Form Letters Administration Details

The Letters Administration Form is used to document the distribution of a deceased person's estate. This form must be filed with the local Probate Court within 30 days of the death. The Letters Administration Form is used to appoint an executor and spell out the deceased person's wishes for the disposition of their estate. The form includes information about the deceased person's assets, debts, and beneficiaries. It is important to have an experienced probate lawyer help you complete this form correctly.

This table includes information about letters administration. Before you fill in the form, it can be worth reading more details on it.

QuestionAnswer
Form NameLetters Administration
Form Length18 pages
Fillable?No
Fillable fields0
Avg. time to fill out4 min 30 sec
Other namesadministration letters, what are letters of administration in probate, which letters administration cta, letters administration

Form Preview Example

 

 

 

 

For Office Use Only

 

Filling Fee Paid

$__________________________________

 

___________________ Certs $ ________________________________

 

$___________________Bond, Fee:______________________________

 

Receipt No: _________

No: ____________________________________

 

DO NOT LEAVE ANY ITEMS BLANK

 

SURROGATE’S COURT OF THE STATE OF NEW YORK

 

 

 

COUNTY OF ___________________________________________

 

 

 

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

- - - - - - - - - - - - - X

 

 

 

ADMINISTRATION PROCEEDING,

PETITION FOR LETTERS OF:

Estate of

[

]

Administration

 

 

[

]

Limited Administration

a/k/a

[

]

Administration with Limitations

 

[

]

Temporary Administration

 

Deceased

 

File No. ________________________________________

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - X

TO THE SURROGATE’S COURT, COUNTY OF ____________________________________________________________________

It is respectfully alleged:

1. The name,domicile and interest in this proceeding of the petitioner,who is of full age,is as follows:

Name: _______________________________________________________________________________________________

Domicile: _____________________________________________________________________________________________

(Street Address)(City/Town/Village)

_____________________________________________________________________________________________________

 

(County)

 

(State)

 

(Zip)

(Telephone Number)

Mailing address is: ______________________________________________________________________________________

 

 

 

(if different from domicile)

 

Citizenship (check one):

[

] U.S.A.

[

] Other (specify)__________________________

Interest of Petitioner (check one):

 

 

 

 

 

[

] Distributee of decedent (state relationship)________________________________________________________________

[

] Other(specify) ______________________________________________________________________________________

Is proposed Administrator an attorney?

[

] Yes

[

] No

 

[If yes, submit statement pursuant to 22 NYCRR 207.16(e); see also 207.52 (Accounting of attorney-fiduciary).]

The proposed Administrator

[

] is

[

] is not a convicted felon nor is he/she otherwise

ineligible, pursuant to SCPA 707 to receive letters.

 

 

 

 

 

If the proposed Administrator is a convicted felon,submit a copy of the Certificate of Relief from Civil Disabilities.

2.The name,domicile,date and place of death, and national citizenship of the above-named decedent are as follows: [The Death Certificate must be filed with this proceeding. If the decedent’s domicile is different from that shown on the death

certificate, check box [

] and attach an affidavit explaining the reason for this inconsistency.]

Name: _______________________________________________________________________________________________

Domicile: _____________________________________________________________________________________________

 

(Street Number)

 

 

 

 

(City,Village/Town)

_____________________________________________________________________________________________________

 

(State)

 

 

 

 

(Zip Code)

 

Township of:

__________________________________ County of:

________________________________________

Date of Death:

__________________________________ Place of Death: ________________________________________

Citizenship:

(check one): [ ]

U.S.A.

[ ]

Other (specify) _________________________________________

A1 (03/18)

 

 

 

 

 

 

Page 1 of 18

 

 

 

 

 

 

 

[Note: For Items 3a through c: Do not include any assets that are jointly held, held in trust for another, or have a named beneficiary.]

3.(a) The estimated gross value of the decedent’s personal property passing by intestacy is less than

$____________________________________________________

(b) The estimated gross value of the decedent’s real property, in this state, which is [ ] improved, [ ] unimproved, passing by intestacy is less than

$_____________________________________________________

A brief description of each parcel is as follows:

___________________________________________________________________________________________________________

(c) The estimated gross rent for a period of eighteen (18) months is the sum of $ ____________________________________

(d) In addition to the value of the personal property stated in paragraph (3) the following right of action existed on behalf of the decedent and survived his/her death, or is granted to the administrator of the decedent by special provision of law,and it is impractical to give a bond sufficient to cover the probable amount to be recovered the rein: [Write“NONE or state briefly the cause of action and the person against whom it exists, including names and carrier].

