Information Sheet For Ancillary Administration

MERCER COUNTY SURROGATE'S COURT Diane Gerofsky, Surrogate INFORMATION SHEET FOR ANCILLARY ADMINISTRATION (This form is used when the decedent had no Last Will and Testament and the estate is over $20,000 leaving a Surviving Spouse or the estate is over $ 10,000 with no surviving spouse and no appointment was made in the state of domicile) The following must be provided at time of application: 1. Certificate from the equivalent of the Surrogate's Court from the county of domicile that no proceedings or caveat have been filed in the county of domicile in that state. 2. Certified copy of the death certificate 3. Copy of the deed of real property or proof of person property located in the County of Mercer in the State of New Jersey NAME OF DECEASED:________________________________Date of Death_____________________ Residence of Deceased at Time of Death:________________________________________________ (Indicate borough, township, town, or city or county) ___________________________________________________________________________________ Name(s) of Person seeking to qualify as administrator:________________________________________ ___________________________________________________________________________________ Address(es) of Adminstrator(s):_________________________________________________________ (Indicate borough, township, town, or city or county) _________________________________________________Telephone No:______________________ Attorney of Record: ______________________________________ Telephone No:_________________ Address:____________________________________________________________________________ SPOUSE, DOMESTIC PARTNER OR CIVIL UNION PARTNER AND NEXT OF KIN NAME ADDRESS RELATIONSHIP TO TO DECEASED AGE IF UNDER 18 ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ Note: If surviving spouse, domestic partner or civil union partner and there are child(ren) please indicate if child(ren) is/are of both decedent and surviving spouse or only of the decedent. Names of all adult persons whose right to administration is prior or equal to that of applicant and who will sign renunciations in favor of applicant if choosing not to co-administer __________________________________________________________________________________ __________________________________________________________________________________ Page 1 of 2 - Fact Sheet for Ancillary Administration American LegalNet, Inc. www.FormsWorkFlow.com Approximate value and description of Personal Property Passing by Intestacy (Exclude assets that pass outside the Estate): Detailed description:___________________________________________________________ Dollar Value: ________________________________________________________________ Approximate value of and detailed description of Real Property passing by intestacy located in the County of Mercer Detailed description:_____________________________________________________________ Dollar value: ___________________________________________________________________ Number of Short Certificates Requested:__________________________________________ Date You Wish Administrator to Qualify:___________________________________________ Is the Administrator appearing in the Trenton office to qualify? (Yes)________ (No)_________ or Is an Out of State Administrator appearing before a Notary Public? (Yes) ______ (No) __________ or (If yes, please indicate name and address including county of the Notary Public): Name: ___________________________________________ Address: __________________________________________ ___________________________________________ Telephone No:_____________________________ Is the Administrator appearing at a satellite office? (Yes)________ (No)__________ If yes, please indicate which satellite office. Lawrence Satellite___________ (First Tuesday of each month) Ewing Satellite ___________ (Second Tuesday of each month) Hamilton Satellite___________ (Third Tuesday of each month) Hopewell Satellite __________ (Third Friday of each month) Pennington Satellite_________ (Second Thursday of each month) E Windsor Satellite__________ (Fourth Tuesday of each month) Princeton Satellite__________ (Fourth Thursday of each month) Robbinsville Satellite _______ (First Thursday of 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 Exemplified Proceedings and Death Certificate to this office by fax or mail at least 48 hours prior to the appointment. Contact Kelly at (609) 9896336 to make the appointment MERCER COUNTY SURROGATE=S COURT P.O. BOX 8068 TRENTON, NEW JERSEY 08650-0068 Fax: (609) 278-1242 Phone: (609) 989-6331 E-mail: dgerofsky@mercercounty.org Page 2 of 2 - Fact Sheet for Ancillary Administrator American LegalNet, Inc. www.FormsWorkFlow.com