New York Form Wd 3 PDF Details

When navigating the complexities of settling an estate in New York, the Surrogate’s Court comes into play, particularly in cases involving wrongful death. The WD-3 form serves as a crucial document in this process, providing a structured way for administrators to seek the court's permission to settle wrongful death claims and to detail their handling of the decedent's estate. This form requires the administrator to account for their proceedings meticulously, listing assets like claims against insurance companies stemming from the wrongful death, detailing disbursements for funeral expenses and attorney fees, and specifying the distribution of the remaining estate among the decedent's next of kin. It also addresses rejected claims against the estate, such as those from social services or family members, ensuring a comprehensive overview of the estate's standing. Furthermore, the form includes provisions for the administrator to declare any outstanding bills and the specific allocation of the settlement among beneficiaries, emphasizing transparency and accountability in managing and distributing the estate's assets. This legal document not only facilitates the administrative process but also underscores the importance of a clear and fair resolution for those left behind, making it an essential tool in the administration of justice within New York’s legal framework.

QuestionAnswer
Form NameNew York Form Wd 3
Form Length3 pages
Fillable?No
Fillable fields0
Avg. time to fill out45 sec
Other namesWDacct nys surrogates court form wd 3 account

Form Preview Example

Form WD-3 (4/98)

SURROGATE’S COURT OF THE STATE OF NEW YORK

COUNTY OF

In the Matter of the Application of

 

 

 

 

 

 

 

 

 

as Administrat

 

 

of the Goods, Chattels and

 

 

 

 

 

 

 

 

 

Credits which were of

 

 

 

 

 

 

ACCOUNT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Deceased.

 

File #

 

 

 

For leave to compromise a certain cause of action for

 

 

 

 

 

 

 

 

 

wrongful death of the decedent and to render and have

 

 

 

 

 

 

 

 

 

judicially settled an account of the proceedings as such

 

 

 

 

 

 

 

 

 

Administrat

 

 

.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TO THE SURROGATE’S COURT:

 

 

 

 

 

 

 

 

 

1. I

 

 

 

 

 

 

 

 

 

do render the following account of my

 

 

 

proceedings as administrat

 

 

of the goods, chattels and credits which were of

 

 

,

 

deceased, consisting of a claim against

 

 

 

 

 

, who is insured by

 

 

 

 

 

 

 

 

 

 

Insurance Company, for wrongful death arising on or about

 

 

,

as the result of an automobile accident involving the decedent and

 

.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2.Letters of Administration of the goods, chattels and credits of the decedent were issued to me on

_______________________, said letters being limited to the prosecution only, and not for the collection of any proceeds of, any action or claim for wrongful death. Simultaneously herewith, leave is being asked to

compromise the claim for wrongful death of the decedent for the sum of $

 

.

3.There is submitted with this account my petition as administrat________; and affidavit by

,Esq., attorney for the petitioner herein; a copy of the paid funeral bill; and waivers of the necessary parties.

4.In view of the facts and circumstances, it is my opinion that a satisfactory result has been achieved through the efforts of my attorneys, and they are requesting disbursements in the sum of

$

 

 

and that they receive thereafter a fee of

 

% of the net proceeds.

5.

The funeral bill in the sum of $

 

has been paid through no-fault insurance.

6.There are no outstanding hospital bills or doctors’ bills.

7.The only property coming into my hands is by reason of the compromise of the claim against the

Insurance Company in the sum of $

 

.

 

 

8. The decedent left surviving no other next of kin except

 

,

his/her widow/widower, and

,

his/her children. All of the above persons are entitled to share in the proceeds of the compromise.

(NOTE: WHERE THERE ARE NO DISTRIBUTEES UNDER A DISABILITY, THE RENDERING OF AN ACCOUNT IS USUALLY NOT REQUIRED.)

(NOTE: REIMBURSEMENT OF FUNDS PAID FOR FUNERAL AND OTHER ADMINISTRATIVE EXPENSES, UNDER MOST CIRCUMSTANCES, ARE ALLOWABLE, AS ARE STATUTORY COMMISSIONS TO THE ADMINISTRAT(OR)(RIX). IF REIMBURSEMENT OR COMMISSIONS ARE NOT SOUGHT, THE PETITION SHOULD CONTAIN A WAIVER THEREOF).