___________________________________________________________________________________________________________

___________________________________________________________________________________________________________

___________________________________________________________________________________________________________

(e) If decedent is survived by a spouse and a parent, or parents but no issue,and there is a claim for wrongful death, check here [ ] and furnish names(s) and address(es) of parent(s) in Paragraph 7. See EPTL5-4.4.

4.A diligent search and inquiry, including a search of any safe deposit box,has been made for a will of the decedent and none has been found. Petitioner(s)(has)(have) been unable to obtain any information concerning any will of the decedent and therefore allege(s),upon information and belief,that the decedent died without leaving any last will.

5.A search of the records of this Court shows that no application has ever been made for letters of administration upon the estate of the decedent or for the probate of a will of the decedent, and your petitioner is informed and verily believes that no such application ever has been made to the Surrogate’s Court of any other county of this state.

6.The decedent left surviving the following who would inherit his/her estate pursuant to EPTL4-1.1 and 4-1.2:

a.[] Spouse(husband/wife).

b.[] Child or children or descendants of predeceased child or children. [Must include marital, nonmarital

and adopted].

c.[] Any issue of the decedent adopted by persons related to the decedent (DRLSection117).

d.[] Mother/Father.

e.[] Sisters or brothers, either of whole or half blood, and issue of predeceased sisters or brothers.

f.[] Grandmother/Grandfather.

g.[] Aunts or uncles, and children of predeceased aunts and uncles (first cousins).

h.[] First cousins once removed (children of first cousins).

[Information is required only as to those classes of surviving relatives who would take the property of decedent pursuant to EPTL4-1.1.State “number” of survivors in each class. Insert “No” in all prior classes. Insert “X” in all subsequent classes].

Page 2 of 18

7.The decedent left surviving the following distributees, or other necessary parties, whose names, degrees of relationship, domiciles, post office address and citizenship are as follows:

[Note: Show clearly how each person is related to decedent. If relationship is through an ancestor who is deceased, give name,date of death, and relationship of the ancestor to the decedent. Use rider sheet if space in paragraph (7) is not sufficient. See Uniform Rules 207.16(b).

If any person listed in paragraph(7)is a non-marital person,or descended from an on marital person,attach a copy of the order affiliation or Schedule A. If any person listed in paragraph (7) was adopted by any persons related by blood or marriage to decedent or descended from such persons, attach Schedule B].

7a. The following are of full age and under no disability:[If non-marital or adopted-out person,so indicate by attaching Schedule A and/or B]

Name

Relationship

Domicile and Mailing Address

Citizenship Mailing Address

___________________________

________________________

_________________________

________________________

___________________________

________________________

_________________________

________________________

___________________________

________________________

_________________________

________________________

___________________________

________________________

_________________________

________________________

___________________________

________________________

_________________________

________________________

___________________________

________________________

_________________________

________________________

___________________________

________________________

_________________________

________________________

___________________________

________________________

_________________________

________________________

7b. The following are infants and/or persons under disability: [Attach applicable Schedule A, B, C, and/or D]

Name

Relationship

Domicile and Mailing Address

Citizenship Mailing Address

___________________________

________________________

_________________________

________________________

___________________________

________________________

_________________________

________________________

___________________________

________________________

_________________________

________________________

___________________________

________________________

_________________________

________________________

___________________________

________________________

_________________________

________________________

___________________________

________________________

_________________________

________________________

___________________________

________________________

_________________________

________________________

___________________________

________________________

_________________________

________________________

8 There are no outstanding debts or funeral expenses, except: [Write “NONE” or state same]

___________________________________________________________________________________________________________

___________________________________________________________________________________________________________

___________________________________________________________________________________________________________

___________________________________________________________________________________________________________

___________________________________________________________________________________________________________

___________________________________________________________________________________________________________

___________________________________________________________________________________________________________

___________________________________________________________________________________________________________

___________________________________________________________________________________________________________

Page 3 of 18

9.There are no other persons interested in this proceeding other than those here in before mentioned. WHEREFORE, your petitioner respectfully prays that: [Check and complete all relief requested]

