MERCER COUNTY SURROGATE’S COURT Diane Gerofsky, Surrogate INFORMATION SHEET FOR PROBATE NAME OF DECEASED:________________________________Date of Death_____________________ Residence of Deceased at Time of Death:________________________________________________ (Indicate borough, township, town, or city or county) ___________________________________________________________________________________ Name(s) of Executor who will qualify:_____________________________________________ ___________________________________________________________________________________ Address(es) of Executor(s):_____________________________________________________________ (Indicate borough, township, town, or city or county) _____________________________________________________Telephone No: __________________ Date of Will:________________________________ Date of Codicil(s):__________________________ Is Will Self-Proving? (Yes)______(No)______ If not, give names and addresses of all witnesses to Will: ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ Name of Witness Appearing to Prove Will:_______________________________________ Attorney of Record: ________________________________________ Telephone No: _____________ Address: ___________________________________________________________________________ NAME ADDRESS NEXT OF KIN RELATIONSHIP TO AGE IF TO DECEASED UNDER 18 ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ Page 1 of 2 - Fact Sheet for Probate American LegalNet, Inc. www.FormsWorkflow.com If named Executor is not qualifying, state the reason - e.g. predeceased, wishes to renounce: ___________________________________________________________________________________ Renunciation(s) (Yes)______(No)______ Names of Person(s) Renouncing: _____________________ ___________________________________________________________________________________ Name of Proposed Administrator C.T.A.:_______________________________________________ Address:____________________________________________________________________________ Approximate Value of Personalty Passing By Will (if Administration C.T.A.): $__________________ Approximate Value of Real Estate Passing By Will (if Administration is C.T.A.): $___________________ Rule to Bar Creditors (Yes)______(No)______ ( Deaths on or before February 26, 2005 only) Number of Short Certificates Requested:__________________________________________ Date You Wish Executor to Qualify:___________________________________________ Is the executor appearing in the Trenton office to probate? (Yes)________ (No)_________ Is the executor appearing at a satellite office? (Yes)________ (No)__________ If yes, please indicate which satellite office. Lawrence Satellite___________ Ewing Satellite ___________ Hamilton Satellite___________ Hopewell Satellite ___________ Pennington Satellite_________ E Windsor Satellite__________ Princeton Twp Satellite______ Washington Twp Satellite ______ PLEASE NOTE: When making your appointment with the Surrogate=s Court for a satellite office, kindly return this sheet together with a copy of the Will and Death Certificate to this office by fax or mail at least twenty-four hours prior to the appointment. Contact Kelly at (609) 989-6336 to make the appointment MERCER COUNTY SURROGATE=S COURT P.O. BOX 8068 TRENTON, NEW JERSEY 08650-0068 Fax: (609) 278-1242 Phone: (609) 989-6331 E-mail: dgerofsky@mercercounty.org Page 2 of 2 - Fact Sheet for Probate American LegalNet, Inc. www.FormsWorkflow.com