Docket No.: ______________ State of New Jersey Camden County Surrogate's Court In the matter of the Estate of: __________________________________, Deceased AKA: ____________________________ To the Surrogate of the County of Camden: The undersigned applicant(s) for Letters of Limited Administration -- Heirs hereby constitute the Surrogate of Camden County and their successors in office my (our) true and lawful attorney upon whom all original process in any action at law or equity against the above estate may be served. It is agreed that any original process so served against the above estate, shall be of the same force and effect as if duly served on me (us) within this State. Dated: Signed, sealed and delivered in the Presence of } AUTHORIZATION TO ACCEPT SERVICE OF PROCESS _______________________________________ } Name ___________________________________ Address _________________________________ __________________________________ Name ___________________________________ Address _________________________________ __________________________________ G2 Page 1 of 1 American LegalNet, Inc. www.USCourtForms.com