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Get MA MPC 170 2012-2023

Me Last Name Date of Death: The Petitioner(s) (hereafter "Petitioner"), an interested person(s), makes the following statements: 1. Information about the Decedent: Name: First Name Middle Name Also known as: Last Name Name Domicile at death: (Address) (Apt, Unit, No. etc.) (City/Town) (State) (Zip) 2. Information about the Petitioner: Name: First Name (Address) Mailing Address, if different: Last Name M.I. (Apt, Unit, No. etc.) (Address) (City/Town) (Apt, Unit, No. etc.) (C.

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