State of New Jersey Ocean County Surrogate's Court In the Matter of the Estate of Renunciation of Administration , deceased To the Surrogate of the County of Ocean: I, _____________________________________,next of kin and heir of the above named decedent, late of Ocean County, do hereby renounce my right of Administration , and request the appointment of_______________________________________as the Administrator/rix. _____________________________________ Signed in the presence of ______________________________ Notary Public STATE OF NEW JERSEY COUNTY OF ss: Be it Remembered, that on ____________________________ before me, the undersigned authority personally appeared _________________________________ who I am satisfied is the person in the foregoing instrument named, to whom I first made known the contents thereof, he/she did thereupon acknowledge that he/she signed, sealed and delivered the same as his/her act and deed, for the uses and purposes therein expressed. AFFIX SEAL _______________________________________ Notary Public American LegalNet, Inc. www.FormsWorkflow.com