 

 

 

(

) a. process issue to all necessary parties to show cause why letters should not be issued as requested;

 

 

 

(

) b. an order be granted dispensing with service of process upon those persons named in Paragraph(7) who have a right to

 

 

 

letters prior or equal to that of the person nominated, and who are non-domiciliaries or whose names or whereabouts

 

 

 

are unknown and cannot be ascertained;

 

 

 

(

) c. a decree award Letters of:

 

 

[

] Administration to_________________________________________________________________________________

 

[

] Limited Administration to __________________________________________________________________________

 

[

] Administration with Limitation to_____________________________________________________________________

 

[

] Temporary Administration to _______________________________________________________________________

or to such other person or persons having a prior right as may be entitled thereto, and;

 

 

 

(

) d. That the authority of the representative under the forgoing Letters be limited with respect to the prosecution or

 

 

 

enforcement of a cause of action on behalf of the estate,as follows: the administrator(s) may not enforce a judgment or

 

 

 

receive any funds without further order of the Surrogate.

 

 

 

(

) e. That the authority of the representative under the foregoing Letters be limited as follows:

 

 

 

 

_____________________________________________________________________________________________________

_____________________________________________________________________________________________________

_____________________________________________________________________________________________________

_____________________________________________________________________________________________________

_____________________________________________________________________________________________________

_____________________________________________________________________________________________________

( ) f. [State any other relief requested.] _____________________________________________________________________

___________________________________________________________________________________________________________

Dated: ________________________________________________

 

1. ____________________________________________________

2. _______________________________________________

(Signature of Petitioner)

(Signature of Petitioner)

______________________________________________________

_________________________________________________

(Print Name)

(Print Name)

Page 4 of 18

STATE OF NEW YORK

)

 

) ss:

COUNTY OF

)

COMBINED VERIFICATION, OATH AND DESIGNATION

[For use when petitioner is to be appointed administrator]

I, the undersigned the petitioner named in the foregoing petition, being duly sworn, say:

1.VERIFICATION: I have read the foregoing petition subscribed by me and know the contents thereof, and the same is true of my own knowledge, except as to the matters there in stated to be alleged upon information and belief,and as to those matters I believe it to be true.

2.OATH OF ADMINISTRATOR as indicated above: I am over eighteen (18) years of age and a citizen of the United States; and I will well,faithfully and honestly discharge the duties of Administrator of the goods, chattels and credits of said decedent according to law. I am not ineligible, pursuant to SCPA707,to receive letters and will duly account for all moneys and other property that will come into my hands.

3.DESIGNATION OF CLERK FOR SERVICE OF PROCESS: I do hereby designate the Clerk of the Surrogate’s Court of

________________ County, and his/her successor in office, as a person on whom service of any process, issuing from such Surrogate’s Court may be made in like manner and with like effect as if it were served personally upon me, whenever I cannot be found and served within the State of New York after due diligence used.

My domicile is:_______________________________________________________________________________________________

(Street/Number)(City,Village/Town)(State)(Zip)

___________________________________________________

Signature of Petitioner

On the _______________________ day of ________________________,20 _______________________, before me personally came

___________________________________________________________________________________________________________

to me known 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.

______________________________________________________

Notary Public

Commission Expires:

(Affix Notary Stamp or Seal)

Signature of Attorney: ___________________________________

 

Print Name: ____________________________________________

 

Firm Name: ____________________________________________

Tel.No.: __________________________________________

Address of Attorney: __________________________________________________________________________________________

Page 5 of 18

SURROGATE’S COURT OF THE STATE OF NEW YORK

 

COUNTY OF

 

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

X

PROCEEDING FOR

SCHEDULE A

Estate of

NONMARITAL PERSONS

 

(PERSONS BORN OUT OF WEDLOCK)

a/k/a

 

Deceased.

