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Probate / Qualification Instructions

2. In addition, please email a copy of the Will and Death Certificate to jsmall@vacourts.gov.

4. Applicant Information
   Please list the following information for the applicant or the person making the request.

   Please list the following information for the applicant or the person making the request.

6. First Name (Applicant)*

7. Middle Initial (App)

8. Last Name (Applicant)*

10. Address1 (Applicant)*

12. City (Applicant)*

13. State (Applicant)*

14. Zip (Applicant)*

16. Email (Applicant)*

17. Phone Number (Applicant)*

    Please list the easiest number where you can be reached.

18. Relationship to Decedent (Applicant)*

20. If there is a will are you the executor named in the will?*

    1. Yes
    2. No

21. Have you been convicted of a felony?*

    1. Yes
    2. No

23. Have you ever filed for bankruptcy?*

    1. Yes
    2. No

24. What year?

28. Decedent Information
    Please list the following information for the Decedent.

    Please list the following information for the Decedent.

30. First Name (Decedent)*

31. Middle Initial (Decedent)

32. Last Name (Decedent)*

34. Home address at the time of death (Decedent)*

36. City (Decedent)*

37. State (Decedent)*

38. Zip (Decedent)*

40. Marital Status*

    1. Married
    2. Single

    1. Divorced
    2. Widowed

41. Death Location *

    County/City of death

43. Date of Birth (Decedent)*
    Date of Birth (Decedent)

44. Date of Death (Decedent)*
    Date of Death (Decedent)

45. Age at Death (Decedent)*

47. Did the Decedent leave a will?*

    1. Yes
    2. No

48. What date was the Will signed?
    What date was the Will signed?

49. How many pages are in the Will?

51. Value of Personal Assets*

    List the total value of Personal assets that was in the decedent's name only at the time of his/her death.

52. Value of Real Estate*

    List the total value of all real estate that was solely in the decedent's name. Do not include property that was held jointly with the right of survivorship.

56. Heirs at Law
    Heirs at law are required to be listed. The heirs at law are next of kin according to 64.2-200 and do not necessarily inherit under the will. If you have any questions please refer to Qualification Instruction #2 or code 64.2-200.

    Heirs at law are required to be listed. The heirs at law are next of kin according to 64.2-200 and do not necessarily inherit under the will. If you have any questions please refer to Qualification Instruction #2 or code 64.2-200.

58. First Name (Heir 1)*

59. Middle Initial (Heir 1)

60. Last Name (Heir 1)*

62. Address (Heir 1)*

64. City (Heir 1)*

65. State (Heir 1)*

66. Zip (Heir 1)*

68. Relationship to Decedent (Heir 1)*

69. Age (Heir 1)*

    At time of death

73. First Name (Heir 2)

74. Middle Initial (Heir 2)

75. Last Name (Heir 2)

77. Address (Heir 2)

79. City (Heir 2)

80. State (Heir 2)

81. Zip (Heir 2)

83. Relationship to Decedent (Heir 2)

84. Age (Heir 2)

    At time of death

88. First Name (Heir 3)

89. Middle Initial (Heir 3)

90. Last Name (Heir 3)

92. Address (Heir 3)

94. City (Heir 3)

95. State (Heir 3)

96. Zip (Heir 3)

98. Relationship to Decedent (Heir3)

99. Age (Heir 3)

    At time of death

103. First Name (Heir 4)

104. Middle Initial (Heir 4)

105. Last Name (Heir 4)

107. Address (Heir 4)

109. City (Heir 4)

110. State (Heir 4)

111. Zip (Heir 4)

113. Relationship to Decedent (Heir 4)

114. Age (Heir 4)

     At time of death

116. If more than 4 heirs, please email their names and information to

120. Appointment Request

     Please submit the appointment time and date you would like and the Clerk will call or email as soon as possible.

122. Requested Appointment Day and Time
     Requested Appointment Day and Time Start Date

     Requested Appointment Day and Time Start Time

     —

     Requested Appointment Day and Time End Date

     Requested Appointment Day and Time End Time

     You can select a specific time or select a specific range of time you may be available for an appointment.

124. In addition, please email a copy of the Will and Death Certificate to jsmall@vacourts.gov.

Leave This Blank:


126. 1. Receive an email copy of this form.
127. Email address

     This field is not part of the form submission.

128. Submit Submit and Print