COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : State of New Jersey : Docket Index No. No.: ________________ Calendar No. Salem County Surrogate’s Court SUBPOENA JUDICIAL : Plaintiff(s) -against- : In the matter of the Estate of: ____________________________________________________, Deceased : : AKA: ______________________________________________ } APPLICATION ADMINISTRATION AD PROSEQUENDUM Defendant(s) : ...................................................... Applicant (s) ________________________________, ____________________ at ________________________________________ __________________________________________________________________________________________________________ Says: THE PEOPLE OF THE STATE OF NEW YORK 1. Decedent late of _______________________________, ____________ _________, departed this life on ____________, intestate. TO 2. The spouse and next-of-kin of the decedent, with their respective addresses, and the manner and degree in which they severally stand related to the deceased are as follows: Name Relationship GREETINGS: Residence Age of all Minors WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , the Honorable at the Court located at County of in room , on the day of , 20 , at o'clock in the noon, and at any recessed or adjourned date, to testify and give evidence as a witness in this action on the part of the Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a 3. There areresult of next-of-kin and all the foregoing are of full age except as indicated above. no other your failure to comply. 4. Either due notice of this application has been given to, or, all competent adults, whose right to Administration Ad Prosequendum is , one be granted to the Applicant(s). prior or equal to that ofWitness, Honorable renounced their right thereto and requested that the sameof the Justices of the the Applicant(s), have Court in County, day of , 20 5. The death of the said ____________________________ was caused by the wrongful act, neglect or default of _________________ _______________________________________________________ or some other person or persons. (Attorney must sign above and type name below) Wherefore, the Applicant(s) request(s) judgment that ________________________ be appointed Administrator/rix Ad Prosequendum of the said ________________________________ to prosecute any action, proceeding or claim for their death brought or made under Attorney(s) for the statute in such cases provided. Dated: ____/____/20___, at ________________, New Jersey _________________________________________ Signature Office and P.O. Address F1.DOC Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: Page 1 of 2 American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : STATE OF NEW JERSEY COUNTY OF SALEM Docket No. ___________________ Index No.: : } Calendar No. : JUDICIAL SUBPOENA SS. Plaintiff(s) ___________________________________, being duly sworn, says; I am/we are the Applicant(s) in the foregoing application named. -against- : The allegations thereof are true to the best of my/our knowledge and belief. : Sworn and subscribed before me on: : ____/____/20___ Defendant(s) Signature : ...................................................... Notary Public of the State of New Jersey THE PEOPLE OF THE STATE OF NEW YORK My Commission Expires: _____________________ TO Affix Seal STATE OF NEW JERSEY COUNTYGREETINGS: OF SALEM } QUALIFICATION SS. WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , the Honorable at the Court 1. ________________________ died on orlocated at about _________________ without a Will so far as I know and verily believe. County of in well and , on the 20 , at 2. I will room truly perform the duties day of of Administrator/rix ,Ad Prosequendum ofo'clock in the the said deceased. noon, and at any recessed or adjourned date, to testify and give evidence as a witness in this action on the part of the ___________________________________________, being duly sworn, say(s); Sworn and subscribed before me on: ____/____/____ Your failure to comply with this subpoena isSignature punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply. ____________________________ Special Probate Clerk Court in Witness, Honorable County, , one of the Justices of the day of , 20 Attorney of Record: ____________________________ (Attorney must sign above and type name below) ____________________________ ____________________________ ____________________________ Attorney(s) for Office and P.O. Address F1.DOC Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: Page 2 of 2 American LegalNet, Inc. www.USCourtForms.com