SOMERSET COUNTY SURROGATE222S COURT ADMINISTRATION CASE INFORMATION FORM Name of deceased Legal residence at time of death Date of death Date of birth Name of Administrator Relationship to decedent Address Telephone Please complete the attached Administration questionnaire if applicable and return with this document Number of certificates requested Please attach a list of all accounts with date of death values. (banks, stocks, car title, etc.) Submitted by Telephone Fax (908-) or Email (surrogatesoffice@co.somerset.nj.us) completed Case Information form, Administration questionnaire, death certificate and a list of all assets belonging to the deceased American LegalNet, Inc. www.FormsWorkFlow.com