Form 16-11 A
(Rule 16-11)
COURT FILE NUMBER
___________________________ (to be completed by court)
COURT OF QUEEN’S BENCH FOR SASKATCHEWAN
JUDICIAL CENTRE OF
______REGINA_____________
IN THE ESTAT OF
___________ JANE DOE ______DECEASED
APPLICATION FOR GRANT OF PROBATE
The application of JOHN DAVID DOE, of Regina, Saskatchewan, STATES THAT:
1.
JANE DOE, late of Regina, Saskatchewan, deceased, died at Swift Current,
Saskatchewan on or about the 29th day of September, 2006 and at the time of death resided
in Saskatchewan (or resided outside of Saskatchewan but had property in Saskatchewan).
2.
The deceased made a Last Will and Testament dated the 27th day of November,
1992, (and codicil or codicils dated the ___ day of _____, ___) and was at the time of
making the Will (and codicils) the full age of 18 years.1
3.
The following beneficiaries (beneficiary), and no other persons, are entitled to share
in the estate of the Deceased: (show here the name and address of each beneficiary and the
relationship to the deceased)
NAME AND ADDRESS
John David Doe
658 Pine St.
Regina, Saskatchewan
S4H 3T8
Sally Lynn Brown
(named in the will as Sally Lynn Doe)
1783 Smith St
Calgary, Alberta
T5H 7Y8
RELATIONSHIP
Adult Son
Adult Daughter
(If applicable, add:)
3. (a) The deceased died intestate as to a portion of his/her estate leaving surviving the
following persons, and no others, who are entitled by law to share in the estate: (Show here
the name and address of each beneficiary and the relationship to the deceased.)
4.
Every Person named as a beneficiary survived the deceased.2
5.
No beneficiary is now under the age of eighteen (18) years, and no child under the
age of eighteen (18) years survived the deceased, and no posthumous child has been or will
be born to the deceased. 3
6.
The deceased was not survived by any dependent adult who is a beneficiary of the
estate or may have a claim against it under the Dependant’s Relief Act or The Family
Property Act. 4
7.
The deceased was 65 years of age at death.
8.
The deceased was married (state marital status) at death.
9.
The deceased did not, after execution of the will, marry or cohabitate in a spousal
relationship continuously for two years.5
10.
After making the will and before his/her death, the marriage of the testor was not
terminated by a final judgment of divorce nor was it found to be void or declared a nullity
by a court in a proceeding to which the testator was a party, nor did the testator and his/her
spouse, who were not legally married, cease to cohabit in a spousal relationship for at least
24 months.6
(select applicable paragraph 11)
11.
The applicant(s) is (are) the executor(s) named in the will and (each) is of the full
age of 18 years (or a trust company). Or
11
The Applicant is the alternate Executor named in the Will and is 18 years of age or
more. The first-named Executor, namely Sally Lynn Brown, has renounced her right to
probate and her renunciation is filed herewith.
12.
Neither witness to the Will is a beneficiary or the spouse of a beneficiary named in
the Will.7
13.
The value of the estate for the purpose of Local Registrar’s fees is $326,983.32.
14.
No other application for grant has been made to this Honourable Court to prove the
Will or for letters of administration with the will annexed, to the best of the Applicant’s
information and belief.
Therefore the Applicant requests that probate of the Will of the Deceased may be granted
by this Honourable Court.
DATED at _______________________________, Saskatchewan, this _____________day
of ___________________________, 20__.
____________________________
(signature of applicant)
CONTACT INFORMATION AND ADDRESS FOR SERVICE
If prepared by a lawyer for the applicant:
Name of firm:
_____________________________________________
Name of Lawyer in charge of file: _______________________________________
Address of legal firm:
Telephone number:
_____________________________________________
(set out street address)
_____________________________________________
Fax number (if any):
_____________________________________________
E-mail Address (if any)
_____________________________________________
OR
Address for service and contact information of self represented party filing this document
Name of party:
_____________________________________________
Address for Service
Telephone number:
_____________________________________________
(set out street address)
_____________________________________________
Fax number (if any):
_____________________________________________
E-mail Address (if any)
_____________________________________________
This is Exhibit “A” to the Affidavit of
JOHN DAVID DOE, sworn before me at
the City of Regina, in the Province of
Saskatchewan, this __ day of _______, 200_.
__________________________________
A Commissioner for Oath in and for
the Province of Saskatchewan.
NOTES
If otherwise, see clause 16-18(1)(a) of the Queen’s Bench Rules (located online at:
http://www.qp.gov.sk.ca/documents/English/Rules/qbrules.pdf) and The Wills Act, sections 5 & 6 (located
online at: http://www.qp.gov.sk.ca/documents/English/Statutes/Statutes/W14-1.pdf) and set out in the
applicable exception. For the applicable age see the provisions of The Age of Majority Act.
1
2
If otherwise, state whether the deceased beneficiary was a brother, sister, child or other issue of the
deceased, and if so, if he or she is survived by a child now under 18. See section 22 of The Wills Act. If so,
file form 16-12).
3
If otherwise, so state and file form 16-12.
4
If otherwise, so state and file form 16-12.
5
If otherwise, set out the applicable exemption: see clause 16-18(1)(b) of The Queen’s Bench Rules)
6
If otherwise, comply with Rule 16-18(2)
7
If otherwise, set out the applicable exception: see clause 16-18(1)(c) of the rules.
NOTE: all red text must be either deleted or replaced with the specific
information to your situation and changed into black print. The red text is only
to highlight where information may be changed.