Present HON. PETER J. KELLY, Surrogate In the Matter of the Application to Examine an Safe Deposit Box of At a Surrogate's Court held in and for the County of Queens, State of New York, at Jamaica, in said County, on the day of , 20 FILE # Deceased. Upon reading and filing the petition of day of , 20 the Order to Examine Safe Deposit Box verified on the a corporation doing business in the State of New York, is hereby directed to permit said petitioner or agent to examine the safe deposit box of said decedent in the presence of an officer of the corporation, and if a will be found therein, the said corporation is directed forthwith to deliver the same to the Clerk of this Court, or if a policy or policies of insurance in the name of the decedent and payable to a named beneficiary or beneficiaries named therein, the said policy shall be delivered the to the beneficiary or beneficiaries named therein, and if a deed to a burial plot, in which the decedent is to be interred, be found the said corporation is hereby directed to deliver the same to the petitioner, or the agent of the petitioner, and it is further Directed that the petitioner, or the agent of the petitioner, be permitted to make a copy of any paper or papers found in said box bearing upon the desire of said decedent as to the disposal of his or her remains, and it is further Directed that the said petitioner, or agent of the petitioner, be permitted to make an inventory of the contents of said safe deposit box. SURROGATE P-15-O(2/11) American LegalNet, Inc. www.FormsWorkFlow.com