SOMERSET COUNTY SURROGATE222S COURT SOMERSET COUNTY MINOR222S CASE INFORMATION FORM Name of Minor Residence Social Security No. Age Date of birth Amount to be deposited Money coming from: Court Order Insurance Other (specify) PLEASE SUBMIT COPY OF BIRTH CERTIFICATE AND ORDER (IF APPLICABLE) Name and address of guardian(s) Telephone (Home) (Work) Next of Kin Relationship Address Father Mother Attorney of Record Address Telephone Fax (908- or Email (surrogatesoffice@co.somerset.nj.us) completed Case Information form, copy of birth certificate and order (if applicable) American LegalNet, Inc. www.FormsWorkFlow.com