CIRCUMSTANCES OF REQUEST. Mark the appropriate box to indicate the circumstances under which you are using this form. • Mark box 1 if the estate has been settled through court proceedings and the legal representative is no longer acting. • Mark box 2 if the estate is being settled in accordance with State statute (for example: Summary Administration, Small Estates Act, Texas Muniment of Title, or Louisiana Judgment of Possession).
CIRCUMSTANCES OF REQUEST. Mark the appropriate box to indicate the circumstances under which you are using this form. See Part B of the instructions for evidence requirements.
1. This request is made in connection with an estate that has been administered, the legal representative discharged, and the estate closed. Evidence – a certified copy of the final account or decree of distribution.
2. This request is made in connection with an estate that is being settled in accordance with State statute (for example: Summary Administration, Small Estates Act, Texas Muniment of Title, or Louisiana Judgment of Possession). Evidence – Submit evidence in accordance with state law or statute.
PART C – PERSONS ENTITLED
1. List all persons entitled to the securities and/or payments (according to the supporting evidence):
2. List all persons from Item 1 who are under legal disability (if any):
