SOMERSET COUNTY SURROGATE222S COURT AFFIDAVIT OF SURVIVING SPOUSE CASE INFORMATION FORM Name of deceased Residence Date of death Date of birth Name of Affiant (party seeking Affidavit) Address of Affiant Telephone Children of deceased Name Address Fax (908- or Email (surrogatesoffice@co.somerset.nj.us) completed Case Information form, death certificate and a list of all assets belonging to the deceased (copy of car title, bank statement etc.) American LegalNet, Inc. www.FormsWorkFlow.com