New York > Statewide > Surrogates Court > Administration
Petition For Letters Of Administration A-1 - New York
| Petition For Letters Of Administration Form. This is a New York form and can be used in Administration Surrogates Court Statewide . |
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For Office Use Only Filling Fee Paid $ $ Receipt No: DO NOT LEAVE ANY ITEMS BLANK Certs $ Bond, Fee: No: SURROGATE'S COURT OF THE STATE OF NEW YORK COUNTY OF ----------------------------------------------------------------------------------X ADMINISTRATION PROCEEDING, PETITION FOR LETTERS OF: Estate of ( ) Adm inistration ( ) Lim ited Adm inistration a/k/a ( ) Adm inistration with Lim itations ( ) Tem porary Adm inistration Deceased File No. ----------------------------------------------------------------------------------X TO THE SURROGATE'S COURT, COUNTY OF It is respectfully alleged: 1. The nam e, dom icile and interest in this proceeding of the petitioner, who is of full age, is as follows: Nam e: Dom icile: (Street Address) (County) Mailing address is: (if different from domicile) Citizenship (check one): ( ) U.S.A. ( ) Other (specify) (State) (Zip) (City/Town/Village) (Telephone Number) Interest of Petitioner (check one): ( ( ) ) Distributee of decedent (state relationship) Other (specify) ( ) No [If yes, subm it statem ent pursuant to 22 NYCRR Is proposed Adm inistrator an attorney? ( ) Yes 207.16(e); see also 207.52 (Accounting of attorney-fiduciary).] 2. The nam e, dom icile, date and place of death, and national citizenship of the above-nam ed decedent are as follows: [The Death Certificate must be filed with this proceeding. If the decedent's dom icile is different from that shown on the death certificate, check box and attach an affidavit explaining the reason for this inconsistency.] Nam e: Dom icile: (Street Number) (State) Township of: Date of Death: Citizenship: (check one): ( ) U.S.A. ( ) (City, Village/Town) (Zip Code) County of: Place of Death: Other (specify) A-1 (12/98) -1- American LegalNet, Inc. www.FormsWorkFlow.com [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 estim ated gross value of the decedent's personal property passing by intestacy is less than $ (b) The estim ated gross value of the decedent's real property, in this state, which is ( passing by intestacy is less than A brief description of each parcel is as follows: $ ) improved ( ) unimproved, (c) The estim ated gross rent for a period of eighteen (18) m onths 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 adm inistrator of the decedent by special provision of law, and it is im practical to give a bond sufficient to cover the probable am ount to be recovered therein: [W rite "NONE or state briefly the cause of action and the person against w hom it exists, including nam es 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 nam es(s) and address(es) of parent(s) in Paragraph 7. See EPTL 5-4.4. 4. A diligent search and inquiry, including a search of any safe deposit box, has been m ade for a will of the decedent and none has been found. Petitioner(s) (has) (have) been unable to obtain any inform ation concerning any will of the decedent and therefore allege(s), upon inform ation 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 m ade for letters of adm inistration upon the estate of the decedent or for the probate of a will of the decedent, and your petitioner is inform ed and verily believes that no such application ever has been m ade 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 EPTL 4-1.1 and 4-1.2: a. ( b. ( ) ) Spouse (husband/wife). Child or children or descendants of predeceased child or children. [M ust include marital, nonm arital and adopted]. Any issue of the decedent adopted by persons related to the decedent (DRL Section 117). Mother/Father. Sisters or brothers, either of whole or half blood, and issue of predeceased sisters or brothers. Grandm other/Grandfather. Aunts or uncles, and children of predeceased aunts and uncles (first cousins). First cousins once rem oved (children of first cousins). c. ( d. ( e. ( f. ( g. ( h. ( ) ) ) ) ) ) [Inform ation is required only as to those classes of surviving relatives who would take the property of decedent pursuant to EPTL 4-1.1. State "number" of survivors in each class. Insert "No" in all prior classes. Insert "X" in all subsequent classes]. -2- American LegalNet, Inc. www.FormsWorkFlow.com 7. The decedent left surviving the following distributees, or other necessary parties, whose nam es, degrees of relationship, dom iciles, 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 nonmarital person, or descended from a nonmarital person, attach a copy of the order of filiation or Schedule A. If any person listed in paragraph (7) w as 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 nonm arital or adopted-out person, so indicate by attaching Schedule A and/or B] Nam e _________________ _________________ _________________ _________________ _________________ _________________ _________________ _________________ Relationship __________________ __________________ __________________ __________________ __________________ __________________ __________________ __________________ Dom icile and Mailing Address _____________________ _____________________ _____________________ _____________________ _____________________ _____________________ _____________________ _____________________ Citizenship _____________ _____________ _____________ _______
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