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SUPERIOR COURT OF CALIFORNIA COUNTY OF SANTA CLARA (The Superior Court of California, County of Santa Clara)

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PB-4078 01/01/2021 Probate Ex Parte Relief Checklist Page 1 of 4
SUPERIOR COURT OF CALIFORNIA
COUNTY OF SANTA CLARA
____________________________________________________________________________
Probate Ex Parte Relief Checklist
Case Number: _________________________
Case Name: _________________________________________________________________
Party Seeking Ex Parte Relief: __________________________________________________
Attorney or Party Contact Information:
Attorney/Party Name: ____________________________________________________
Email Address: _________________________________________________________
Telephone No.: _________________________________________________________
Petition type: □ Heggstad □ Modify Trust □ Approve Settlement Agreement
□ Preliminary Distribution □ Other
Urgency:
□ urgent □ not urgent
Party seeking ex parte relief is (check all that apply):
□ Trustee □ Personal Representative □ Trust Beneficiary □ Estate Heir
□ Surviving Spouse □ Guardian □ Conservator □ Creditor
□ Other (explain): ____________________________________________________________.
PB-4078 01/01/2021 Probate Ex Parte Relief Checklist Page 2 of 4
Interested Parties - Competent Adults
List the full name(s) and relationship(s) of all interested persons who are both adults and
competent (please attach an extra sheet if more space is required):
Name Relationship Consent? Y / N
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
Interested Parties - Minors or Persons Lacking Capacity
List the full name(s) and relationship(s) of all interested persons who are minors and/or otherwise
lack capacity, and whether any guardian ad litem, conservator, or attorney in fact has been
appointed (please attach an extra sheet if more space is required):
Name Relationship GAL/CNR/AIF
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
Qualification of Guardian Ad Litem
The Guardian Ad Litem is (check all that apply): □ An attorney licensed to practice in
California; □ Represented by an attorney licensed to practice in California;
□ Other (explain):___________________________________________________________.
PB-4078 01/01/2021 Probate Ex Parte Relief Checklist Page 3 of 4
Parties who have objected or may object:
The following parties have indicated they object or may object to the proposed relief:
Name Relationship
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
Heggstad Petitions
Evidence of the settlor’s intent is based on (check all that apply):
□ Pour over will □ General assignment □ Assets listed on schedule A
□ Other: ________________________________________________________________
Petition to Modify Trust
Purpose of Proposed Modification(s) (check all that apply) :
□ To eliminate a bypass trust in favor of a survivor’s trust
□ To create a special needs trust where one did not exist
□ To fill a vacancy in the office of trustee □ To modify the powers/duties of trustee(s)
□ To grant a power of appointment over an irrevocable trust
□ Other - briefly describe: _______________________________________________
Authority for modification:
□ Probate Code 17200 □ Probate Code 15403 □ Probate Code 15404
PB-4078 01/01/2021 Probate Ex Parte Relief Checklist Page 4 of 4
□ Probate Code 15409 □ Other ____________________________________
Petition to Approve Settlement Agreement (check all that apply):
□ All trust beneficiaries/estate heirs/interested parties have signed the settlement
agreement, or
□ Not all interested parties signed the settlement agreement
□ The settlement agreement contains a provision that the agreement shall be made a court order
Petition for Preliminary Distribution from an Estate
The value of the estate as reflected in the I & A is: _________________________________
Approximate amount owed to creditors, including lien holders:_________________________
Total dollar amount of assignments by beneficiaries:_________________________________
Approximate costs of administration, including fees and reimbursements:__________________
The amount of requested distribution and the person(s) to whom the distribution would be made:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
____ months have passed since letters were issued
Petition □ requests □ does not request additional bond be set as a result of distribution.
There □ are □ are not currently unpaid creditors of the estate.
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SUPERIOR COURT OF CALIFORNIA COUNTY OF SANTA CLARA (The Superior Court of California, County of Santa Clara)

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Completed 29 June 2021

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