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Next Of Kin Supplemental Affidavit And Declaration - New Jersey

Next Of Kin Supplemental Affidavit And Declaration Form. This is a New Jersey form and can be used in Administration Essex Local County .
 Fillable pdf Last Modified 2/21/2014
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Docket No.: State of New Jersey Essex County Surrogate's Court THEODORE N. STEPHENS, II SURROGATE Hall of Records, Room 206 Newark, New Jersey 07102 Phone 973-621-4900 Fax 973-621-2647 Natalynn Dunson-Harrison DEPUTY SURROGATE In the matter of the Estate of: ____________________________, Deceased AKA: _______________ NEXT OF KIN SUPPLEMENTAL AFFIDAVIT OF ASSETS AND DECLARATION In Lieu of Administration Where Real and Personal Estate Does Not Exceed $10,000.00 (R.S. 3B:10-4) I, and say(s): , of full age, being duly sworn, depose(s) 1. 2. I reside at . I am related to who died on , in the County of Essex and State of with a residence of New Jersey without leaving a Will. The decedent was my _____________________________. All of the decedent's next of kin NOT PREVIOUSLY LISTED are as follows: NAME 3. 4. Relationship (and age if a minor) ADDRESS/RESIDENCE American LegalNet, Inc. www.FormsWorkFlow.com 1 5. The assets in the sole name of the decedent or held "as tenants in common" with decedent, known to me at this time do not exceed the sum of $10,000.00, and are as follows: TOTAL ESTIMATED AMOUNT/VALUE $ $ ITEMS Cash on hand: Balances in bank accounts of decedent (list accounts) Corporate Stocks, bonds and notes, etc: $ Life insurance taken out by decedent without A named beneficiary or payable to the Estate: $ Automobiles (include year, made, model, and VIN #): $ Household effects, jewelry, other chattel, etc.: $ All other personal property belonging to the Estate: (Refund checks, security deposits, etc.) $ Real Estate, located at (list separately by type and address): (If market value is unknown, may use tax assessed value) $ REMARKS: TOTAL VALUATION OFF ALL PROPERTY: $ 6. Therefore, I am entitled to take custody of and duly administer said assets without Letters of Administration, in accordance with the Laws of New Jersey, N.J.S.A. 3B:10-4 and will report the findings of any additional assets. ___________________________________ Signature Subscribed and sworn to before me on this day of , 20 . Notary Public/Attorney at Law of New Jersey American LegalNet, Inc. www.FormsWorkFlow.com 2
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