SURROGATE'S COURT OF THE STATE OF NEW YORK COUNTY OF ---------------------------------------------------------------------------------X LETTER S OF AD MINISTRAT ION c.t.a. W ILL OF a/k/a RENUNCIATION OF LETTERS OF ADM INIS TR AT ION c.t.a., WAIVER OF PROCESS AND CONSENT TO DISPENSE W ITH BOND File No. Deceased. --------------------------------------------------------------------------X The undersigned, [ ] a beneficiary with equal or prior right to receive letters [ ] a beneficiary of the estate [ ] a creditor [ ] other (specify) hereby personally appears in this proceeding in the Surrogate's Court of 1. 2. 3. Renounces all rights to Letters of Administration c.t.a. W aives the issuance and service of citation in the above entitled proceeding. Consents that Letters of Administration c.t.a. be granted by the Court to or any other person or persons entitled thereto without any notice whatsoever to the undersigned. 4. Consents to dispense with bond of the Administrator c.t.a. and if such consent be filed by some but not all of the persons interested in the estate, specifically releases any claim under any bond that may be required of such Administrator c.t.a. County and , a person interested in this estate as Date Signature Street Address Re lationship Print Name Tow n/S tate /Zip STATE OF NEW YORK CO UN TY OF On ss.: , 20 , before me personally came , to me known and known to me to be the person described in and who executed the foregoing instrument. Such person duly swore to such instrument before me and duly acknowledged that he/she executed the same. Nota ry Public Com mission Expires: (Affix No tary Sta m p or Seal) Na m e of A ttorne y: Addres s of A ttorne y: CTA-3 (7/98) Tel. No.: American LegalNet, Inc. www.FormsWorkflow.com