File# _______________________________________________

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - X

[NOTE: Nonmarital children (or their issue) who would be distributees if they (or their ancestors) were born in wedlock will not be regarded as distributees unless satisfactory proof is submitted establishing paternity]. See EPTL 4-1.2 which sets forth methods of establishing paternity.

Name of alleged distributee: _______________________________

 

Date of birth: ___________________________________________

Relationship to decedent: ____________________________

Name of father:

________________________________________

 

Name of mother:

_______________________________________

 

Does the birth certificate contain the father’s name?

Yes [

]

No [

]

If yes, attach copy of birth certificate.

 

 

 

 

Has an order of filiation establishing paternity been entered?

Yes [

]

No [

]

If yes, attach copy of order.

 

 

 

 

Did the nonmarital person live with his or her father?

Yes [

]

No [

]

If yes, give dates and places of residence: ___________________________________________________________________

___________________________________________________________________________________________________________

___________________________________________________________________________________________________________

___________________________________________________________________________________________________________

Page 6 of 18

SURROGATE’S COURT OF THE STATE OF NEW YORK COUNTY OF

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

X

PROCEEDING FOR

SCHEDULE B

Estate of

ISSUE OF THE DECEDENT

 

WHO WERE THE SUBJECT

a/k/a

OF AN ADOPTION

Deceased.

File # _______________________________________________

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

X

Name of child: _________________________________________________________________________________________

Relationship to decedent prior to adoption: __________________________________________________________________

Date of adoption: _______________________________________________________________________________________

Was this a step-parent adoption?(i.e.,was the child adopted by the spouse of the decedent’s former spouse?) Yes[ ] No[]

If yes,name of adoptive father or mother: ____________________________________________________________________

If not a step-parent adoption,indicate below the biological relationship of the adoptive parent to the child:

 

 

 

[

] grandparent(s)

 

 

 

[

] brother or sister

 

 

 

[

] aunt or uncle

 

 

 

[

] first cousin

 

 

 

[

] nephew or niece

 

 

 

Name of the adoptive parent: ___________________________________________________________________________________

Page 7 of 18

SURROGATE’S COURT OF THE STATE OF NEW YORK

 

COUNTY OF

 

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

X

PROCEEDING FOR

SCHEDULE C

Estate of

INFANTS

a/k/a

 

Deceased.

File # _______________________________________________

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

X

[NOTE: Please furnish all of the information requested, otherwise the petition may be rejected.]

Name: _______________________________________________________________________________________________

Date of birth: __________________________________________________________________________________________

_____________________________________________________________________________________________________

Relationship to the decedent: _____________________________________________________________________________

With whom does the infant reside? _________________________________________________________________________

Name of mother: _______________________________________________________________________________________

Is she alive? ___________________________________________________________________________________________

Name of Father:________________________________________________________________________________________

Is he alive?____________________________________________________________________________________________

Does infant have a court-appointed guardian?

Yes [ ]

No [ ]

If yes, name and address of guardian: _____________________________________________________________________

Name: _______________________________________________________________________________________________

Date of birth: __________________________________________________________________________________________

Relationship to the decedent: _____________________________________________________________________________

With whom does the infant reside? _________________________________________________________________________

Name of mother: _______________________________________________________________________________________

Is she alive? ___________________________________________________________________________________________

Name of Father:________________________________________________________________________________________

Is he alive?____________________________________________________________________________________________

Does infant have a court-appointed guardian?

Yes [ ]

No [ ]

If yes,name and address of guardian: _____________________________________________________________________

Page 8 of 18

SURROGATE’S COURT OF THE STATE OF NEW YORK COUNTY OF

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

X

PROCEEDING FOR

SCHEDULE D

Estate of

PERSONS UNDER DISABILITY

 

OTHER THAN INFANTS

a/k/a

 

Deceased.

File # _______________________________________________

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - X

[use additional sheets if more than one]

1.Name: ____________________________________ Relationship: _________________________________________________

Residence: _________________________________________________________________________________________________

With whom does this person reside? _____________________________________________________________________________

If this person is in prison, name of prison: _________________________________________________________________________

Does this person have a court-appointed fiduciary?

