Information Sheet For Affidavit Of Surviving Spouse Domestic Partner Or Civil Union Partner Or Next Of Kin

MERCER COUNTY SURROGATE'S COURT Diane Gerofsky, Surrogate INFORMATION SHEET FOR AFFIDAVIT OF SURVIVING SPOUSE, DOMESTIC PARTNER OR CIVIL UNION PARTNER AFFIDAVIT OF NEXT OF KIN Circle the type of proceedings sought: 1. Affidavit of Surviving Spouse or Domestic Partner or Civil Union Partner 2. Affidavit of Next of Kin NAME OF DECEASED:_____________________________________Date of Death:_______________ Residence of Deceased at Time of Death:_________________________________________________ (Indicate borough, township, town or city or county) ___________________________________________________________________________________ NAME OF PERSON SEEKING TO QUALIFY AS AFFIANT:__________________________________ Address of Affiant:____________________________________________________________________ __________________________________________________ Telephone No:____________________ SPOUSE, DOMESTIC PARTNER, CIVIL UNION PARTNER OR NEXT OF KIN NAME RESIDING ADDRESS RELATIONSHIP TO DECEASED AGE IF UNDER 18 ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ Names of all adult persons who have equal right to affidavit (next of kin) who are prior to or equal to that of the applicant and who will sign consents in favor of the applicant: ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ List with description all of the Personal or Real Property Passing by Intestacy (exclude assets that pass outside of the Estate) and exact value: ________________________________________________________________ $_____________ _________________________________________________________________ $_____________ _________________________________________________________________ $ ____________ _________________________________________________________________ $ ____________ _________________________________________________________________ $ ____________ _________________________________________________________________ $ ____________ Page 1 of 2 - Information Sheet for Affidavit American LegalNet, Inc. www.FormsWorkFlow.com Date you wish Affiant to qualify:_______________________________ Is the Affiant appearing in the Trenton office to do Affidavit? (Yes)________ (No)_________ Is the affiant appearing at a satellite office? (Yes)________ (No)_________ Lawrence Satellite_________ Robbinsville Satellite _______ Ewing Satellite _________ Pennington Satellite________ Hamilton Satellite__________ Hopewell Satellite__________ E Windsor Satellite________ Princeton Twp Satellite________ (First Tuesday each month) (First Thursday each month) (Second Tuesday each month) (Second Thursday each month) (Third Tuesday each month) (Third Friday each month) (Fourth Tuesday each month) (Fourth Thursday each month) PLEASE NOTE: When making your appointment with the Surrogate's Court for a satellite office, kindly return this sheet together with a copy of the Death Certificate to this office at least 48 hours prior to the appointment. To schedule an appointment contact Kelly at (609) 989-6336. MERCER COUNTY SURROGATE'S COURT P.O. BOX 8068 TRENTON, NEW JERSEY 08650 Fax: (609) 278-1242 Phone: (609) 989-6331 Email: dgerofsky@mercercounty.org American LegalNet, Inc. www.FormsWorkFlow.com