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: _________________________________________ SUPPLEMENTAL } AFFIDAVIT OF NEXT-OF-KIN Defendant(s) : ...................................................... I, ________________________________________ of full age, being sworn upon my oath according to law, deposes and say: 1. I reside at ________________________________________________________________________________________________ 2. Decedent THE PEOPLE OF THE STATE OF NEW YORK departed this life ____________________ without leaving a Will. 3. Decedent resided at his death at ________________________________________ in the County of Salem and State of New Jersey. TO 4. The names, residences and relationship of all the next of kin of said decedent are as follows: Name Relationship Residence Age of all Minors GREETINGS: 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 result of your failure to comply. Court in Witness, Honorable County, , one of the Justices of the day of , 20 (Attorney must sign above and type name below) Attorney(s) for Office and P.O. Address G1S.DOC Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: Page 1 of 2 American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. AFFIDAVIT OF NEXT-OF-KIN : Docket No.: _______________________ Index No. : Plaintiff(s) Calendar No. : JUDICIAL SUBPOENA -against: The real and personal estate of said decedent does not exceed in value the sum of ten thousand ($10,000.00) dollars consisting of assets of the following nature, value and location: : Asset Description Value Location : Defendant(s) : ...................................................... THE PEOPLE OF THE STATE OF NEW YORK TO GREETINGS: 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 I have presented for filing the consent of all of said next of kin who have capacity to consent and am therefore entitled to said personal Your failure to in accordance with N.J.S.A. is 10-4. assets without Letters of Administrationcomply with this subpoena3B: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. Sworn and subscribed before me on: ______/______/20____ Witness, Honorable Court in County, _______________________________________________ , one of the Justices of the day of Signature , 20 __________________________________________ A Notary Public of the State of New Jersey My Commission Expires: ____________________ (Attorney must sign above and type name below) Affix Seal Attorney(s) for Attorney of Record: ____________________________ ____________________________ ____________________________ Office and P.O. Address ____________________________ G1S.DOC Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: Page 2 of 2 American LegalNet, Inc. www.USCourtForms.com