Docket No.: ________________ State of New Jersey Essex County Surrogate's Court THEODORE N. STEPHENS, II SURROGATE Hall of Records, Room 206 Newark, New Jersey 07102 Phone: 973-621-4900 Fax: 973-621-2654 DEVERO D. MCDOUGAL DEPUTY SURROGATE In the matter of the Estate of: ______________________________________, Deceased AKA: ________________________________ } APPLICATION FOR LETTERS OF SUBSTITUTIONARY ADMINISTRATION C.T.A. The applicant(s) __________________________, _____________________ at _________________________________________ _______________________________________________________________SSN: ________________________________, Says: 1. Decedent died testate, resident of _______________ in the County of _________________ and State of ________________ on ______________, leaving a Will dated _____________, wherein decedent appointed ________________ Executor/rix(s). 2. On ________________, said Will was duly probated by the ____________________________________________________ and Letters Testamentary were issued by it to _________________________________, ___________________________ 3. The said ________________________, after qualifying and entering upon the duties of said office, but before completing the same __________________________ leaving certain assets of the estate of the said decedent un-administered, of a value not exceeding the sum of _______________________. 4. Decedent left surviving heirs at law and next of kin, the following persons: Name Relationship Residence Age of all Minors 5. 6. There are no other heirs or next of kin. The competent, adult persons whose right to Substitutionary Administration C.T.A. upon the said estate is prior or equal to that of the applicant(s), with their addresses and the manner and degree in which they severally stand related to the decedent, are as follows Name Residence Interest in Estate 1_APPLIC_FOR_LETTERS_OF_SUB_ADM_CTA American LegalNet, Inc. www.FormsWorkFlow.com Page 1 of 2 Docket No.: ____________________ 7. All the competent, adult persons whose right to Substitutionary Administration C.T.A. upon the said estate is prior or equal to that of the applicant(s) have duly renounced their right thereto and requested that Letters be issued to the applicant(s). Applicant(s) is/are the person(s) first entitled to Letters of Substitutionary Administration C.T.A. and no other competent, adult person(s) is/are entitled thereto. Due notice of this application has been given to all competent, adult persons whose right to _____________________________ Administration with the Will Annexed upon the said estate is prior or equal to that of the applicant. Wherefore, the applicant(s) requests judgment granting to him/her/them Letters of _________________________ Administration with the Will Annexed. _______________________________________________________________________ Signature STATE OF NEW JERSEY COUNTY OF ESSEX } SS. Applicant(s) being duly sworn, according to law, upon their oath depose and say: I am (we are) the Applicant(s) named in the foregoing application and the allegations thereof are true to the best of my (our) knowledge and belief and the value of the entire estate is ______________________. Sworn and subscribed before me on ______/______/______ Signature A Notary Public of the State of ____________________________ My Commission Expires: _____________________ Affix Seal Attorney of Record: ______________________________________ ______________________________________ ______________________________________ ______________________________________ ______________________________________ 1_APPLIC_FOR_LETTERS_OF_SUB_ADM_CTA American LegalNet, Inc. www.FormsWorkFlow.com Page 2 of 2