Commonwealth of Massachusetts
The Trial Court Docket No.
Division Probate and Family Court Department
SALE OF REAL ESTATE
ADMINISTRATOR - EXECUTOR
Name of Deceased Date of Death
Domicile at Death
(street address) (city or town) (zip)
TO THE HONORABLE JUSTICES OF THE PROBATE AND FAMILY COURT
of the will - administrator/trix of the estate of
that he/she/they gave bond for the faithful performance of his/her/their duties on
20 ; that the deceased was at the time of his/her death the owner of certain real estate situated in
in the County of bounded and described as follows:
the same being all part of the real estate of the deceased.
That it is for the advantage of all parties interested that the same be sold; that an advantageous offer for the purchase of
this real estate has been made to the petitioner(s) in the sum of dollars.
Petitioner(s), named in a petition dated and on file in this County, requesting authority to sell certain
real estate belonging to the estate of the deceased and therein described, certify/ies under the penalties of perjury that the
names of all persons known to me/us as having or claiming any interest in this real estate derived from any deed or
conveyance or mortgage, through or under any of the heirs or devisees of the deceased are as follows:
Name Residence Interest in the Property
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I/We certify that the estate of the deceased does does not exceed $1000 in value.
Moreover, the petitioner(s) certify/ies that MassHealth is is not an interested party in this matter due to:
the filing of a written claim against the estate pursuant to G.L. c. 118E, s. 32.
the filing of a Notice of Claim pursuant to G.L. c. 197, s. 9(d)
Notice of this petition has been sent to MassHealth, P.O. Box 15205, Worcester, Massachusetts 01615-0205
CJP 76 (11/09)
WHEREFORE your petitioner(s) request(s) that he/she/they may be authorized to sell the real estate at private sale
in accordance with this offer, or at public auction for a larger sum, upon the following terms:
and that he/she/they may become the purchaser(s) of this real estate.
Signature of Petitioner 1
Signature of Petitioner 2
The undersigned, being all persons interested, assent to the foregoing petition.
Sign if you assent to the
Print Name Residence Relationship Check if Applicable
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CJP 76 (11/09)