State of Rhode Island and Providence Plantations
DATE FILED
Probate Court
WAIVER (SECTION A)
RIGL 33-22-5
FOR
COURT USE ONLY
OR
ADVERTISING (SECTION B)
RIGL 33-22-11
STATE OF RHODE ISLAND
Select County
County of
PROBATE COURT OF THE
Select City or Town
Estate of
City or Town of
Alias
No.
SECTION A
The undersigned, all of full age and sound mind, waive notice of the pendency of the attached
(type of petition)
and assent to action thereon by the Court at any time. (If waived, all heirs sign here.)
Name of Heir/
Signature of
Beneficiary
Heir/Beneficiary
HEIR/BENEFICIARY SIGN HERE
Notary Public
Notary Public
NOTARY SIGN HERE
Signature
Subscribed to and sworn before me on the following date:
My commission expires:
Name of Heir/
Signature of
Beneficiary
Heir/Beneficiary
HEIR/BENEFICIARY SIGN HERE
Notary Public
Notary Public
NOTARY SIGN HERE
Signature
Subscribed to and sworn before me on the following date:
My commission expires:
Name of Heir/
Signature of
Beneficiary
Heir/Beneficiary
HEIR/BENEFICIARY SIGN HERE
Notary Public
Notary Public
NOTARY SIGN HERE
Signature
Subscribed to and sworn before me on the following date:
My commission expires:
Name of Heir/
Signature of
HEIR/BENEFICIARY SIGN HERE
Beneficiary
Heir/Beneficiary
Notary Public
Notary Public
NOTARY SIGN HERE
(print name)
Signature
Subscribed to and sworn before me on the following date:
My commission expires:
PC-9.1 (Rev. 08/18)
Page 1 of 2
State of Rhode Island and Providence Plantations
DATE FILED
Probate Court
WAIVER (SECTION A)
RIGL 33-22-5
FOR
COURT USE ONLY
OR
ADVERTISING (SECTION B)
RIGL 33-22-11
STATE OF RHODE ISLAND
Select County
County of
PROBATE COURT OF THE
Select City or Town
Estate of
City or Town of
Alias
No.
SECTION A
The undersigned, all of full age and sound mind, waive notice of the pendency of the attached
(type of petition)
and assent to action thereon by the Court at any time. (If waived, all heirs sign here.)
Name of Heir/
Signature of
Beneficiary
Heir/Beneficiary
HEIR/BENEFICIARY SIGN HERE
Notary Public
Notary Public
NOTARY SIGN HERE
Signature
Subscribed to and sworn before me on the following date:
My commission expires:
Name of Heir/
Signature of
Beneficiary
Heir/Beneficiary
HEIR/BENEFICIARY SIGN HERE
Notary Public
Notary Public
NOTARY SIGN HERE
Signature
Subscribed to and sworn before me on the following date:
My commission expires:
Name of Heir/
Signature of
Beneficiary
Heir/Beneficiary
HEIR/BENEFICIARY SIGN HERE
Notary Public
Notary Public
NOTARY SIGN HERE
Signature
Subscribed to and sworn before me on the following date:
My commission expires:
Name of Heir/
Signature of
HEIR/BENEFICIARY SIGN HERE
Beneficiary
Heir/Beneficiary
Notary Public
Notary Public
NOTARY SIGN HERE
(print name)
Signature
Subscribed to and sworn before me on the following date:
My commission expires:
PC-9.1 (Rev. 08/18)
Page 1 of 2
SECTION B
Notice of matters pending and for hearing in said Court. The Court will be in session at the:
on the dates specified in notices below at
for hearing said matters.
(Make a copy of newspaper clipping and paste copy in this space.)
Name of
Probate Clerk
Signature of
Date
PROBATE CLERK SIGN HERE
Probate Clerk
Published in the following newspaper on the following dates:
Name of
Newspaper
Dates of
Publication
PC-9.1 (Rev. 08/18)
Page 2 of 2