Yes[

 

 

 

]

No[

]

If yes,give name,title and address: _________________________________________________________________________

_____________________________________________________________________________________________________

If no,describe nature of disability: __________________________________________________________________________

_____________________________________________________________________________________________________

If no,give name and address of relative or friend interested in his or her welfare: _____________________________________

_____________________________________________________________________________________________________

2.Where abouts unknown/Unknowns [persons whose addresses or names are unknown to petitioner;if known,give name and relationship to decedent]

___________________________________________________________________________________________________________

___________________________________________________________________________________________________________

___________________________________________________________________________________________________________

___________________________________________________________________________________________________________

___________________________________________________________________________________________________________

___________________________________________________________________________________________________________

___________________________________________________________________________________________________________

___________________________________________________________________________________________________________

___________________________________________________________________________________________________________

___________________________________________________________________________________________________________

Page 9 of 18

ADMINISTRATION CITATION

File No. __________________________________________

 

SURROGATE’S COURT -____________________COUNTY

 

CITATION

 

THE PEOPLE OF THE STATE OF NEW YORK,

 

By the Grace of God Free and Independent,

TO

A petition having been duly filed by _________________________________________________________ , who is domiciled at

___________________________________________________________________________________________________________

YOU ARE HERE BY CITED TO SHOW CAUSE before the Surrogate’s Court,_______________________________________

County, at __________________

, New York, on ______________________ ,20 ____ at _________ o’clock in

the ________________________

noon of that day, why a decree should not be made in the estate of ________________________

___________________________________________________________________________________________________________

lately domiciled at ____________________________________________________________________________________________

in the County of _________________________________________ ,New York, granting Letters of Administration upon the estate of

the decedent to _________________________________________ or to such other person as may be entitled there to.

(State any further relief requested)

 

_________________________________________________

 

HON.

Dated, Attested and Sealed, __________________ , 20________

Surrogate

(Seal)

 

 

_________________________________________________

 

Chief Clerk

Name of

 

Attorney for Petitioner ____________________________________

Tel.No. ___________________________________________

Address of Attorney___________________________________________________________________________________________

Note: This citation is served upon you as required by law. You are not required to appear. If you fail to appear it will be assumed you do not object to the relief requested. You have a right to have an attorney-at-law appear for you.

Page 10 of 18

SURROGATE’S COURT OF THE STATE OF NEW YORK COUNTY OF

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - X

ADMINISTRATION PROCEEDING

 

Estate of

NOTICE OF APPLICATION FOR

 

LETTERS OF ADMINISTRATION

 

(SCPA 1005)

a/k/a

 

Deceased.

File No. ____________________

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - X

Notice is Hereby Given That:

(1) an application for Letters of Administration upon the estate of the above-named decedent, has been made

by, ________________________________________________________________________________________________ petitioner,

whose post office address is: ___________________________________________________________________________________

(2)each and every name of the intestate decedent known to the undersigned is as indicated in the above caption.

(3)petitioner prays that a decree be made directing the issuance of Letters of Administration to _________________________

_____________________________________________________________________________________________________

(4)the name and post office address of each and every distributee of the above-named decedent, as set forth in the petition and known to the undersigned, are as follows:

(a) Distributees who have been duly cited, have waived citation or have appeared in this proceeding:

Name of Distributee

Domicile and Post Office Address

__________________________________________

__________________________________________

__________________________________________

__________________________________________

__________________________________________

__________________________________________

(b) Other Distributees;

 

Name of Distributee

Domicile and Post Office Address

__________________________________________

__________________________________________

__________________________________________

__________________________________________

__________________________________________

__________________________________________

[CONTINUE ON REVERSE SIDE IF MORE SPACE NEEDED]

(5)That the undersigned does not know of any other distributees of the said decedent.

(6)That Letters of Administration will issue on or after ______________________ ,20 ________

Dated: _______________________ ,20 _________

__________________________________________

 

Signature of Petitioner or Attorney

__________________________________________

__________________________________________

Attorney for Petitioner

Print Name

__________________________________________

__________________________________________

Address (Office)

Address

__________________________________________

 

Tel No.

