2
Nov. 2014
The decedent was survived by - (please check appropriate boxes)
a. Spouse/Domestic Partner. No Spouse/Domestic Partner. Check appropriate box and go to b.
b. Children. Descendants of predeceased children. If so, stop here; if not, go to c.
c. Grandchildren. Descendants of predeceased grandchildren. If so, stop here; if not, go to d.
d. Parents. If so, stop here; if not go to e.
e. Brothers and/or Sisters. Descendants of predeceased brothers and/or sisters. If so, stop here; if not, go to f.
f. Nieces and/or Nephews. Descendants of predeceased nieces and/or nephews. If so, stop here; if not, go to g.
g. Uncles and/or Aunts. If so, stop here; if not, go to h.
h. First cousins. If so, stop here; if not, go to i.
i. Grandparents. If so, stop here; if not, go to j.
j. Other heirs. If none, go to k.
k. Notify Office of the Attorney General, Chief of the Civil Enforcement Section, 441 4th Street, N.W., Washington, D.C.
20001.
LIST OF INTERESTED PERSONS must include names of heirs if decedent died intestate; heirs and legatees, including trustees and all named Personal
Representatives if the decedent died testate. Refer to D.C. Code, secs. 19-301 through 312 and sec. 20-101(d)(1). If under age of 18 or an adult who is
legally disabled, also list as an interested person the judicially appointed guardian, conservator or committee for such person. If no judicially appointed
representative exists, then list the parent or custodian or an attorney-in-fact, if any, for such person (subject to the terms of the power of attorney), or
any other person with legal authority to act for such disabled person.
Note: If each trustee is also a petitioning party or acting personal representative, list all beneficiaries under trust. Refer to D.C. Code, sec. 20-101(g).
Any creditor of the decedent, including those persons whose rights accrue at the time of death, who has timely presented a claim in excess of $500 that
has not been barred or discharged is also an interested person. Petitioner(s) should update list of interested persons or creditors with claims in excess
of $500 as they become known.
Indicate, when applicable, grandchildren and nieces and nephews by family groups, by showing the name of their
deceased parent who was related to the decedent
Sample:
Joe Petitioner 1234 Hexagon Street, N.W.
Washington, D.C. 20000
Son/heir/legatee/petitioner
Interested persons Address Relationship (Age, if under 18)
______________________________ ______________________________________ ______________________
______________________________ ______________________________________ ______________________
______________________________ ______________________________________ ______________________
______________________________ ______________________________________ ______________________
______________________________ ______________________________________ ______________________
______________________________ ______________________________________ ______________________
______________________________ ______________________________________ ______________________
______________________________ ______________________________________ ______________________
(Use continuation sheet, if necessary)
WITNESS TO WILLS/CODICILS (Names)
_____________________________________________________________________________________________
_____________________________________________________________________________________________