Haw. Prob. R. Flag Sheet 1-E

Probate No.

(Attorney for Petitioner or Pro Se Petitioner)

Tel. No. Estate of

I. Publication Notice

1. Name of decedent as actually published

2. Dates of actual publication (in 3 consecutive weeks):

; ; .

II. Tax (Estate or Transfer Tax)

1. Has a receipt, certificate, or release from the

Taxation Department been filed? Yes No

2. If “No,” will it be filed by the date of the hearing? Yes No

III. Inventory

1. State the date of decedent’s death:

2. State the value of the estate at death: $

IV. Approvals by Beneficiaries

1. List the names of all residuary beneficiaries under the will, or by intestacy, and

state whether their approvals have been filed.

Approval Filed?

Name Yes No

2. Have all receipts for specific bequests been filed? Yes No

3. If “No,” list such specific devisees under item No. 1 above.

V. Proof of Service

1. List or attach a list of all interested persons who are entitled to notice of hearing.

Basis Upon Which Person

Name Is Entitled to Notice

2. Was notice served on all interested persons?

(HRS §560:1-401) Yes No

3. If “No,” were waivers of notice obtained and filed for all

interested persons other than those served under 2 above? Yes No

4. If “No,” list the names of all interested persons who have not been served.

VI. Fees

Has the court been requested to review the reasonableness of the compensation of any

person employed by the personal representative or the reasonableness of the

compensation determined by the personal representative as reasonable for the personal representative’s own services pursuant to HRS §560:3-721? Yes No

An affidavit detailing the hourly rate and time spent for the services provided must be

filed.

VII. Prayer for Special Matters

(Note: Anything beyond the normal and ordinary probate matters shall be specified in this classification as special or unusual matters.)

1.Special matters requested? Yes No

2. If “Yes,” enumerate such special matters.

VIII. Objection or Opposition

1. Are you aware of any opposition or objection to this petition? Yes No

2. If “Yes,” state by whom (include the relationship of the objector to the decedent or beneficiaries) and the grounds for the objection, if known.

THE UNDERSIGNED HEREBY CERTIFIES THAT TO THE BEST OF SAID INDIVIDUAL’S KNOWLEDGE AND BELIEF ALL OF THE FOREGOING FACTS

AND FIGURES ARE TRUE AND CORRECT.

Attorney for Petitioner or Pro Se Petitioner

Hearing Date