 

A-3

Page 11 of 18

SURROGATE’S COURT OF THE STATE OF NEW YORK COUNTY OF

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

- - - - - - - - - - X

ADMINISTRATION PROCEEDING

AFFIDAVIT OF MAILING

Estate of

NOTICE OF APPLICATION FOR

 

LETTERS OF ADMINISTRATION

 

(SCPA 1005)

a/k/a

 

 

Deceased. File No._____________________

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

- - - - - - - - - - X

STATE OF NEW YORK

 

COUNTY OF

ss.:

______________________________________________________ , residing at __________________________________ New York,

being duly sworn,deposes and says that deponent is over the age of eighteen years; that on _____________________ , 20 _______

deponent mailed a copy of the foregoing Notice of application for Letters of administration, contained in a securely closed postpaid wrapper, directed to each of the persons named in paragraph 4(b), respectively, as follows:

whose post office address is____________________________________________________________________________________

whose post office address is____________________________________________________________________________________

whose post office address is____________________________________________________________________________________

whose post office address is____________________________________________________________________________________

whose post office address is____________________________________________________________________________________

whose post office address is____________________________________________________________________________________

whose post office address is____________________________________________________________________________________

whose post office address is____________________________________________________________________________________

by depositing the document in a letter box or other official depository under the exclusive care and custody of the United States Post Office, located at:

___________________________________________________________________________________________________________

Sworn to before me this __________________________________ _________________________________________________

day of______________________________________________ ,20______________________________________ Signature

Notary Public

Commission Expires:

(Affix Stamp or Seal)

A-4

Page 12 of 18

SURROGATE’S COURT OF THE STATE OF NEW YORK

COUNTY OF

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - X

ADMINISTRATION PROCEEDING

 

Estate of

NOTICE TO CONSUL

 

GENERAL

a/k/a

 

Deceased.

File No _______________________________________________

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - X

TO THE CONSUL GENERAL OF

AT THE CITY OF NEW YORK

PLEASE TAKE NOTICE that a petition (will be) (has been) presented to the Surrogate’s Court,

County of __________________________________________ ,on ______________,20 ___________________________ , with

respect to the Estate of the above-named decedent and it appears from the petition that:

a. the deceased was a subject of _____________________________________________________________________ or

b. the following distributees are nonresidents of the United States:

NamesAddressesCitizenship

__________________________________ __________________________________ _________________________________

__________________________________ __________________________________ _________________________________

_________________________________

Attorney for Petitioner

_________________________________

Address

_________________________________

Telephone No.

STATE OF NEW YORK

COUNTY OF _________________________________________ss.:

____________________________________ being duly sworn,says:

That he/she resides at__________________ , New York; that on the

__________________________________________ ,20 ________ , he/she served a copy of the above NOTICE on the Consul General

of ________________________________________ at _________ ,New York City,by mailing same to the office of the aforesaid Consul.

_________________________________

Signature

Sworn to before me this ______________________

day of_____________________________________ ,20 ________

______________________________________________________

Notary Public

Commission Expires: (Affix Stamp and Seal)

A-5

Page 13 of 18

 

At a Surrogate’s Court of the State of New York Held

 

in and for the County of _______________________ ,

 

at _________________________________New York

 

on _______________________ ,20 _____________

PRESENT:

 

HON. _____________________________________

 

Surrogate.

 

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

- - - - - - - - - - X

ADMINISTRATION PROCEEDING

DECREE APPOINTING

Estate of

ADMINISTRATOR

a/k/a

FileNo. _______________________________________________

 

Deceased.

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - X

A petition having been filed by _____________________________________________________________ praying that administration

of the goods, chattels and credits of the above-named decedent be granted to ___________________________________________ ;

and all persons named in such petition,required to be cited,having been duly cited to show cause why such relief should not be granted or having duly waived the issuance of such citation and consented thereto; and it appearing

that _______________________________________________________________________________________________________

is in all respects competent to act as administrat ____________________________________________of the estate of said deceased,

and a

 

 

bond having been filed and approved in the amount of $ _____________________________________________________

[

]

 

 

bond having been dispensed with

[

]

and such representative(s) otherwise having qualified therefore; now, after due deliberation,with no one appearing in opposition thereto, it is

ORDERED AND DECREED that Letters of Administration issue to ________________________________________________

___________________________________________________________________________________________________________

ORDERED AND DECREED, that the authority of such representative(s) be restricted in accordance with, and that letters herein issued contain, the limitation, if any, which appears immediately below.

