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: _______________________________________ } POWER OF ATTORNEY ADMINISTRATOR C.T.A. KNOW ALL MEN BY THESE PRESENTS, that I, _______________________________ residing at _______________________ _______________________________________________ pursuant to the provisions of Revised Statutes 3B: 14-47 do hereby make, constitute and appoint Theodore N. Stephens II Surrogate of the County of Essex, in the State of New Jersey, and their successors in office, my true and lawful attorney, upon whom may be served any and all process affecting the aforesaid estate, or any interest therein, whereof I am the Administrator/rix C.T.A. And I do further agree that any process against the aforesaid estate, so served, shall be of the same effect as if duly served upon me within this State. __________________________________________________ Signature STATE OF NEW JERSEY COUNTY OF ESSEX } SS. BE IT REMEMBERED, That on ______/______/______ before me, the subscriber, a Notary Public of the State of New Jersey, personally appeared _______________________________, who I am satisfied is the person in the foregoing power of attorney named, and I having first made known to them the contents thereof, they did thereupon acknowledge that they signed, sealed and delivered the said power of attorney as their voluntary act and deed for the uses and purposes therein expressed. __________________________________________________ Notary Public of the State of New Jersey My Commission Expires: ____________________________ Affix Seal 3 POA ADMIN CTA American LegalNet, Inc. www.FormsWorkFlow.com Page 1 of 1