Letters of administration with the will annexed may be in substantially the following form, after properly entitling the court:

In the Matter of the Estate of )

) Case No.

)

deceased. ) Letters of Administration With the Will

………………………………..) Annexed

On ……… (day) …… (month) …… (year), the court entered an order admitting the decedent’s will to probate and appointing (name) as administrator with the will annexed of the decedent’s estate. The order includes:

[ ] a directive for the establishment of a blocked account for sums in excess of $ ……….;

[ ] a directive for the posting of a bond in the sum of $ ……….; or

[ ] a directive for both the establishment of a blocked account for sums in excess of $ ………. and the posting of a bond in the sum of $ ………...

The administrator with the will annexed, after being duly qualified, may act and has the authority and duties of administrator with the will annexed.

In testimony of which, I have this date signed these letters and affixed the seal of the court.

CLERK OF THE COURT

By ……………………….

Deputy Clerk (date)

OATH

I, ………………………………………………………, whose mailing address is ……………………………………………., solemnly affirm that I will faithfully perform according to law the duties of administrator with the will annexed, and that all matters stated in any petition or paper filed with the court by me are true of my own knowledge or, if any matters are stated on information and belief, I believe them to be true.

…………………………………………

Administrator With the Will Annexed

SUBSCRIBED AND AFFIRMED before me this ….…. (day) of ….…. (month) of ……… (year).

CLERK OF COURT

By .....................................................

Deputy Clerk

(or) ....................................................

NOTARY PUBLIC

County of ……… State of ............

[48:107:1941; 1931 NCL § 9882.48] — (NRS A 1999, 2280)