HUNTERDON COUNTY SURROGATE'S COURT Hunterdon County Justice Center, 65 Park Avenue, P.O. Box 2900, Flemington, NJ 08822 Tel.: (908)788-1156 - Fax: 788-1586 - email: surrogate@co.hunterdon.nj.us INFORMATION SHEET ADMINISTRATION AD PROSEQUENDUM AFTER COMPLETING THE INFORMATION BELOW PLEASE FAX WITH A COPY OF THE DEATH CERTIFICATE TO 788-1586. At that time if you would like to make an appointment please do so or let us know approximately when your client will appear in this Court. If you have any questions please call or fax. NAME OF DECEASED AGE Also known as Legal residence at time of death Township, Borough or City the residence was located in Date of Death: Administrator: SSN: Phone Number: Full Address: _______ Survivors and next of kin ( include age of minors only) List how exactly they are related to the decedent. (Example: Jane Doe, niece is the child of the decedent's deceased brother, Joe Doe.) Name Relationship Address Age _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ Deceased children? Names of their children, and addresses _________________________________________________________________________________________ Any Children of a prior marriage The death of the said (ex: automobile accident) (Location of accident including county & state) Yes Yes No (Circle One) No (Circle One) , was the result of which occurred in and was caused by the wrongful act, neglect or default of whose address is or some other person or persons. Total number of certificates Attorney for Estate Address American LegalNet, Inc. www.FormsWorkFlow.com