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Here is the text we could read:

Estate of

***USE THIS FORM ONLY IF A DEVISEE NAMED IN THE WILL OR CODICIL IS NOT AN HEIR OF THE TESTATOR***

NOTE: TREAT ALL PERSONS WHO DIED WITHIN 120 HOURS AFTER THE DECEDENT AS IF THEY DID NOT SURVIVE THE
DECEDENT. List persons who died within 120 hours after the decedent in item 18 below.
16. The names of all devisees named in the will and codicils who are not heirs of the decedent (include testamentary trustees

and beneficiaries of testamentary trusts) are

17. Of the devisees listed in 16, the following died before the decedent. Their names and relationships to the decedent are

18. The following devisees died within 120 hours after the decedent. Their names, relationships to decedent, and the date
and time of their deaths are:

NAME

RELATIONSHIP

DATE OF DEATH

TIME OF DEATH

19. The following are descendants of the predeceased devisees named above, who survived the decedent:

20. Class gifts in the will or codicils, where the members are not specifically identified by name, are as follows:

Do not write below this line - For court use onlyPC 566 (12/18) SUPPLEMENTAL TESTIMONY TO IDENTIFY NONHEIR DEVISEES, Testate EstateMCL 700.2702, MCL 700.2707-700.2710,MCR 5.302Approved, SCAO JIS CODE: TSSSTATE OF MICHIGANPROBATE COURTCOUNTY OFSUPPLEMENTAL TESTIMONYTO IDENTIFY NONHEIR DEVISEESTestate EstateFILE NO.(SEE SECOND PAGE) 21. The following devisees named above are under legal disability. Their names, legal disabilities, and names of their
representative(s) are

22. The following deceased devisees survived the decedent by more than 120 hours. Their names and the names of those
who represent their interests are

23. The guardian ad litem for each devisee under the will and codicils who is unborn, unknown, or unascertainable is

Subscribed and sworn to before me on

County, Michigan.

My commission expires:

Date

Signature:

Judge/Deputy register/Notary public

Notary public, State of Michigan, County of

Date

Signature

Attorney signature

Address

Name (type or print) Bar no.

City, state, zip Telephone no.

PC 566, Supplemental Testimony to Identify Nonheir Devisees, Testate Estate

This info page is part of the LIT Lab's Form Explorer project. It is not associated with the Michigan state courts. To learn more about the project, check out our about page.

Downloads: You can download both the original form (last checked 2023-03) and the machine-processed form with normalized data fields.

About This Form:

Sourced from www.courts.michigan.gov/Estates-Trusts (2023-03)
Page(s): 2
Fields(s): 45
Average fields per page: 22
Reading Level: Grade 9
LIST Grouping(s): ES-03-00-00-00, ES-00-00-00-00, ES-02-00-00-00.

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Identified Data Fields:

We have done our best to automaticly identify and name form fields according to our naming conventions. When possible, we've used names tied to our question library. See e.g., user1_name. If we think we've found a match to a question in our library, it is highlighted in green. Novel names are auto generated. So, you will probably need to edit some of them if you're trying to stick to the convention.

Here are the fields we could identify.

stat_e_f_n_cour_count was STATE OF MICHIGAN PROBATE COURT COUNTY OF (0.67 conf)
fil_e was FILE NO (0.48 conf)
estate was Estate of (0.48 conf)
undefined__1 was undefined (0.38 conf)
devisees_listed_following_died_decedent_names_relationships was 17 Of the devisees listed in 16 the following died before the decedent Their names and relationships to the decedent are (0.36 conf)
following_devisees_died_within_hours_decedent_names_relationships_date was 18 The following devisees died within 120 hours after the decedent Their names relationships to decedent and the date (0.36 conf)
undefined__2 was undefined_2 (0.39 conf)
name_row__1 was NAMERow1 (0.43 conf)
relationship_row__1 was RELATIONSHIPRow1 (0.39 conf)
dat_e_f_death_row__1 was DATE OF DEATHRow1 (0.41 conf)
tim_e_f_death_row__1 was TIME OF DEATHRow1 (0.41 conf)
name_row__2 was NAMERow2 (0.43 conf)
relationship_row__2 was RELATIONSHIPRow2 (0.39 conf)
dat_e_f_death_row__2 was DATE OF DEATHRow2 (0.41 conf)
tim_e_f_death_row__2 was TIME OF DEATHRow2 (0.41 conf)
descendants_predeceased_named_survived was 19 The following are descendants of the predeceased devisees named above who survived the decedent (0.30 conf)
members_identified_follows was 20 Class gifts in the will or codicils where the members are not specifically identified by name are as follows (0.37 conf)
undefined__3 was undefined_3 (0.39 conf)
row was Row1 (0.35 conf)
undefined__4 was undefined_4 (0.39 conf)
text__1 was Text1 (0.35 conf)
text__2 was Text2 (0.35 conf)
text__3 was Text3 (0.35 conf)
text__4 was Text4 (0.35 conf)
text__5 was Text5 (0.35 conf)
following_legal_disabilities was 21 The following devisees named above are under legal disability Their names legal disabilities and names of their (0.28 conf)
following_deceased_devisees_survived_decedent_hours_names was 22 The following deceased devisees survived the decedent by more than 120 hours Their names and the names of those (0.37 conf)
guardian_ad_litem_devisee_codicils_unborn_unknown_unascertainable was 23 The guardian ad litem for each devisee under the will and codicils who is unborn unknown or unascertainable is (0.42 conf)
undefined__5 was undefined_5 (0.39 conf)
undefined__6 was undefined_6 (0.39 conf)
undefined__7 was undefined_7 (0.39 conf)
signature_date__1 was Date (1.00 conf)
county_michigan was County Michigan (0.44 conf)
signature_date__2 was Date_2 (1.00 conf)
judge_deputy_register_public was JudgeDeputy registerNotary public (0.41 conf)
public_state_michigan_county was Notary public State of Michigan County of (0.51 conf)
name_type_print was Name type or print (0.45 conf)
bar was Bar no (0.41 conf)
users1_address_line_one was Address (1.00 conf)
users1_address_line_two was City state zip (1.00 conf)
telephone was Telephone no (0.44 conf)
text__6 was Text6 (0.35 conf)
text__7 was Text7 (0.35 conf)
text__8 was Text8 (0.35 conf)
text__9 was Text9 (0.35 conf)

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The Legal Innovation & Technology Lab's Form Explorer Beta @ Suffolk Law School Last updated 2023-04-02

PC 566, Supplemental Testimony to Identify Nonheir Devisees, Testate Estate

About This Form:

Identified Data Fields:

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The Legal Innovation & Technology Lab's Form Explorer ^Beta @ Suffolk Law School Last updated 2023-04-02