AOC-805 Doc.

Code: PPW
EA L TH OF KE 99-P-4
Rev. 2-17 or PWF NW Case No. ____________________

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Page 1 of 3 lex
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justitia
Court ____________________

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Commonwealth of Kentucky RT
OF JUS
County ____________________
Court of Justice www.courts.ky.gov
Division ____________________
KRS 394.145; KRS 395.015 PETITION

IN RE: Estate of _________________________________________________________________________________

Decedent’s Information: SSN: ______________ Birthdate: _______________ Date of Death: _________________

Last Address: __________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
Decedent died: q Intestate (without a Will) q Testate (with a Will)

q PROBATE OF WILL
PETITION FOR q APPOINTMENT OF ADMINISTRATOR/ADMINISTRATRIX
q APPOINTMENT OF EXECUTOR/EXECUTRIX
Petitioner states there has been no previous administration in the Decedent's estate in Kentucky or elsewhere. Further,
Petitioner states that the statements in the caption are true, and that the names of the surviving spouse, heirs at law and
next of kin known to Petitioner are as follows (use additional paper if necessary):

Name: __________________________________________ Relation: ______________________ Age: _________

Address: ______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________

Name: __________________________________________ Relation: ______________________ Age: _________

Address: ______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________

Name: __________________________________________ Relation: ______________________ Age: _________

Address: ______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________

Decedent owned/had interest in the following real estate with estimated market values as noted:
_______________________________________________________________________________________________
_______________________________________________________________________________________________
______________________________________________________________ Estimated Total: $ ________________
AOC-805
Rev. 2-17
Page 2 of 3
Decedent owned/had interest in the following personal property with estimated market values as noted:
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________ Estimated Total: $ _______________________

Petitioner is indebted to or owes Decedent $______________.

q Petitioner applies for probate of Decedent's Will, filed herewith, which is his/her Last Will and Testament.
q Petitioner prays ____________________________________________________________, whose address is
_______________________________________________________________________________________________
_______________________________________________________________________________________________
be appointed q Executor/Executrix q Administrator/Administratrix of said estate and who offers as surety on the bond
the following: ______________________________________________. All the foregoing statements are true.

Petitioner's Signature:_____________________________________________ Phone No.: ___________________

Petitioner's Name (Printed): ________________________________________________________________________

Petitioner's Address:______________________________________________________________________________
_______________________________________________________________________________________________

Subscribed and sworn before me by Petitioner on _______________________, 2______. My commission will expire:
________________________, 2_______.

___________________________________________
Name/Title

This certifies this Petition was prepared or subscribed by the undersigned in accordance with the meaning and tenor
of Kentucky Civil Rule No. 11. (Attorney must prepare and present separate Order of Probate or complete Order
on Page 3 of this Petition). (To be filled in duplicate).

Attorney’s Signature:___________________________________________ Phone No.:_____________________

Attorney’s Name (Printed): _______________________________________________________________________
Address:______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________

WAIVER

We, the undersigned, surviving spouse and next of kin of the above-named Decedent, resident of _________________
County, Kentucky, hereby waive notice of the hearing of the Petition and if applicable, the presentation of said Decedent's
Will for probate and/or appointment of fiduciary, and request the Court to appoint ________________________________
as q Executor/Executrix q Administrator/Administratrix.
____________________________________________ ____________________________________________
____________________________________________ ____________________________________________
____________________________________________ ____________________________________________
____________________________________________ ____________________________________________
AOC-805
Rev. 2-17
Page 3 of 3

IN RE: Estate of _________________________________________________________________________________

ORDER

q Petition filed this _______ day of _________________, 2______.

q Will tendered this _______ day of _________________, 2______.

Upon hearing, the Will offered was proven by ______________________________________________ and ORDERED

PROBATED as the Last Will and Testament of Decedent this _______ day of ________________________, 2______.

The Court appoints: ______________________________________________________ as q Executor/Executrix OR

q Administrator/Administratrix of said estate and fixes bond in the sum of $__________________ q with surety OR

q without surety.

________________________________, 2_______ ____________________________________________

Date Judge’s Signature

Distribution: Case File

Revenue Cabinet