Docket No.: _____________ State of New Jersey Camden County Surrogates Court In the matter of the Estate of: RENUNCIATION } __________________________________, Deceased OF ADMINISTRATOR AKA: ____________________________ To: ______________________, Surrogate of the County of Camden I, _________________, _______________ of the above decedent, late of ______________ in the County of Camden do hereby renounce my right of Admstration, and request thini e appointment of ________________. Dated: ____/____/____ STATE OF NEW JERSEY } SS. COUNTY OF CAMDEN Be it remembered, that on this, ____________, before me, undersigned authority, personally appeared _______________________________________, who I am satisfied is the person in the foregoing instrument, to whom I first made known the contents thereof, and thereupon they acknowledged that they signed, sealed and delivered the same as their act and deed, for the uses and purposes therein expressed. E3.DOC Page 1 of 1