9.There are no other claims or creditors of the estate that have been presented to or have come into my hands or knowledge except for the following:

a)The Commissioner of Social Services has submitted a claim of $

for public assistance rendered to decedent and his/her family for the years

. This claim was rejected.

b)

has submitted a claim for $

 

 

 

based on

 

 

 

 

This claim was rejected.

 

 

 

c) Decedent’s father/mother,

has sought a share of the recovery based on an alleged pecuniary loss. This claim was rejected.

10. The following are the only persons interested in this proceeding:

 

[L IST NAMES OF DISTRIBUTEES, ETC .]

 

NAME

RELATIONSHIP

DATE OF BIRTH

County Department

 

of Social Services

 

Possible Creditor

New York State Tax Commission

Possible Creditor

 

 

 

Attorneys

 

 

 

Defendant

Insurance Company

Defendant’s Insurance Company

11.I charge myself as follows with the amount to be received on compromise of the claim for wrongful death against

Insurance Company:

$

-2-

12. I credit myself as follows:

 

 

 

 

a) With the amount to be paid to

 

 

,

 

 

 

 

 

 

 

 

 

 

 

 

 

Esqs., attorneys, including disbursements:

 

$

b) With the amount to be paid to

 

 

,

 

 

 

 

 

 

 

 

 

 

 

 

 

widow/widower and distributee: (

%)

$

 

 

 

 

 

 

 

 

 

 

c) With the amount to be paid to the guardian of the person

and property of

 

 

 

 

 

 

 

,

 

 

infant, jointly with the Trust Officer of

 

 

 

 

 

Bank (

 

 

%):

 

 

 

 

 

$

d) with the amount to be paid to

 

 

,

 

 

 

 

 

 

 

 

 

 

son/daughter (

%):

 

 

 

 

$

 

 

 

 

Total:

 

 

$

Leaving no balance.

 

 

 

 

 

 

 

 

 

 

Dated:

STATE OF NEW YORK

 

COUNTY OF

SS.:

being duly sworn, deposes and says:

That I am the administrat_______ /accountant in the above estate, having been duly appointed by a

decree of this Court.

The foregoing account of proceedings contains to the best of my knowledge and belief a true and complete statement of my receipts and disbursements in the estate of

of all monies and other property belonging to the estate or fund which have come into my hands or which have been received by any person or persons by my order or authority for use since my appointment, and a full and true statement of account of the manner in which I have disposed of same and all property remaining in my hands at the present time, and a full and true account of the nature of each and every transaction may by me since my appointment.

 

I do not know of any error or omission in said account to the prejudice of any person interested in

said estate or fund.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

___________________________________

Sworn to before me this

 

 

 

 

 

day of

 

 

.

 

 

Notary Public

(Form WD-3)

-3-

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1. It is recommended to complete the New York Form Wd 3 correctly, thus pay close attention when filling in the segments that contain all these blank fields:

New York Form Wd 3 writing process clarified (stage 1)

2. When this segment is finished, you're ready insert the required specifics in proceedings as administrat of the, Letters of Administration of the, There is submitted with this, In view of the facts and, achieved through the efforts of my, The funeral bill in the sum of, There are no outstanding hospital, The only property coming into my, Insurance Company in the sum of, and The decedent left surviving no so you can progress further.

The funeral bill in the sum of, achieved through the efforts of my, and The decedent left surviving no in New York Form Wd 3

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Part number 3 in filling out New York Form Wd 3

4. You're ready to fill out this fourth portion! In this case you'll have all of these my hands or knowledge except for, a The Commissioner of Social, b has submitted a claim for based, c Decedents fathermother has, The following are the only, List names of distributees etc, NAME RELATIONSHIP DATE OF BIRTH, and County Department of Social blanks to fill in.

Guidelines on how to complete New York Form Wd 3 step 4

Those who work with this document often make errors while filling out NAME RELATIONSHIP DATE OF BIRTH in this part. Remember to re-examine whatever you enter right here.

5. This form should be concluded by filling in this segment. Here you can see a full list of fields that need accurate information to allow your document submission to be accomplished: Attorneys, Defendant, Insurance Company, Defendants Insurance Company, and I charge myself as follows with.

Best ways to fill in New York Form Wd 3 part 5

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