CC 15:1 Rev. 03/2022 Page 1 of 2 Demand for Notice

Nebraska State Court Form CC 15:1 Rev.03/2022 Neb. Rev. Stat. § 30-2413

IN THE MATTER OF THE ESTATE OF

, Deceased.

Case No.

DEMAND FOR NOTICE

1. Pursuant to Nebraska Probate Code § 30-2413, the undersigned demandsmailed notice pursuant to Nebraska Probate Code § 30-2220(a)(1) of any ofthe following Orders or filings pertaining to the estate of the deceased:

Application for Informal Probate of WillApplication for Informal Appointment of Personal RepresentativeInventory and any Supplemental InventoryCopy of published Notice to Creditors mailed within five days of publicationOther (specify)

2. Demandant has the following financial or property interest in the estate of thedeceased.

3. Demandant waives any publication of any notice pursuant to Nebraska ProbateCode § 30- 2220(a)(2) with respect to each of the items for which notice isabove demanded.

4. Notice should be mailed to the following-named Demandant or Demandant’sattorney at the address below:

** This Demand for Notice will be disposed of five years from the date it is filed if no estate is filed and no other action is taken, unless the court orders extended retention for good cause shown.

CC 15:1 Rev. 03/2022 Page 2 of 2 Demand for Notice

Date ***Signature

Demandant Name (printed) Street Address/P.O. Box

Bar Number and Firm Name (Attorneys) City/State/ZIP Code

Phone Email Address

Nebraska Supreme Court Rule § 2-208 requires individuals involved in a case who are not attorneys and representing themselves to provide their email address to the court in order to receive notice by email from the court about this case.

By checking this box and providing my email address, I have the ability to receive notice from the court by email. I understand I will not receive mailed documents and notices except for those that require specific service as directed by statute or Nebraska Supreme Court Rule.

If I no longer have email capability or if my email or other contact information changes, I must complete a Change of Contact Information Form. By checking this box, I do not have the ability to receive emails. The

reason I cannot receive email is:

CERTIFICATE OF MAILING

I certify that I have mailed a copy of this Demand for Notice, in accordance with the requirements of Nebraska Probate Code § 30-2413, to

, the Personal Representative of the deceased, first class mail, postage prepaid, at the following address,

Street Address/P.O. Box , on .

City/State/ZIP Code

Date: .

Clerk Magistrate