MERCER COUNTY SURROGATE'S COURT Diane Gerofsky, Surrogate INFORMATION SHEET FOR TRUSTEESHIP INDIVIDUAL In the Matter of the Estate of ______________________________ 1. Trustee(s) name, residing address and mailing address if different from residing address and telephone number Name:__________________________________________________________________________ Address: __________________________________________________________________________ Telephone no: ________________________ 2. Trust created under_________________________________________________________________ (State under which Article or Paragraph or Item of the Will the trust was created) 3. Specific Trust title:_________________________________________________________________ (Example: For the benefit of a specific person (who), Family Trust, Marital Trust, Complex Trust, Simple trust, Credit Shelter Trust, Charitable Trust, etc.) 4. Name of Trust Beneficiary Residing Address Interest Under Trust ________________________________________________________________________________ __________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ 5. The initial Trusteeship fee includes 1 Trustee Short Certificate. Do you wish to order additional trustee shorts? ________ No ___________ Yes How many? ______________ 6. Where and when does the trustee(s) wish to qualify? Trustee(s) appearing in Trenton Office __________No _____________ Yes Trustee(s) appearing at a Satellite office __________ No __________ Yes (If yes, indicate which satellite and call for an appointment) Lawrence Satellite_________ Robbinsville Satellite _______ Ewing Satellite _________ Pennington Satellite________ Hamilton Satellite__________ Hopewell Satellite__________ E Windsor Satellite________ Princeton Twp Satellite________ (First Tuesday each month) (First Thursday each month) (Second Tuesday each month) (Second Thursday each month) (Third Tuesday each month) (Third Friday each month) (Fourth Tuesday each month) (Fourth Thursday each month) 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 Death Certificate to this office at least 48 hours prior to the appointment. To schedule an appointment contact Kelly at (609) 989-6336. MERCER COUNTY SURROGATE'S COURT P.O. BOX 8068 TRENTON, NEW JERSEY 08650 Fax: (609) 278-1242 Phone: (609) 989-6331 Email: dgerofsky@mercercounty.org American LegalNet, Inc. www.FormsWorkFlow.com