SOMERSET COUNTY SURROGATE222S COURT ADMINISTRATION QUESTIONNAIRE In order to properly identify heirs who are entitled to take under New Jersey222s amended intestacy statute (NJSA 3B:5-1 et seq.), please provide the following information. Please answer NA if statement does not apply to this estate. 1.Name of deceased 2.Name of surviving spouse (legally married to decedent at the timeof decedent222s death) 3.Name and date of birth of all children born to the marriage of thedecedent and the surviving spouse named in statement 2. Includeany children of decedent who were legally adopted by the survivingspouse. (Please use additional sheet if necessary.) a. dob living at time of decedent222s death? Address b. dob living at time of decedent222s death? Address American LegalNet, Inc. www.FormsWorkFlow.com c. dob living at time of decedent222s death? Address d. dob living at time of decedent222s death? Address 4. Additional children of decedent. These children are not the children of the surviving spouse nor were they adopted by the surviving spouse. (Please use additional sheet if necessary.) a. dob living at time of decedent222s death? Address b. dob living at time of decedent222s death? Address c. dob living at time of decedent222s death? Address d. dob living at time of decedent222s death? Address American LegalNet, Inc. www.FormsWorkFlow.com 5. Additional children of surviving spouse. These children are not the children of the decedent and decedent did not adopt these children. (Please use additional sheet if necessary.) a. dob living at time of decedent222s death? Address b. dob living at time of decedent222s death? Address c. dob living at time of decedent222s death? Address d. dob living at time of decedent222s death? Address 6. If any child named in sections 3, 4, and 5 predeceased the decedent but had surviving children, please provide their name, date of birth and whether or not they were living at the time of decedent222s death. 7. Name of decedent222s parents. Mother: Alive at time of decedent222s death? Yes No Father: Alive at time of decedent222s death? Yes No American LegalNet, Inc. www.FormsWorkFlow.com 8.If there is no surviving spouse, child of decedent, or parent, pleaseprovide the names of the decedent222s brothers and sisters (and theirchildren if they predeceased decedent). If there are no brothersand sisters or nephews and nieces, the clerk assisting you willadvise you of the additional information we will require. If you arecompleting this form outside our office, please call for additionalinstructions. 9.In addition, please provide a list of all assets owned by thedecedent at the time of death that pass through the intestateestate along with the date of death value. (For real estate pleaseinclude a copy of the latest tax bill.) Fax (908-) or Email (surrogatesoffice@co.somerset.nj.us) completed Administration Questionnaire American LegalNet, Inc. www.FormsWorkFlow.com