IN THE COURT OF QUEEN’S BENCH JUDICIAL CENTRE OF REGINA IN THE ESTATE OF JANE DOE, DECEASED APPLICATION FOR GRANT OF PROBATE The application of JOHN DAVID DOE, of Regina, Saskatchewan, STATES THAT: 1. JANE DOE, late of Regina, Saskatchewan, deceased, died at Swift Current, Saskatchewan on or about the 29th day of September, 2006 and at the time of death resided in Saskatchewan (or resided outside of Saskatchewan but had property in Saskatchewan). 2. The deceased made a Last Will and Testament dated the 27th day of November, 1992, (and codicil or codicils dated the ___ day of _____, ___) and was at the time of making the Will (and codicils) the full age of 18 years.1 3. The following beneficiaries (beneficiary), and no other persons, are entitled to share in the estate of the Deceased: NAME AND ADDRESS RELATIONSHIP John David Doe 658 Pine St. Adult Son Regina, Saskatchewan S4H 3T8 Sally Lynn Brown (named in the will as Sally Lynn Doe) Adult Daughter 1783 Smith St Calgary, Alberta T5H 7Y8 (If applicable, add 3(a) as below) 3. (a) The deceased died intestate as to a portion of his/her estate leaving surviving the following persons, and no others, who are entitled by law to share in the estate: (Show here the name and address of each beneficiary and the relationship to the deceased.) 4. Every Person named as a beneficiary survived the deceased.2 5. No beneficiary is now under the age of eighteen (18) years, and no child under the age of eighteen (18) years survived the deceased, and no posthumous child has been or will be born to the deceased. 3 6. The Deceased was not survived by any dependent adult who is a beneficiary of the estate or may have a claim against it under the Dependant’s Relief Act or The Family Property Act. 4 7. The Deceased was 65 years of age at death. 8. The Deceased was married (state marital status) at death. 9. The Deceased did not, after execution of the will, marry or cohabitate in a spousal relationship continuously for two years.5 10. After making the will and before his/her death, the marriage of the testor was not terminated by a final judgment of divorce nor was it found to be void or declared a nullity by a court in a proceeding to which the testator was a party, nor did the testator and his/her spouse, who were not legally married, cease to cohabit in a spousal relationship for at least 24 months.6 11. The Applicant is the alternate Executor named in the Will and is 18 years of age or more. The first-named Executor, namely Sally Lynn Brown, has renounced her right to probate and her renunciation is filed herewith.7 12. Neither witness to the Will is a beneficiary or the spouse of a beneficiary named in the Will.8 13. The value of the estate for the purpose of Local Registrar’s fees is $326,983.32. 14. No other application for grant has been made to this Honourable Court to prove the Will or for letters of administration with the will annexed, to the best of the Applicant’s information and belief. Therefore the Applicant requests that probate of the Will of the Deceased may be granted by this Honourable Court. Dated this ____ day of _____, 200_. ____________________________ JOHN DAVID DOE This document was delivered by: (name and Saskatchewan address required here) This is Exhibit “A” to the Affidavit of JOHN DAVID DOE, sworn before me at the City of Regina, in the Province of Saskatchewan, this __ day of _______, 200_. __________________________________ A Commissioner for Oath in and for the Province of Saskatchewan. NOTES 1 If otherwise, see rule 706(1)(a) of the Queen’s Bench Rules (located online at: http://www.qp.gov.sk.ca/documents/English/Rules/qbrules.pdf) and The Wills Act, sections 5 & 6 (located online at: http://www.qp.gov.sk.ca/documents/English/Statutes/Statutes/W14-1.pdf) and set out in the applicable exception. For the applicable age see the provisions of The Age of Majority Act. 2 If otherwise, state whether the deceased beneficiary was a brother, sister, child or other relative of the testator/testatrix, and if so, if he or she is survived by a child now under 18. See section 32 of The Wills Act. If so, file form 101. 3 If otherwise, so state and file form 101. 4 If otherwise, so state and file form 101. 5 If otherwise, set out the applicable exemption: see Rule 706(1)(b). 6 If otherwise, comply with Rule 706(1). 7 The applicant(s) is/are the executor(s) named in the will and (each) is 18 years of age (or a trust company). 8 If otherwise, set out the applicable exception: see Rule 706(1)(c). NOTE: all red text must be either deleted or replaced with the specific information to your situation and changed into black print. The red text is only to highlight where information may be changed.