_________________________________

Surrogate

A-6

Page 14 of 18

SURROGATE’S COURT OF THE STATE OF NEW YORK

COUNTY OF

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - X

ADMINISTRATION PROCEEDING

 

Estate of

AFFIDAVIT OF

 

REGULARITY

a/k/a

 

Deceased.

File No. ______________________________________________

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - X

STATE OF NEW YORK

 

COUNTY OF

ss.:

__________________________________________ , being duly sworn, deposes and says:

1.That he/she is the attorney for ________________________________________________________________________ ,the

__________________________________________ herein.

2.That all the parties to this proceeding have been duly cited or have waived the issuance and service of a citation herein and consented to the entry of a decree or order in the following manner and form:

a. By service of a copy of the citation issued herein upon the following persons in the manner prescribed by SCPA 307(1), as more fully appears by the proof of service thereof, made in the manner and form by law and filed on____________ , 20 ___________.

Name

Address

Date of Service

__________________________________

__________________________________

_________________________________

__________________________________

__________________________________

_________________________________

b. By service pursuant to an order made herein on ____________ ,20 ______________________ , under SCPA307(2), as

more fully appears by the proof of service thereof, made in the manner prescribed by law and filed herein on __________ ,20______.

Name

Address

Date of Service

__________________________________

__________________________________

_________________________________

__________________________________

__________________________________

_________________________________

 

(Parties who waive or consent)

 

c. By duly executed waivers of the issuance and service of the citation herein and a consent to the entry of a decree or order

and filed herein on ___________________________________________ ,20 ______________________ ,by:

Name

Address

Date of Service

__________________________________

__________________________________

_________________________________

__________________________________

__________________________________

_________________________________

3.That no notice of appearance has been filed herein, except by _________________________________________________

4.That all of the persons named above are of full age and are of sound mind, excepting those herein before stated to be otherwise, and comprise all the parties, as deponent verily believes, who have any interest in this proceeding.

_________________________________

Signature

Sworn to before me this __________________________________

day of_____________________________________ ,20 ________

______________________________________________________

Notary Public

Commission Expires: (Affix Stamp and Seal)

N.B. Where a person cited is an infant, incarcerated, a mentally ill person, a mentally retarded person, a developmentally disabled person, an alcohol abuser or for any cause is mentally incapable of adequately protecting his/her rights, it must so appear in the foregoing affidavit. The age of the infant also must be stated.

A-7

Page 15 of 18

SURROGATE’S COURT OF THE STATE OF NEW YORK COUNTY OF

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - X

ADMINISTRATION PROCEEDING

WAIVER OF CITATION,

Estate of

RENUNCIATION AND CONSENT TO

 

APPOINTMENT OF ADMINISTRATOR

 

(INDIVIDUAL)

a/k/a

 

Deceased.

File No. ______________________________________________

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - X

The undersigned, a distributee or creditor of the above named decedent and being of full age and sound mind hereby voluntarily appears in the Surrogate’s Court of ____________________ County, New York and waives the issuance and service of citation in this matter,

renounces all right to Letters of Administration of the above captioned estate and consents that

 

 

 

 

Letters of Administration

 

[

]

 

 

 

 

 

Letters of Administration with Limitations

[

]

 

 

 

 

Limited Letters of Administration

[

]

be issued to _________________________________________________________________________________________________

or any other person or persons entitled thereto without any notice whatsoever to the undersigned, and consents

 

 

 

 

 

that a bond be dispensed with and hereby specifically release any claim I might have under any bond that may be filed

 

[

]

 

 

 

 

 

 

that a bond in the amount of $ _________________________ be posted.

 

[

]

 

___________________________

________________________

_________________________

________________________

 

 

 

 

 

Date

Signature

Street Address

Relationship

___________________________

________________________

 

 

 

 

 

 

 

Print Name

Town/State/Zip

 

 

STATE OF NEW YORK

COUNTY OF_______________________________ ss.:

On _______________________________________ ,20 ________ , before me personally appeared____________________________

__________________________________________ to me known and known to me to be the person described in and who executed the

foregoing waiver and consent and each duly acknowledged the execution thereof.

