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: ________________________________________ } RENUNCIATION OF RIGHT TO SUBSTITUTIONARY ADMINISTRATION C.T.A. To: Theodore N. Stephens II, Surrogate of the County of Essex: I, ______________________________, _____________________ of the above decedent, late of ___________ in the County of _____________ and State of ________________ being entitled to have Substitutionary Administration C.T.A. of the estate of ___________________, do hereby renounce right of said Substitutionary Administration C.T.A. and request the appointment of _________________________________ as Substitutionary Administrator/rix C.T.A. of said estate. ________________________________________ Signature STATE OF NEW JERSEY COUNTY OF ESSEX }SS. Be it remembered, that on this, ______/______/______, before me, undersigned authority, personally appeared __________________________________ who I am satisfied are the persons in the within instrument named, and I having first made known to them the contents thereof, did acknowledged that they signed, sealed and delivered the same as their voluntary act and deed, for the uses and purposes therein expressed. ____________________________________________ Notary Public of the State of _______________________________ My Commission Expires: ______________________ Affix Seal 4_RENUNCIATION American LegalNet, Inc. www.FormsWorkFlow.com Page 1 of 1