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Any Petitioner Any Street Any Town, CA 90000 555-555-5555 Petitioner, In Pro Per

Superior Court of the State of California For the County of ________________

Estate of: __________________________ Deceased.

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Case No. VERIFIED SUPPLEMENT TO PETITION FOR ________________________________ DATE: TIME: DEPT:

Petitioner, __________________________, as the Petitioner in the aboveentitled action and as a supplement to the Petition for__________________, states as follows: 11. All items of property inventoried were the separate property of the Decedent.

Petitioner has prepared an Inventory and Appraisal along with attachments which was mailed to the Probate Referee on ______________. Upon receipt of the completed Inventory and Appraisal Petitioner will prepare, file and serve the Notice of Allowance or Rejection forms for the claims filed by _____________ on ___________ and ____________ as Petitioner must have the amount of the Inventory and Appraisal to complete said forms, DE-174. 2. Notice in the manner provided by Probate Code 216 is not required to be given

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to the Director of the California Victim Compensation and Government Claims Board. 3. 4. Due to an error ________________________________. All claims paid as listed by the Petitioner were (1) justly due, (2) were paid in

good faith, (3) the amount paid was the true amount of the indebtedness over and above all payments and offsets, and (4) the estate was solvent at the time the claims were paid. Said claims were paid without a formal claim being filed. Said claims were to, __________________________. 5. All statements and figures in the reports and accounts filed with the Petition for

_____________ are true and correct. All statements made by the Petitioner in the Petition for ______________ are true and correct. 6. Be sure to modify these paragraphs to suit your individual situation. Do NOT just use the wording here unless it definitely applies to your particular situation. Be sure to list all of the problems that were listed in the probate notes and what your explanation is, or list the additional information that was requested in the probate notes. Be sure to file this supplement with the Court at least one (1) week before the hearing, or as listed in the local rules of your county.

Dated:_________________

_________________________________________ NAME OF PETITIONER, PETITIONER

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VERIFICATION I, the undersigned, the Petitioner for the above named case, declare that I have read the foregoing Verified Supplement to Petition for ____________________________ and all attachments and know its contents. I declare that the Verified Supplement to Petition for ____________________________, including all attachments, is true to my own knowledge, except as to matters in it stated on my own information and belief, and as to those matters I believe it to be true. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct and that this declaration was executed on ________________,2011 at _________, California. _________________________________________ NAME OF PETITIONER

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