Docket No.: ______________ State of New Jersey Salem County Surrogate’s Court In the matter of the Estate of: _______________________________________________, Deceased } AKA: _________________________________________ RENUNCIATION OF ADMINISTRATOR To: Nicki A. Burke, Surrogate of the County of Salem I, _________________________, ____________________ of the above decedent, late of _________________ in the County of Salem do hereby renounce my right of Administration, and request the appointment of ___________________________________________. Dated: ____/____/20___ ___________ Signature Notary Public STATE OF NEW JERSEY COUNTY OF SALEM } SS. Be it remembered, that on this, ____/____/20___, before me, undersigned authority, personally appeared _________________________, who I am satisfied are the persons in the foregoing instrument, to whom I first made known the contents thereof, and thereupon they acknowledged that they signed, sealed and delivered the same as their voluntary act and deed, for the uses and purposes therein expressed. __________________________________________________ Notary Public My Commission Expires: ____________________ Affix Seal E3.DOC Page 1 of 1 American LegalNet, Inc. www.FormsWorkflow.com