 

__________________________________________

 

Name of Attorney

 

__________________________________________

__________________________________________

__________________________________________

Notary Public

Address

Commission Expires:

 

(Affix Stamp or Seal)

__________________________________________

 

Telephone Number

A-8

 

Page 16 of 18

SURROGATE’S COURT OF THE STATE OF NEW YORK

COUNTY OF

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - X

ADMINISTRATION PROCEEDING

WAIVER OF CITATION AND

Estate of

CONSENT TO APPOINTMENT

 

OF ADMINISTRATOR

 

(CORPORATION)

a/k/a

 

Deceased.

File No. ______________________________________________

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - X

The undersigned corporation, a creditor of the above-named decedent, hereby voluntarily appears in the Surrogate’s

Court of ___________________________________________________ County, New York, and waives the issuance and service of

a citation in this matter and consents that Letters of Administration be issued to ___________________________________________

or any other person or persons entitled there to without any notice whatsoever to the undersigned,without furnishing a bond or other security for the faithful performance of the duties of that office and specifically releasing any claim it might have under any bond that may be furnished.

Dated: ____________________________________ ,20 ________

_______________________________________________

 

(Name of Corporation)

 

By: _______________________________________

 

(Signature of Officer)

 

__________________________________________

 

(Type Name and Title)

STATE OF NEW YORK

COUNTY OF __________________________________________ ss.:

On _______________________________________ ,20 ________ , before me personally came

___________________________________________________________________________________________________________

to me known, who being duly sworn did say that: he resides at_________________________________________________________

_________________________________________________________ ; he is a __________________________________________

______________________________________________________________ of___________________________________________

______________________________________________________ ,the corporation described in and which executed the foregoing

waiver and consent; and that he signed the same thereto by order of the board of directors of the corporation.

 

__________________________________________

 

Name of Attorney

 

__________________________________________

__________________________________________

__________________________________________

Notary Public

Address

Commission Expires:

 

(Affix Stamp or Seal)

__________________________________________

 

Telephone Number

A-9

 

Page 17 of 18

SURROGATE’S COURT OF THE STATE OF NEW YORK COUNTY OF

----------------------------------------------------------------------X

ADMINISTRATION PROCEEDING

Note: File proof of Service at least 3 days before

return date. State clearly date, time and place of service and name of person served (Uniform Rule 207.7(c)).

Estate of

AFFIDAVIT OF SERVICE

 

OF CITATION (Adult)

a/k/a

 

Deceased.

File No. ________________________________________

---------------------------------------------------------------------------

X

STATE OF NEW YORK :COUNTY OF

ss.:

_____________________________________________________ of ___________________________________________________

___________________________________________________ ,being duly sworn, says that I am over the age of eighteen years; that

I made personal service of the citation herein dated _______________________ ,20 _______ on each person named below, each of

whom deponent knew to be the person mentioned and described in said citation,by delivering to and leaving with each of them person- ally a true copy of said citation, as follows:

On __________________________________________________, description, viz: sex _______________ , color of skin__________,

color of hair___________________________________________, approximate age ___________ , weight _______, height ______,

at ________o’clock ___ m. on the _______day of ____________, 20___ ,at _____________________________________________

___________________________________________________________________________________________________________

On __________________________________________________, description, viz: sex _______________ , color of skin__________,

color of hair___________________________________________, approximate age ___________ , weight _______, height ______,

at ________o’clock ___ m. on the _______day of ____________, 20___ ,at _____________________________________________

___________________________________________________________________________________________________________

On __________________________________________________, description, viz: sex _______________ , color of skin__________,

color of hair___________________________________________, approximate age ___________ , weight _______, height ______,

at ________o’clock ___ m. on the _______day of ____________, 20___ ,at _____________________________________________

___________________________________________________________________________________________________________

That none of the aforesaid persons is in the Military Service as defined by the Act of Congress known as the “Soldiers’ and Sailors’ Civil Relief Act of 1940” and in the New York “Soldiers’ and Sailors’ Civil Relief Act.”

__________________________________________

Sworn to before me this __________________________________

day of_____________________________________ ,20 ________

______________________________________________________

Notary Public

Commission Expires: (Affix Stamp and Seal)

A-10

Page 18 of 18