State of New Jersey Docket No.: _____________ Salem County Surrogate’s Court In the matter of the Estate of: ______________________________________________________, Deceased AKA: ________________________________________________ } POWER OF ATTORNEY ADMINISTRATOR KNOW ALL MEN BY THESE PRESENTS, that I, ______________________ _________________ at ______________________ ______________________________________________, pursuant to the provisions of Revised Statutes 3B:14 - 47 do hereby make, constitute and appoint Nicki A. Burke, Surrogate of the County of Salem, in the State of New Jersey, and their successors in office, my true and lawful attorney upon whom may be served any and all process affecting the aforesaid estate, or any interest therein, whereof I am the Administrator/rix. And I do further agree that any process against the aforesaid estate, so served, shall be of the same force and effect as if duly served upon me within this State. In Witness Whereof, I have hereunto set my hand and seal this ____/____/20__. __ Signature Signed, sealed and delivered in the presence of: Notary Public of the State of New Jersey STATE OF NEW JERSEY COUNTY OF SALEM SS. BE IT REMEMBERED, that on this, ____/____/20__, before me, the subscriber, a Notary Public of New Jersey, personally appeared ____________________________, who I am satisfied is the person named in the foregoing power of attorney, and I having first made known to them the contents thereof, they did thereupon acknowledge that they signed, sealed and delivered the said power of attorney as their voluntary act and deed, for the uses and purposes therein expressed. ______________________________________________ Notary Public of the State of New Jersey My Commission Expirees________________ Affix Seal PAA.doc Page 1 of 1 American LegalNet, Inc. www.FormsWorkflow.com