presence of notarial officer)
State of					, County of
This instrument was acknowledged before me on							by

ORDER

The voluntary administrator's authority to administer is expressly limited only to asset(s) listed on this form. Out of the assets collected, the voluntary administrator shall pay debts and expenses of the estate in accordance with RSA 167:13, 554:19 or 557:34 as applicable, and shall take no fees for his/her services.

A statement of administration must be filed no earlier than 60 days, nor later than 90 days, from the administrator's appointment. If an amended petition is filed, the original due dates are applicable. No distribution of the final balance shall be made until the statement is approved by the court. Any distribution should be according to the will of the deceased, if any, or if no will, in accordance with RSA 561.

If letters testamentary or of administration are later granted, the voluntary administrator's power shall cease, and he/she shall deliver to the rightful executor or administrator all assets and funds of the estate in his/her possession, and file a statement of administration with the court.

Petition for Small Estate Administration is granted.

Petition for Small Estate Administration is denied.

Date

Judge

NHJB-2141-P (06/04/2008)	Page 2 of 2
(formerly AOC 148-003)