Docket No.: ______________ 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 State of New Jersey In the matter of the Estate of: ________________________________________, Deceased AKA: ___________________________________________ } APPLICATION PROBATE Applicant (s) ________________________, _________________at _________________________________ ___________________________________SSN:_________________, respectfully shows that: 1. Decedent died testate, resident of __________________ in the County of ______________ and State of _______________on _____________, leaving a Will dated _______________, wherein applicant was appointed as executor/rix 2. The said decedent was domiciled in the County of ______________ and the State of ___________________, at the time of death having a residence at _______________________________________________________ ________________________________________________________________________________________ 3. Decedent left surviving, as spouse, heirs at law and next of kin, the following persons: Name Relationship Residence Age of all Minors 4. There are no other heirs or next of kin known to the applicant. 1_APPLICATION Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com Application Probate Docket No.: _________________ Wherefore, the applicant(s) ____________________________ requests judgment admitting to probate the said Will and/or codicils and directing that Letters Testamentary be granted to Applicants(s). STATE OF NEW JERSEY COUNTY OF ESSEX }SS. Applicant(s) being duly sworn, according to law, upon oath deposes and says that as the applicant(s) in the foregoing complaint that the matters and things therein contained are true to the best of applicant(s) knowledge and belief. Subscribed and sworn to before me on _______________ _______, ________ Signature A Notary Public of the State of _____________________ My Commission Expires: _____________________ Affix Seal Attorney of Record: ____________________________ ____________________________ ____________________________ ____________________________ 1_APPLICATION Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com